Streptococcal

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 migration . Pentoxifylline protects against many neutrophil-mediated lung injuries . This study investigated whether pentoxifylline prevented changes in neutrophil kinetics induced by infusion of complement fragments or neutrophil emigration induced by Streptococcus pneumoniae . Complement fragments were infused in New Zealand White rabbits treated with pentoxifylline or saline, and the circulating neutrophil counts in the arterial and venous blood samples were measured . Neutrophil emigration was induced by intrabronchial instillation of S . pneumoniae and quantitated morphometrically . The results show that, at doses achievable in vivo, pentoxifylline did not prevent either the CD18-dependent or -independent phase of complement-mediated neutrophil sequestration within the pulmonary microvasculature or the release of neutrophils from the bone marrow . Pentoxifylline also did not alter either the deformability of unstimulated leukocytes or stimulus-induced decreases in deformability . Finally, neutrophil emigration into the alveolar space was neither attenuated nor accentuated by pentoxifylline . These data suggest that, in vivo, pentoxifylline does not protect against lung injury by inhibiting neutrophil sequestration or emigration and may act to alter the generation of mediators that affect neutrophil behavior, rather than acting directly on neutrophils.

Arch Pediatr Adolesc Med, 1995 Jan, 149(1), 30 - 5
Penicillin-resistant pneumococci from pediatric patients in the Washington, DC, area; Pikis A et al.; OBJECTIVE: To assess the prevalence and antimicrobial susceptibility of penicillin-resistant pneumococci (PRP) isolated from patients in a pediatric hospital . METHODS: All (108) isolates of Streptococcus pneumoniae recovered from usually sterile body sites between June 1, 1992, and May 31, 1993, were screened for susceptibility to penicillin by the E-test method . Minimum inhibitory concentrations of penicillin and other antibiotics were also determined by an agar dilution method for 10 PRP and 22 penicillin-susceptible strains . RESULTS: Fourteen isolates (12.9%) were PRP by the E-test; nine of these (8.3%) were intermediately resistant and five (4.6%) were highly resistant . All strains were sensitive to rifampin and vancomycin . Increased frequency of resistance to oral and parenteral cephalosporins and carbapenems was found among PRP; for most of these antibiotics, resistance exceeded 40% of the PRP . In addition, 20% of the PRP were resistant to macrolides and all penicillin-susceptible and PRP were resistant to a combination of trimethoprim and sulfamethoxazole . CONCLUSIONS: The decreased susceptibility to oral and parenteral cephalosporins, macrolides, a combination of trimethoprim and sulfamethoxazole, and carbapenems creates a significant problem in the treatment of pneumococcal infections in both ambulatory and hospitalized patients.

Biochem J, 1995 Jan 1, 305 ( Pt 1), 173 - 80
Human kininogens interact with M protein, a bacterial surface protein and virulence determinant; Ben Nasr AB et al.; Streptococcus pyogenes, the most significant streptococcal species in clinical medicine, expresses surface proteins with affinity for several human plasma proteins . Here we report that kininogens, the precursors to the vasoactive kinins, bind to the surface of S . pyogenes . M protein, a surface molecule and a major virulence factor-in these bacteria, occurs in > 80 different serotypes . Among 49 strains of S . pyogenes, all of different M serotypes, 41 bound radiolabelled kininogens, whereas 6 M protein-negative mutant strains showed no affinity . M protein of most serotypes bind fibrinogen, and among the 55 strains tested, binding of kininogens was closely correlated to fibrinogen binding (r = 0.88, P < 0.0001) . Western blotting, slot binding and enzyme immunoassay experiments demonstrated that M proteins isolated from S . pyogenes of three different M protein serotypes (M1, M6 and M46) bound kininogens . The affinity between kininogens and M1 protein was determined to be 5 x 10(7) M-1 and < or = 10(6) M-1 for high molecular weight (H-kininogen) and low molecular weight kininogen, respectively . The kininogen binding site was tentatively mapped to the N-terminal portion of M1 protein, and this site does not overlap the specific and separate binding sites for albumin, IgG and fibrinogen using monoclonal antibodies to, and synthetic peptides of, the kininogen sequence, the major M protein-binding site(s) was mapped to the C-terminal portion of the H-kininogen light chain . We anticipate that the kininogen-M protein interaction contributes to the host-parasite relationship in S . pyogenes infections.

J Clin Invest, 1995 Jan, 95(1), 142 - 50
Dual function of pneumolysin in the early pathogenesis of murine pneumococcal pneumonia; Rubins JB et al.; Streptococcus pneumoniae is one of the most common etiologic agents of community-acquired pneumonia, particularly bacteremic pneumonia . Pneumolysin, a multifunctional cytotoxin, is a putative virulence factor for S . pneumoniae; however, a direct role for pneumolysin in the early pathogenesis of pneumococcal pneumonia has not been confirmed in vivo . We compared the growth of a pneumolysin-deficient (PLY{-}) type 2 S . pneumoniae strain with its isogenic wild-type strain (PLY{+}) after direct endotracheal instillation of bacteria into murine lungs . Compared with PLY(-) bacteria, infection with PLY(+) bacteria produced greater injury to the alveolar-capillary barrier, as assayed by albumin concentrations in alveolar lavage, and substantially greater numbers of PLY(+) bacteria were recovered in alveolar lavages and lung homogenates at 3 and 6 h after infection . The presence of pneumolysin also contributed to the development of bacteremia, which was detected at 3 h after intratracheal instillation of PLY(+) bacteria . The direct effects of pneumolysin on lung injury and on the ability of pneumococci to evade local lung defenses was confirmed by addition of purified recombinant pneumolysin to inocula of PLY(-) pneumococci, which promoted growth of PLY(-) bacteria in the lung to levels comparable to those seen with the PLY(+) strain . We further demonstrated the contributions of both the cytolytic and the complement-activating properties of pneumolysin on enhanced bacterial growth in murine lungs using genetically modified pneumolysin congeners and genetically complement-deficient mice . Thus, pneumolysin facilitates intraalveolar replication of pneumococci, penetration of bacteria from alveoli into the interstitium of the lung, and dissemination of pneumococci into the bloodstream during experimental pneumonia . Moreover, both the cytotoxic and the complement-activating activities of pneumolysin may contribute independently to the acute pulmonary injury and the high rates of bacteremia which characterize pneumococcal pneumonia.

Infect Immun, 1995 Jan, 63(1), 57 - 65
Molecular and structural requirements of a lipoteichoic acid from Enterococcus hirae ATCC 9790 for cytokine-inducing, antitumor, and antigenic activities; Takada H et al.; Comparison was made between the immunobiological and antigenic properties of two lipoteichoic acid (LTA) fractions (LTA-1 and -2) from Enterococcus hirae ATCC 9790, their glycolipid portions, and synthetic compounds partially mimicking the above bacterial products . The more lipophilic LTA-2 fraction was capable of inducing serum tumor necrosis factor alpha and interleukin-6 in muramyldipeptide-primed mice and serum gamma interferon in those primed with Propionibacterium acnes . The LTA-2 fraction also induced tumor necrosis factor alpha, interleukin-6, and thymocyte-activating factor (essentially interleukin-1) in murine peritoneal macrophage cultures . Consecutive intravenous injections of muramyldipeptide and the LTA-2 fraction in Meth A fibrosarcoma-bearing BALB/c mice caused hemorrhagic necrosis and marked regression leading to complete regression of the tumor with no accompanying weakening or lethal effects . The LTA-2 fraction was at least 10,000-fold less pyrogenic in rabbits than a reference endotoxic lipopolysaccharide . The more hydrophilic LTA-1 fraction, on the other hand, showed at most marginal activity in the in vivo and in vitro assays . Natural glycolipids (NGL-1 and -2) which were prepared from a chloroform-methanol extract of Streptococcus pyogenes and E . hirae cells, and comparable in structure to the lipid moieties of the LTA-1 and -2 fractions, respectively, were practically inactive in all of the assays . None of the test synthetic compounds was immunobiologically active, although synthetic partial counterparts of the structure of LTA proposed by W . Fischer (Handb . Lipid Res . 6:123-234, 1990) reacted with murine monoclonal antibody TS-2, which was raised against OK-432, a penicillin-killed S . pyogenes preparation, and capable of neutralizing the cytokine-inducing activities of the LTA-2 fraction.

Infect Immun, 1995 Jan, 63(1), 345 - 8
Expression of the Arp protein, a member of the M protein family, is not sufficient to inhibit phagocytosis of Streptococcus pyogenes; Husmann LK et al.; Many Streptococcus pyogenes immunoglobulin-binding proteins have structural similarities to the antiphagocytic M protein, including the well-known C repeats . One of these molecules is the immunoglobulin A-binding protein Arp, which is expressed by a serotype 4 strain for which no antiphagocytic M protein has yet been described . We expressed Arp4 in an S . pyogenes strain from which the structural gene for the M protein has been deleted and found that Arp4 is not sufficient to inhibit phagocytosis.

Infect Immun, 1995 Jan, 63(1), 238 - 47
Revised sequence of the Porphyromonas gingivalis prtT cysteine protease/hemagglutinin gene: homology with streptococcal pyrogenic exotoxin B/streptococcal proteinase; Madden TE et al.; The prtT gene from Porphyromonas gingivalis ATCC 53977 was previously isolated from an Escherichia coli clone possessing trypsinlike protease activity upstream of a region encoding hemagglutinin activity (J . Otogoto and H . Kuramitsu, Infect . Immun . 61;117-123, 1993) . Subsequent molecular analysis of this gene has revealed that the PrtT protein is larger than originally reported, encompassing the hemagglutination region . Results of primer extension experiments indicate that the translation start site was originally misidentified . An alternate open reading frame of nearly 2.7 kb, which encodes a protein in the size range of 96 to 99 kDa, was identified . In vitro transcription-translation experiments confirm this size, and Northern (RNA) blot experiments indicate that the protease is translated from a 3.3-kb mRNA . Searching the EMBL protein database revealed that the amino acid sequence of the revised PrtT is similar to sequences of two related proteins from Streptococcus pyogenes . PrtT is 31% identical and 73% similar over 401 amino acids to streptococcal pyrogenic exotoxin B . In addition, it is 36% identical and 74% similar over 244 amino acids with streptococcal proteinase, which is closely related to streptococcal pyrogenic exotoxin B . The similarity is particularly high at the putative active site of streptococcal proteinase, which is similar to the active sites of the family of cysteine proteases . Thus, we conclude that PrtT is a 96- to 99-kDa cysteine protease and hemagglutinin with significant similarity to streptococcal enzymes.

Arch Pathol Lab Med, 1995 Jan, 119(1), 23 - 9
DNA fingerprinting of pathogenic bacteria by fluorophore-enhanced repetitive sequence-based polymerase chain reaction; Versalovic J et al.; Fluorophore-labeled oligonucleotide primers complementary to defined interspersed repetitive sequences conserved in diverse bacteria were used in the polymerase chain reaction to generate DNA fingerprint patterns from selected pathogenic bacteria . Fluorophore-enhanced, repetitive sequence-based polymerase chain reaction allowed discrimination between unrelated isolates of penicillin-resistant Streptococcus pneumoniae recovered from pediatric patients and Mycobacterium avium cultured from patients with acquired immunodeficiency syndrome . Combinations of oligonucleotide primers labeled with distinct fluorescent dyes enabled simultaneous DNA fingerprinting and Shiga-like toxin gene detection in enterohemorrhagic Escherichia coli isolates . Fluorophore-enhanced, repetitive sequence-based polymerase chain reaction was performed with either purified DNA or intact cells that were lysed during the polymerase chain reaction . Fluorophore-enhanced, repetitive sequence-based polymerase chain reaction successfully combines polymerase chain reaction amplification and fluorescent label detection for DNA fingerprinting of cultured bacterial pathogens.

J Bacteriol, 1995 Jan, 177(1), 86 - 93
The rec locus, a competence-induced operon in Streptococcus pneumoniae; Pearce BJ et al.; To study competence and the process of transformation (TFN) in pneumococci, we developed a method for isolating TFN- mutants using insertional inactivation coupled with fusions to the gene for alkaline phosphatase (phoA) . One TFN- mutant transformed 2 log units less efficiently than the parent strain . Reconstitution of the mutated region revealed a locus, rec, that contains two polycistronic genes, exp10 and the previously identified recA (B . Martin, J . M . Ruellan, J . F . Angulo, R . Devoret, and J . P . Claverys, Nucleic Acids Res . 20:6412, 1992) . Exp10 is likely to be a membrane-associated protein, as it has a prokaryotic signal sequence and an Exp10-PhoA fusion localized with cell membranes . On the basis of sequence similarity, pneumococcal RecA is a member of bacterial RecA proteins responsible for homologous recombination of DNA . DNA-RNA hybridization analysis showed that this locus is transcribed as a polycistronic message, with increased transcription occurring during competence . With an Exp10-PhoA chimera used as a reporter, there was a 10-fold increase in the expression of the rec locus during competence while there was only minimal expression under growth conditions that repressed competence . The TFN- mutant containing the exp10-phoA fusion produced activator, a small extracellular polypeptide that induces competence, and the expression of rec was induced in response to activator . Therefore, the rec locus is directly required for genetic transformation and is regulated by the cell signaling mechanism that induces competence.

J Bacteriol, 1995 Jan, 177(1), 66 - 74
A cluster of four genes encoding enzymes for five steps in the folate biosynthetic pathway of Streptococcus pneumoniae; Lacks SA et al.; Two genes, sulB and sulC, in a folate biosynthetic gene cluster of Streptococcus pneumoniae were identified after determination of the DNA sequence between two previously reported genes, sulA and sulD, in a cloned segment of chromosomal DNA containing a mutation to sulfonamide resistance . The gene products, SulB and SulC, correspond to polypeptides of 49 and 21 kDa, respectively . SulC has GTP cyclohydrolase activity and catalyzes the first step in the folate biosynthetic pathway . SulB apparently has dihydrofolate synthetase activity in that it complements a folC mutant of Escherichia coli and thus catalyzes the last step in the pathway . Prior work showed that SulA, a dihydropteroate synthase, and SulD, a bifunctional enzyme, catalyze three intervening steps . Mapping of the mRNA transcribed from the operon was consistent with its beginning at a promoter with a -35 site (gTGtCc) and an extended -10 site (T-TG-TAaAAT) and its termination at the end of a hairpin structure, which would give a transcript 3,745 nucleotides in length . SulC showed a considerable conservation of sequence by comparison with proven or putative GTP cyclohydrolases from four unrelated species, with 38 to 53% of the residues being identical . A similar comparison of SulB with dihydrofolate synthetases showed an identity of only 26 to 37% . Overall, comparisons of the five folate biosynthetic enzymes in different species suggest that S . pneumoniae is related more closely to other gram-positive bacteria, less closely to eucaryotes, and least closely to the gram-negative E . coli . The varied arrangements of folate biosynthetic genes in different species imply an early evolutionary period of fluidity in genomic rearrangement.

Dev Biol Stand, 1995, 84, 211 - 9
The history of live bacterial vaccines; Lindberg AA; Recent developments have made it possible to construct non-reverting live bacterial vaccine candidates with defined deletions of two or more genes . Such vaccines have proven safe and immunogenic in human volunteers . Since the virulent parent strains are only pathogenic to man (S . typhi, S . flexneri, and V . cholerae), they pose no threat to the environment . Besides holding promise as efficacious vaccines for protection against typhoid fever, bacillary dysentery and cholera, the attenuated strains are well suited as vectors for delivery of heterologous antigenic epitopes from micro-organisms such as Helicobacter pylori, Neisseira gonorrhoeae, rotavirus, HIV and many others . Instead of using a virulent parent bacterium as the starting organism for making a vector, attempts have recently been made to employ non-pathogenic bacteria of the normal human flora, such as Streptococcus gordonii for delivery of foreign antigens . At present, the feasibility of this approach for human beings remains to be proven.

Scand J Infect Dis, 1995, 27(1), 52 - 6
Detecting erythromycin resistance in Streptococcus pyogenes: reliability of the disk diffusion method and the breakpoint susceptibility testing method . Finnish Study Group for Antimicrobial Resistance (FIRE); Nissinen A et al.; Erythromycin susceptibility of clinical Streptococcus pyogenes isolates was determined at 19 Finnish clinical microbiology laboratories by their routine disk diffusion method and by a screening method adapted from the breakpoint susceptibility testing method . Results obtained at 12 laboratories using 4 major variants of the disk method were further evaluated . From these laboratories, 286 consecutive resistant and 349 consecutive susceptible isolates were sent to the Antimicrobial Research Laboratory, Turku where the MIC of erythromycin was determined . 96% and 97% of the disk results were correct, as compared with MIC results, when general and laboratory-specific breakpoints, respectively, were used . The results of the screening method were comparable to those of the disk method.

J Gynecol Obstet Biol Reprod (Paris), 1995, 24(2), 198 - 203
{Validation trial of a neonatal prophylactic antibiotic protocol in the delivery room}; Unal D et al.; Maternofetal infection occurs in 1 to 10 of every 1,000 newborns . Prognosis is poor and an extremely rapid the clinical course is sometimes observed . The situation suggests that widespread use of antibiotics and more than 90% of the newborns receiving antibiotics are not infected . A prospective study based on simple, recognized criteria predictive of maternal-fetal infection was conducted in 3,392 deliveries to evaluate the effect of an antibiotic prophylaxy protocol . Specificity, sensitivity, positive and negative predictive value were evaluated for each of the eleven criteria retained with the goal of increasing sensitivity and decrease the use of unnecessary antibiotics . Among the 3,392 infants delivered from January 1989 to December 1990, 286 (8.4%) newborns entered the study and were given mezlocillin (150 mg/kg/12 h) . This treatment was stopped at 48 hours of life if the infant was not infected . RESULTS . Infection was confirmed in 48 of 3,392 infants (1.4%) . All were in the risk group: 48/286 (16.7%) . The germs the most often found were group B Streptococcus (n = 16), Escherichia coli (n = 8) and Listeria monocytogenes (n = 3) . Nine criteria were well correlated with maternal-fetal infection . The two most important criteria were maternal pyrexia above 39 degrees C and Apgar score below 7 to 5 min (poor neonatal adaptation), with a 99% and 90% and a positive predictive value of 80% and 37% respectively . Inversely, Two criteria were poorly correlated with maternal-fetal infection: labour duration above 12 hours and instrumental extraction (positive predictive value from 10% to 17%).(ABSTRACT TRUNCATED AT 250 WORDS)

East Afr Med J, 1995 Jan, 72(1), 33 - 6
Antistreptolysin O and antideoxyribonuclease B titres in blood donors and in patients with features of nonsuppurative sequelae of group A streptococcus infection in Tanzania; Mhalu FS et al.; Antistreptolysin O (ASO) and antideoxyribonuclease B (ADN B) titres were determined on sera from blood donors in Dar es Salaam, Tanzania and from Bergen, Norway and were compared with titres in patients with features of postgroup A streptococcal diseases in Dar es Salaam . The upper limit of normal ASO titres in Dar es Salaam was 200 mu/ml and for ADN B it was 300 u/ml while in Bergen the upper limit of normal ASO titre was 250 u/ml and that of ADN B was 100 u/ml . Titres of ASO in Dar es Salaam and Bergen were consistent with those from sub-Saharan Africa and from other continents . Upper limit of normal ADN B titres in adults in Dar es Salaam were higher than those in Bergen probably due to higher frequencies of group A streptococcal skin infections in Dar es Salaam than in Bergen . Patients with features of postgroup A streptococcal diseases in Dar es Salaam had antibody titres above the upper limits of normal in 32.8% of the patients for ASO and in 45.9% for ADN B . ASO and ADN B titres or ASO and any other reliable test for antibody to group A streptococcus should be utilised together in providing strong evidence of recent infection with the group A streptococcus or of postgroup A streptococcal disease.

J Foot Ankle Surg, 1995 Jan-Feb, 34(1), 61 - 4
Microbiology of osteomyelitis in diabetic foot infections; Lavery LA et al.; The objective of this report is to describe the bacterial pathogens in diabetic patients with osteomyelitis due to neuropathic foot ulcerations . The authors reviewed the records of 36 diabetic patients with osteomyelitis of the foot due to neuropathic ulceration . Intraoperative deep soft tissue and bone specimens were obtained from each patient . The mean age of patients was 56.7 years, and the mean duration of diabetes was 14.9 years . Streptococcus species (61%) and Staphylococcus aureus (47%) were the most common organisms identified . Gram-negative aerobes were found in 18 cultures (50%) . Only five patients' cultures (14%) were identified with anaerobic pathogens . The average number of pathogens per patient was 2.25 . The most common bacterial pathogens in bone infections in diabetics were Streptococcus species and Staphylococcus aureus . Anaerobes were uncommon.

Zhonghua Min Guo Xiao Er Ke Yi Xue Hui Za Zhi, 1995 Jan-Feb, 36(1), 20 - 3
Sinusitis and bronchial asthma in children; Huang JL et al.; Sinus disease has been assumed to exist in children with respiratory tract allergies . We consecutively evaluated 375 patients (245 male, 130 female) with childhood onset asthma, between 5 and 15 years of age (mean 7.8 years of age) . Abnormal Waters radiographs were found in 205 patients (54.7%) which included mucosal wall thickening greater than 6 mm (67.3%), complete opacification (22.9%) and air-fluid levels (9.8%) . The level of immunoglobulin (Ig) E was found to be much higher in non-sinusitis asthmatic children than in asthmatic children with sinusitis (1207 IU/mL vs . 644 IU/mL) . The IgG, IgA, IgM and erythrocyte sedimentation rate (ESR) values were not significantly different in the two groups . All patients were treated with antibiotics for 3 to 6 weeks . Five patients required surgical intervention after antibiotic treatment had little success . Streptococcus viridans was isolated from 4 patients following surgical aspirates and Peptostreptococcus anaerobius was isolated in only one patient . In conclusion, sinusitis in children may be an aggravating factor for chronic reactive lower airway disease . Optimal treatment may decrease the need of asthmatic medication.

Zh Mikrobiol Epidemiol Immunobiol, 1995 Jan-Feb, (1), 56 - 8
{The immunosuppressive activity of Streptococcus aureus peptidoglycan}; Posur VK et al.; The immunosuppressive activity of peptidoglycan, obtained from S . aureus was studied in mouse experiments on the model of delayed hypersensitivity (DH) to guinea pig antigens . The study revealed that PG suppressed DH, this action being linked with its insoluble fraction . The soluble part of PG did not suppress DH . Experiments with the use of immunosorbent demonstrated the existence of serological similarity between the active factor of the soluble part of PG and its insoluble part.

Zh Mikrobiol Epidemiol Immunobiol, 1995 Jan-Feb, (1), 53 - 5
{The effect of substances produced by a strain of Streptococcus sp . Thom-1606 on phagocytic activity}; Golshmid VK et al.; Among the substances produced by Streptococcus sp . strain TOM-1606 two fractions having the opposite influence on the phagocytic activity of peritoneal macrophages of white mice were detected . The fraction corresponding to peptides with a molecular weight not exceeding 10 kD activated natural phagocytosis . As shown in our earlier works, this fraction also had the maximum antimicrobial activity . The fraction with a molecular weight of 70-100 kD inhibited natural phagocytosis, acting as an immunosuppressive agent.

Biomed Pharmacother, 1995, 49(1), 19 - 25
Group B streptococcal disease in newborns: a global perspective on prevention; Schuchat A; Group B Streptococcus (GBS) is an important cause of neonatal sepsis in many areas . Although incidence data are available for a minority of countries, the magnitude of illness due to this bacterium appears to vary substantially . Disease may vary due to the prevalence of asymptomatic GBS colonization, the virulence of circulating strains, the frequency of predisposing conditions such as low birth weight, or differences in obstetric practices . Approaches to prevention of neonatal GBS disease include administering antibiotics to high risk mothers intrapartum, use of intrapartum vaginal disinfectants, development of GBS vaccines, and nonspecific approaches . Determinants of prevention policies in a given area depend on the incidence of disease, the structure of health care delivery, cost-effectiveness, and cultural attitudes . Much GBS disease among newborns is now preventable, yet data on incidence are needed to guide selection of appropriate approaches to disease prevention.

Br J Clin Pract, 1995 Jan-Feb, 49(1), 28 - 32
Tonsillopharyngitis: evaluation of short-term treatment with cefuroxime axetil versus standard 10-day penicillin V therapy; Gehanno P et al.; Recent resurgence in serious streptococcal infections and rising failure rates with the standard 10-day course of therapy with penicillin V for group A beta-haemolytic streptococcus (GABHS)-associated tonsillopharyngitis (pharyngitis and/or tonsillitis) have heightened interest in alternative treatments for this infection . Reasons for failure of the standard therapy include penicillin tolerance, increased virulence of GABHS strains, inactivation by beta-lactamase, and poor compliance . Short, 4-5-day courses with oral cephalosporins, such as cefuroxime axetil, have recently proven to be effective alternatives . Cefuroxime axetil provides resolution of clinical symptoms and fever within 2.5 days of onset of therapy, and its short course of treatment may improve compliance.

J Hosp Infect, 1995 Jan, 29(1), 57 - 64
Epidemiology and clinical spectrum of pneumococcal infections: an Israeli viewpoint; Yigla M et al.; We performed a prospective study of consecutive pneumococcal infections documented during a six-month period in our clinical microbiology laboratory . A total of 59 cultures obtained from clinically significant specimens of 58 patients were positive for Streptococcus pneumoniae . Relative penicillin resistance occurred in 14 strains (24%) and only one (1.7%) was highly resistant to penicillin (minimum inhibitory concentration = 2.0 micrograms ml-1) . Resistance to common alternative drugs was not found . Serotypes were of a wide variety, however types 1, 7 and 14 predominated (60% of all blood culture isolates) . Twenty-three patients with community-acquired infection required hospitalization . Nosocomial pneumonia developed in three additional cases (14%) . Invasive disease was diagnosed in 24 patients with pneumonia representing the most common infection (22 patients) . Pneumonia was characterized by a high incidence of serious underlying diseases (82%) and associated bacteraemia (68%) . Compared with controls, patients with penicillin-resistant pneumococcal pneumonia had a significantly higher incidence of previous hospitalizations and use of antibiotics (57 vs . 7%, P = 0.02) . The overall case fatality rate was high (36%) and did not differ significantly between patients with pneumonia due to resistant and susceptible strains . The epidemiology and clinical spectrum of serious pneumococcal infections in Israel is similar to those described in many parts of the world, but high level resistance to penicillin and to other alternative drugs is still rare.

Zentralbl Bakteriol, 1995 Jan, 282(1), 7 - 12
Therapy of penicillin-resistant pneumococcal meningitis; Schwartz MT et al.; Antimicrobial therapy of pneumococcal meningitis has been altered in recent years based on changes in pneumococcal susceptibility patterns, with emergence of strains that are either relatively or highly resistant to penicillin G (minimal inhibitory concentrations of 0.1-1.0 micrograms/ml and > or = 2 micrograms/ml, respectively . In areas of the world where relatively penicillin-resistant strains of Streptococcus pneumoniae are present, the third generation cephalosporins (either cefotaxime or ceftriaxone) should be used as empiric therapy, and for highly penicillin-resistant pneumococcal strains, vancomycin (with or without rifampin) is recommended . It is imperative that susceptibility testing be performed on all cerebrospinal fluid pneumococcal isolates to guide the choice of antimicrobial therapy . Vaccination recommendations with the 23-valent pneumococcal vaccine should also be strictly enforced for use in appropriate populations that are at increased risk of pneumococcal infections.

Eur J Clin Microbiol Infect Dis, 1995, 14 Suppl 1, S18 - 25
Multiply-resistant pneumococcus: therapeutic problems in the management of serious infections; Lister PD; The control of penicillin-resistant pneumococci has become one of the more serious therapeutic challenges facing clinicians today . The occurrence and geographical coverage of these microorganisms have increased rapidly since they were first recognized in the late 1960s . They have now been reported from every continent, and in some regions can account for over 60% of the pneumococci isolated . An even greater concern is the propensity of penicillin-resistant pneumococci towards resistance to multiple antibiotics, including the cephalosporins and non-beta-lactam drugs . In areas where multiply-resistant strains are common, the therapeutic choices for the treatment of life-threatening infections may be limited to drugs which are either toxic for the patient or for which we are only beginning to gain clinical experience . As the importance of Streptococcus pneumoniae in meningitis continues to increase and multiply-resistant strains become more widespread and entrenched, it is essential that the search for more well-tolerated and effective treatment regimens continues . However, unless the effect of antibiotics on the selection of these resistant pathogens is addressed and a more judicious approach towards drug use is taken; this resistance problem will continue well into the future.

Eur J Clin Microbiol Infect Dis, 1995 Jan, 14(1), 54 - 8
Carriage of Streptococcus pyogenes among infants and toddlers attending day-care facilities in closed communities in southern Israel; Yagupsky P et al.; Infants and toddlers attending ten day-care facilities in closed communities in southern Israel were tested monthly for pharyngeal carriage of Streptococcus pyogenes and associated respiratory morbidity . Overall, the prevalence of Streptococcus pyogenes was 2.7% in infants and 8.4% in toddlers, reaching 8.5% and 17.8% in the two groups, respectively by midwinter . In 4 of 61 (6.6%) infants and 15 of 67 (22.4%) toddlers, the organism was recovered in more than one month (range 2 to 5 months) . Streptococcus pyogenes in the pharynx was only associated with rhinitis during the spring and summer but not with other respiratory symptoms . During the study period, a mean of 0.9 strains were isolated in day-care facilities attended by infants, while a mean of 2.1 strains were found in toddlers . Young children attending day-care facilities show early acquisition of Streptococcus pyogenes in the pharynx.

Zentralbl Hyg Umweltmed, 1995 Jan, 196(5), 437 - 43
Decontamination of dental equipment . A validation of three devices designed for cleaning, disinfecting, and lubricating of dental high-speed turbines and handpieces; Andersen HK et al.; This study deals with the decontamination of dental turbines and handpieces (DTH) aiming at eliminating the cross-infection risk in dental practice . Three types of equipment designed for cleaning/lubricating DTH were validated . The effect of the three devices was determined for four different types of DTH, which were artificially contaminated with Streptococcus salivarius ATCC 13419 in a controlled manner . Sampling was carried out by collecting one ml water flushed through the DTH connected to a dental unit . The study resulted in a model for testing the decontamination potential of a cleaning/lubrication device for DTH . One of the devices could not reduce the contamination, while two others were able to reduce the bioburden with at least 3.9 logarithmic steps . However none of the devices tested could constantly eliminate the contamination, for which reason an additional heat treatment of the DTH is recommended.

Clin Pediatr (Phila), 1995 Jan, 34(1), 2 - 6
Lung abscess in infants and children; Emanuel B et al.; We retrospectively reviewed 18 cases of primary lung abscess and 10 cases of secondary lung abscess in infants and children during a 6-year period . Among 18 patients with primary abscesses, nine were boys and nine girls, from 9 months to 20 years old, but only two of 18 were less than 5 years old . Each had a solitary abscess . Location of abscesses included the right lower lobe (8), the right upper lobe (3), the left upper lobe (1), and the left lower lobe (6) . One patient had Streptococcus pneumoniae bacteremia . Other bacterial isolates were from the upper respiratory tract and of uncertain significance . All patients recovered, although lobectomy was considered necessary in five patients because of failure to respond to intravenous antibiotic therapy . Secondary lung abscesses occurred in six boys and four girls who were from 2 1/2 months to 13 years old . All 10 had solitary, right-sided lesions, seven in the right lower lobe and three in the right upper lobe . Bacteria of unclear significance were recovered from three of 10 patients, while two had documented gram-negative bacteremia . Three secondary abscess patients underwent lobectomy because of perceived inadequate response to medical therapy, including intravenous antibiotics . Based upon the literature and our experience, therapy for pulmonary abscess should include a parenteral antibiotic with gram-positive activity against both penicillinase-producing Staphylococcus aureus and anaerobes for a minimum of 3 weeks.(ABSTRACT TRUNCATED AT 250 WORDS)

Clin Diagn Lab Immunol, 1995 Jan, 2(1), 91 - 7
Enhancement of natural killer cell activity in human immunodeficiency virus-infected subjects by in vitro treatment with biologic response modifier OK-432; Huang XL et al.; A decrease in natural killer (NK) cell function has been related to the progression of human immunodeficiency virus (HIV) infection . In the present study, we assessed the ability of a streptococcus-derived biologic response modifier, OK-432, to augment NK lysis of uninfected K562 and U937 cells and HIV-infected U937 cells by peripheral blood mononuclear cells (PBMC) from HIV-seropositive homosexual men . Optimal two- to fourfold increases in lysis of the three targets were observed after pretreatment of PBMC from HIV-negative subjects for 4 h with 2 micrograms of OK-432 per ml . This effect was related primarily to gamma interferon (IFN-gamma) production induced by OK-432 and was not linked to production of tumor necrosis factors alpha and beta or to monocytes in the cultures . The enhancing effect of OK-432 on NK cell function was diminished but still evident in PBMC from subjects with relatively early-phase (< 3-year) HIV infection and high CD4+ cell counts and was lower in subjects with longer-term HIV infection (> 3 years), in association with reduced production of IFN-gamma . Augmentation of NK cell activity in HIV-infected men by OK-432 was comparable to that induced by treatment of cells with 1,000 U of IFN-alpha or interleukin 2 per ml . The data suggest that the NK cell-enhancing effects of OK-432 are at least in part mediated by IFN-gamma and that OK-432 may be effective in treatment of patients with early-phase HIV infection.

Clin Diagn Lab Immunol, 1995 Jan, 2(1), 14 - 7
Serum antibody response to proteins of Moraxella (Branhamella) catarrhalis in patients with lower respiratory tract infection; Christensen JJ et al.; We searched for antibodies against Moraxella (Branhamella) catarrhalis proteins in the sera of patients with lower respiratory tract infection . Sera from 48 patients with M . catarrhalis and 39 patients without M . catarrhalis in their lower respiratory tract specimens were studied by a gel electrophoresis-immunoperoxidase technique; sera from 23 healthy adult blood donors were also included . Immunoglobulin G (IgG) antibodies against a 28-kDa protein were found significantly more frequently in patients with M . catarrhalis in lower respiratory tract specimens (71%) than in patients without M . catarrhalis in lower respiratory tract specimens (28%) or healthy adult blood donors (22%) . Seroconversion, from the acute to the convalescent stages, occurred in at least eight patients with M . catarrhalis and in one patient without detectable M . catarrhalis . IgG antibodies against other M . catarrhalis proteins were found in most sera, including those obtained from blood donors . By adsorption experiments the 28-kDa protein was demonstrated to be surface exposed . IgM antibodies against an 85-kDa protein were found in serum from one patient from whom M . catarrhalis and Streptococcus pneumoniae were isolated from the lower respiratory tract, while IgA antibodies against M . catarrhalis proteins could not be detected in any serum specimen.

FEMS Immunol Med Microbiol, 1995 Jan, 10(2), 133 - 7
A study of pathogenic factors of Streptococcus pneumoniae strains causing meningitis; Kostyukova NN et al.; Pneumococcal meningitis in St . Petersburg in the period 1985-1991 occurred in 1.7-2.3 children per 100,000 annually . The most common serotypes among pneumococcal strains isolated from patients with meningitis were 19, 1, 6, 15, and 2, whereas, among the capsulated strains isolated from carriers, type 3 predominated . Only one third of strains from cases of meningitis were highly virulent for mice (types 1, 2, 3) . Hyaluronidase was produced by all the 39 studied strains, 22 (84.6 +/- 7.1%) out of 26 strains from patients with otitis media, and only by 15 (11.5 +/- 2.8%) out of 130 strains isolated from carriers . Non-capsulated strains lacked this enzyme . Results of intranasal inoculation of pneumococcal strains with different hyaluronidase activity and addition of exogenous hyaluronidase to strains which did not produce the enzyme confirm the hypothesis that this enzyme plays an important role in bacterial dissemination and breaching of the blood brain barrier by pneumococci . It was concluded that high hyaluronidase activity, presence of capsule, and pneumolysin or serotype (1, 2, and 19) despite hyaluronidase titer, are the most important factors contributing to the development of pneumococcal meningitis . The role of the mouse toxic factor is unclear.

Vet Microbiol, 1995 Jan, 43(1), 33 - 40
Experimental streptococcal meningo-encephalitis in cultured fish; Eldar A et al.; In 1984 a disease of fish appeared in Israel which spread rapidly in cultured fishponds . The disease affected tilapia (Oreochromis aura x Oreochromis nilotica hybrids) and trout (Oncorhynchus mykiss) . Common carp (Cyprinus carpus), although reared in community with tilapia were not susceptible to the disease . Various species of ornamental cyprinids and cichlids were also affected . Morbidity was high and mortality ranged between 50% (in trout) and 30% (in tilapia) . Clinical and pathological findings indicated that the tilapia and trout suffered from meningitis and menigo-encephalitis . Two new streptococcal species, Streptococcus shiloi and Streptococcus difficile were isolated from diseased fish . The disease was reproduced experimentally in both trout and tilapia with the two streptococcal species . The LD50s of S . shiloi and S . difficile strains cultured in vitro (two to three passages on BHI medium) were 10(7)-10(8) cfu . The virulence of these strains was increased (LD50:10(2)-10(5) cfu) after three passages in vivo (brain to brain passage in fish without culture on agar plates) . Highly virulent strains did not differ from low virulent strains by any identifiable extrachromosomal elements.

Proteins, 1995 Jan, 21(1), 11 - 21
Thermodynamic genetics of the folding of the B1 immunoglobulin-binding domain from streptococcal protein G; O'Neil KT et al.; A method has been developed to select proteins that are thermodynamically destabilized yet still folded and functional . The DNA encoding the B1 IgG-binding domain from Group G Streptococcus (Strp G) has been fused to gene III of bacteriophage M13 . The resulting fusion protein is displayed on the surface of the phage thus enabling the phage to bind to IgG molecules . In addition, these phage exhibit a small plaque phenotype that is reversed by mutations that destabilize the Strp G domain . By selecting phage with large plaque morphology that retain their IgG-binding function, it is possible to identify mutants that are folded but destabilized compared with wild-type Strp G . Such mutants can be divided into three general categories: 1) those that disrupt packing of hydrophobic side chains in the protein interior; 2) those that destabilize secondary structure; and 3) those that alter specific hydrogen bonds involving amino acid side chains . A number of the mutants have been physically characterized by circular dichroism and nuclear magnetic resonance and have been shown to have structures similar to wild-type Strp G but stabilities that were decreased by 2-5 kcal/mol.

Vet Res, 1995, 26(1), 43 - 56
{Antiseptic and antibiotic resistance of 310 gram-positive strains isolated from udders after use of post-milking teat germicides}; Martin H et al.; The sensitivity of 310 Gram-positive strains, isolated from milking cows udders, to 4 antiseptics (cetrimide, chlorhexidine, hexachlorophene and mercury) and 9 antibiotics (ampicillin, streptomycin, erythromycin, chloramphenicol, kanamycin, tetracycline, gentamycin, novobiocin and oxacillin) was determined . The statistical analysis of correlation was carried out for the bacterial species studied (Staphylococcus, Streptococcus and Bacillus), the scattering of the minimum inhibitory concentrations of which has proved to be statistically heterogeneous towards antiseptics and antibiotics . This analysis revealed positive links between chlorhexidine and 5 antibiotics for Streptococcus and between hexachlorophene and oxacillin for Bacillus . The analysis of results at the level of bacterial species, taking into account a loss of sensitivity of 4 times the modal minimum inhibitory concentration of the species reveals the importance of the strains which are resistant to many antibiotics and especially the Enterococcus and the species Staphylococcus epidermidis . Indeed, these strains are possible reservoirs of plasmids of resistance to antibiotics and antiseptics.

Res Vet Sci, 1995 Jan, 58(1), 75 - 81
Immunisation of mares to control endometritis caused by Streptococcus zooepidemicus; Widders PR et al.; Normal mares were immunised by the intramuscular and intrauterine administration of an antigen with adjuvant and they and unimmunised control mares were later challenged by the intrauterine instillation of pathogenic Streptococcus zooepidemicus; the response of all the mares was monitored clinically and bacteriologically for seven days . Significantly fewer S zooepidemicus were present in cervical swabs taken from the immunised mares than from the control mares (P < 0.01) and the degree of inflammation in the genital tract of the immunised mares was also significantly less (P < 0.001) . This protective effect of immunisation was associated with the specific IgG response in the serum, and an IgG and IgA response in the uterine secretions . These results are the first demonstration that a previous immunisation with a suitable antigen can reduce an infection of the reproductive tract of mares.

J Clin Microbiol, 1995 Jan, 33(1), 229 - 32
Comparison of antimicrobial susceptibility methods for detection of penicillin-resistant Streptococcus pneumoniae; Kiska DL et al.; We sought to determine if commercially available susceptibility tests were accurate in detecting penicillin resistance and relative resistance in Streptococcus pneumoniae . We compared the reference MIC method with oxacillin disk screening and three commercial tests, E-test (AB Biodisk), JustOne (Radiometer America), and MicroScan Pos MIC Panel Type 6 (Baxter Diagnostics), with 80 selected clinical isolates . Thirty-three additional isolates were tested by the reference method and the E-test to further validate the latter method . Oxacillin screening was effective in detecting all penicillin-resistant and relatively resistant strains of S . pneumoniae . The MicroScan method was not effective in detecting penicillin resistance or relative resistance . The JustOne system classified only 6 (35%) of 17 resistant strains correctly, with 11 resistant strains classified as relatively resistant . The E-test correctly classified 30 (83%) of 36 resistant isolates, with 6 resistant isolates interpreted as relatively resistant . For determining penicillin MICs for S . pneumoniae, the E-test was the most accurate of the commercial systems that we studied.

Rev Port Cardiol, 1995 Jan, 14(1), 53 - 8
{The acquired immunodeficiency syndrome, hypertrophic myocardiopathy and multivalvular infectious endocarditis . Apropos a clinical case}; Jaques AK et al.; We present a clinical case of a 33 years old young male, gypsy, intravenous drug abuser with heroine and cocaine and AIDS diagnosis . The clinical anamnesis was mainly fever and systolic heart murmur in a clinical scenario of AIDS . The two-dimensional echocardiographic study was clearly diagnostic of an hypertrophic obstructive cardiomyopathy of the left ventricle . This study showed also the presence of multiple vegetations of the mitral, aortic and pulmonic valves in a clinical setting of an acute Streptococcus Viridans infective endocarditis . In this case report we discuss the incidence of this type of multiple cardiac lesions and particularly the presence of this specific pathogenic agent in this high risk group of patients with intravenous drug abuse and systemic immunosuppression . We pointed out the rarity of these findings of left side valvular vegetations associated with this type of cardiomyopathy and the different factors related to infective endocarditis.

Antimicrob Agents Chemother, 1995 Jan, 39(1), 271 - 2
In vivo correlates for Streptococcus pneumoniae penicillin resistance in acute otitis media; Gehanno P et al.; Eighty-four children suffering from acute otitis media caused by Streptococcus pneumoniae were treated prospectively with cefuroxime axetil suspension (30 mg/kg of body weight twice daily for 8 days) . The high incidence of isolates with decreased susceptibilities to penicillin (42 of 84 isolates) allowed us to establish a relationship between clinical success and the penicillin MICs for pneumococcal isolates . It was found that cefuroxime axetil is clinically effective in the treatment of acute otitis media caused by penicillin-susceptible and penicillin-intermediate strains of S . pneumoniae . The results indicate that the risk of treatment failure with cefuroxime axetil was increased in children with otitis media caused by S . pneumoniae when the penicillin MIC were greater than or equal to 2 mg/liter.

Cancer Biother, 1995 Summer, 10(2), 131 - 8
Combination therapy with traditional Chinese medicines and Streptococcus pyogenes products (OK 432) for endogenous tumor necrosis factor therapy . A preliminary report; Haranaka K et al.; The antitumor activity of combination therapy with traditional Chinese medicines and OK432 (Streptococcus pyogenes) for cancer patients was investigated . Excellent antitumor activity of this treatment was achieved in one patient with hepatocellular carcinoma . The present report describes the clinical course of this patient and examines the contribution of production of tumor necrosis factor (TNF) and interferon-gamma (IFN) . Endogenous production of TNF could be observed after drip intravenous injection of OK 432 in the serum of patients treated by previous oral administration of traditional Chinese medicines . The serum levels of IFN were very low and remained at almost undetectable levels under these conditions . The selective use of immunostimulants such as traditional Chinese medicines may be of value in combination with other therapies such as drip infusion of OK 432, in the treatment of advanced cancer or of aged patients because of the low toxicity . One patient out of 12 revealed a partial response as assessed by the antitumor activity . However, with this treatment, patients did become free from pain and a good performance status was supported.

Eur Arch Otorhinolaryngol, 1995, 252(3), 153 - 8
Superoxide dismutase in an animal model of otitis media; Parks RR et al.; Cu, Zn superoxide dismutase (SOD) is a metalloprotein that catalyzes the dismutation of the superoxide anion into O2- and H2O2, and therefore functions to maintain a low intracellular concentration of an otherwise toxic metabolite of oxygen . SOD protects living tissue from the destructive effects of free radicals . Increasing evidence implicates free radicals, including the superoxide radical (O2-), in the pathogenesis of disease, including otitis media . In an effort to elucidate the role free radicals play in the pathogenesis of otitis media, SOD was localized immunocytochemically to determine its cellular distribution in specimens of guinea pig middle ear . In normal ears, SOD was found concentrated in the epithelium of the middle ear mucosa . Low quantities were characteristic of connective tissue, bone, and cartilage . In streptococcus-infected ears, SOD localized similarly, concentrating in the epithelium . The infected ears had extensive submucosal edema which stained poorly and appeared to have less SOD than did normal ears . This was confirmed by an assay using laser densitometry of Western blots to quantify the amount of SOD in the mucosa of normal versus infected middle ears . This demonstrated a value of SOD in normal mucosa of 1.77 +/- 0.48 micrograms/mg of protein compared with 1.02 +/- 0.28 micrograms/mg in the infected mucosa . The two groups were significantly different at P < 0.05 . These findings are discussed, and suggestions for future experimentation addressed.

Scand J Infect Dis, 1995, 27(2), 119 - 21
DNA fingerprinting of Streptococcus pyogenes from patients with recurrent pharyngotonsillitis by means of random amplified Polymorphic DNA analysis; Osterlund A et al.; In recent years, several DNA fingerprinting methods have been tried for the epidemiological investigation of Streptococcus pyogenes isolates . We chose the Random Amplified Polymorphic DNA (RAPD) method for the typing of pre- and post-antibiotic treatment S . pyogenes isolates obtained from 14 patients with pharyngotonsillitis . Isolates from 4 patients had been collected 10 years earlier than from the others . Hence epidemiological connections between the strains were unlikely . Both pre- and post-antibiotic treatment isolates showed identical RAPD patterns, indicating that recurrences in these patients had been caused by homologous strains of S . pyogenes . It was possible by means of RAPD to differentiate between 12 different T-types and occasionally between clones of the same serotype of S . pyogenes . The RAPD method is an easier alternative to traditional DNA-typing techniques and provides quick results with minimal technical complexity.

Zentralbl Neurochir, 1995, 56(2), 64 - 8
{Spontaneous brain abscess--bacteriology, therapy and prognosis}; Braun V et al.; Spontaneous intracranial abscesses are quite rare in western industrial countries . According to the recently published papers, each neurosurgical centre is expecting 2 to 4 cases a year . Whereas in the last three years we only operated on one or two cases a year we treated 8 cases in the first ten months of 1994 . Although this remarkable increase is not statistically significant, further observations seem to be indicated . In 5 cases the origin of the abscess remained unknown . 3 patients had odontogeneous focuses, 2 middle ear and 2 pulmonary infections . One patient was operated on for spontaneous liver abscess few days before . Streptococcus was found in 9 cases, Bacteroides, Nocardia and Rhodoturola in 1 case each . For one patient no pathogen could be detected . In regard of our results, minimal invasive neurosurgical aspiration of the abscess with adjacent longterm antibiotic therapy gives a good prognosis with little morbidity . In contrast the mortality rate rises if diagnostic procedures are delayed or if the detected microorganism is highly resistant to current antibiotics.

Caries Res, 1995, 29(3), 237 - 42
Investigation of the effects of aluminum mouthrinses on rat dental caries and plaque; Kleber CJ et al.; The effects of topically applied mouthrinses containing AlCl3, or AlK(SO4)2 on dental caries and plaque were investigated in a rat model . For comparison, NaF and a two-step treatment of AlCl3 and NaF were also tested . Six groups of 20 weanling rats were inoculated with Streptococcus sobrinus 6715 and provided a caries-inducing diet and distilled water ad libitum . Test agents were topically applied twice daily 5 days per week at a concentration of 0.037 mol/l in a mouthrinse vehicle and were compared with a vehicle control rinse and a distilled water control . After 10 weeks none of the treatments reduced plaque amounts relative to the controls . The AlCl3 and AlK(SO4)2 rinses significantly reduced both smooth-surface and sulcal caries by approximately 40% . The cariostatic activity of the aluminum rinses was equivalent to an equimolar NaF mouthrinse on smooth surface lesions, but was statistically less than NaF on sulcal caries . The two-step treatment with AlCl3 and NaF indicated numerically additive effects, but the results were not statistically better than with NaF alone . Dentine caries progression paralleled the enamel caries prevalence results . No deaths, toxicologic effects, or inhibition of growth rates were observed in any treatment group . This study confirmed that topically applied solutions of aluminum salts inhibited caries formation in the rat caries model and showed that the cariostatic activity of aluminum was maintained in a compatible mouthrinse vehicle.

Caries Res, 1995, 29(3), 192 - 7
Effect of dentine and collagen on the lethal photosensitization of Streptococcus mutans; Burns T et al.; Suspensions of the cariogenic bacterium, Streptococcus mutans were treated with either toluidine blue O or aluminium disulphonated phthalocyanine and then exposed to light from a helium-neon or gallium-aluminium-arsenide laser, respectively, after passing through demineralized dentine slices . Bacteria were also embedded in a collagen matrix prior to sensitization and exposure to the laser light . When dentine slices were interposed between the laser light and the bacterial suspension, substantial kills (10(7) CFU) were achieved at energy doses of 876, 1,752, and 3,504 mJ with the helium-neon laser and of 1,188, 2,376, and 4,752 mJ with the gallium-aluminium-arsenide laser . There was no apparent relationship between the extent of killing and the degree of demineralization of the dentine . Prolonging the exposure of the sensitized bacteria to the laser light increased the kill achieved . Substantial numbers (10(8) to 10(10) CFU) of S . mutans were also killed when embedded in a collagen matrix and exposed to 438 and 1,314 mJ of helium-neon laser light and 594 and 1,782 mJ of light from the gallium-aluminium-arsenide laser . These results imply that lethal photosensitization may be effective at killing S . mutans in a carious lesion, even when the organism is embedded in demineralized dentine.

Zhonghua Yi Xue Za Zhi, 1995 Jan, 75(1), 19 - 21, 61
{Streptococcus pneumoniae-induced pulmonary consolidation prevented with tumor necrosis factor alpha monoclonal antibody in mouse}; Cui X et al.; Streptococcus pneumoniae stimulate mouse peritoneal macrophages to release tumor necrosis factor alpha (TNF alpha) in vitro . When penicillin was added to lysate bacterium, TNF alpha release was accelerated . 150 Kunming mice were infected with streptococcus pnumoniae through inspiration . Dynamic changes of TNF alpha concentration in serum and bronchoalveolar lavage fluid were detected; pulmonary pathological changes were also observed . It was found that TNF alpha monoclonal antibody significantly attenuates TNF alpha activity in serum and bronchoalveolar lavage fluid, white blood cell chemotaxis, emigation, and infiltration were inhibited . We conclude that streptococcus pneumoniae infection stimulates TNF alpha release, and TNF alpha is probably the major mediator that causes tissue damage during streptococcus pneumoniae infection . As penicillin accelerates TNFa release, single therapy of penicillin may worse tissue damage.

Ann Trop Paediatr, 1995, 15(1), 93 - 6
The changing face of neonatal septicaemia; Daoud AS et al.; A prospective study was undertaken over a 1-year period in northern Jordan to determine the incidence, causes and characteristics of neonatal septicaemia which is a major cause of mortality and morbidity in newborns . The study identified 47 septicaemic neonates, representing an incidence of 2.3/1000 live births . Respiratory distress and hyperbilirubinaemia were the prominent presenting clinical findings . Gram-negative organisms were cultured from 46 neonates with Klebsiella species, accounting for 64% of cases . There were no cases of infection with group B Streptococcus or Listeria monocytogenes . The overall mortality rate was 40% . Prematurity and low birthweight, early onset septicaemia and concomitant meningitis were associated with high mortality . The high incidence of Gram-negative septicaemia and the antibiotic sensitivity pattern of the organisms indicated the use of cefotaxime or ceftazidime as initial therapy while awaiting culture results . Continued surveillance of neonatal septicaemia is mandatory due to temporal changes in the causative organisms and their antibiotic sensitivity.

Acta Clin Belg, 1995, 50(2), 81 - 6
Streptococcus pyogenes bacteremia: a retrospective study in a Belgian university hospital; Van de Mierop F et al.; We retrospectively studied 29 cases of S.pyogenes bacteremia, treated from September 1985 through September 1993, in order to define the clinical pattern, predisposing factors and the outcome of S.pyogenes bacteremia in our region . The number of infections, the clinical picture and mortality rate of S.pyogenes bacteremia did not change during the study period and only 2 of 29 cases presented with a fulminant clinical course, meeting the criteria of streptococcal toxic shock syndrome . In many patients, predisposing factors such as skin abnormalities (n = 14) and airway diseases (n = 10) could be identified . Patients with underlying skin disease were mostly characterized by a clinically benign bacteremia with good prognosis . We suspect that the recently reported so-called rising incidence of severe S.pyogenes infections might be due to epidemiologic clustering and selection bias in certain regions.

Intensive Care Med, 1995 Jan, 21(1), 24 - 31
A five-year study of severe community-acquired pneumonia with emphasis on prognosis in patients admitted to an intensive care unit; Leroy O et al.; OBJECTIVES: To characterize the epidemiology and to determine the prognosis factors in severe community-acquired pneumonia among patients admitted to an intensive care unit . DESIGN: Retrospective clinical study . SETTING: Intensive Care and Infectious Diseases Unit of a municipal general hospital of Lille University Medical School . PATIENTS: 299 consecutive patients exhibiting severe community-acquired pneumonia . MEASUREMENTS AND RESULTS: On admission to ICU, 149 patients required mechanical ventilation for acute respiratory failure and 44 exhibited septic shock . Pulmonary involvement was bilateral in 71 patients . There were 260 organisms isolated from 197 patients (65.9%), the most frequent being Streptococcus pneumoniae (n = 80), Staphylococcus spp . (n = 57) and Gram-negative bacilli (n = 81) . Overall mortality was 28.5% (85 patients) . According to univariate analysis, mortality was associated with age over 60 years, anticipated death within 5 years, immunosuppression, shock, mechanical ventilation, bilateral pulmonary involvement, bacteremia, neutrophil count < 3500/mm3, total serum protein level < 45 g/l, serum creatinine > 15 mg/l, non-aspiration pneumonia, ineffective initial therapy and complications . Multivariate analysis selected only 5 factors significantly associated with prognosis: anticipated death within 5 years, shock, bacteremia, non-pneumonia-related complications and ineffective initial therapy . CONCLUSION: The effectiveness of the initial therapy appears to be the most significant prognosis factor and, as the one and only related to the initial medical intervention, suggests a need for permanent optimization of our antimicrobial strategies.

Mol Microbiol, 1995 Jan, 15(2), 367 - 79
The recA gene of Streptococcus pneumoniae is part of a competence-induced operon and controls lysogenic induction; Martin B et al.; The recently identified recA gene of the naturally transformable bacterium Streptococcus pneumoniae has been further characterized by constructing a recA null mutation and by investigating its regulation . The recA mutation has been shown to confer both DNA repair (as judged from sensitivity to u.v . and methyl methane sulphonate) and recombination deficiencies . Plasmid transformation into the recA mutant was also drastically reduced . Western blotting established that recA gene expression is increased several fold at the onset of competence for genetic transformation . Increased expression was associated with the appearance of a recA-specific transcript, approximately 5.7 kb long . This transcript indicated that recA is part of a competence-inducible (cin) operon . The major (about 4.3 kb) transcript detected from non-competent cells did not include cinA, the first gene in the operon, suggesting that this gene could be specifically required at some stage in the transformation process . Detection of small amounts of the 5.7 kb polycistronic mRNA in cells treated with mitomycin C suggested that the operon could also be damage inducible . In addition, mitomycin C treatment of a recA- lysogenic strain did not lead to prophage induction and cell lysis . This is unlike the situation of a recA+ lysogen . Together these results demonstrate that RecA controls lysogenic induction and suggest the existence of a SOS repair system in S . pneumoniae.

Acta Haematol, 1995, 94(2), 95 - 7
Hemolytic anemia in a patient with subacute bacterial endocarditis due to Streptococcus sanguis; Inada T et al.; We describe a case of hemolytic anemia with subacute bacterial endocarditis due to Streptococcus sanguis . The major hematological features of the patient were a normocytic anemia with reticulocytosis, an elevation of serum lactate dehydrogenase, and a marked reduction of serum haptoglobin . All these signs of hemolytic anemia fluctuated in parallel with changes in inflammatory activity and were dramatically improved by the administration of benzylpenicillin, suggesting that the infection with S . sanguis itself was the cause of hemolytic anemia in this case.

Cancer, 1994 Dec 15, 74(12), 3097 - 103
Intratumoral injection of a streptococcal preparation, OK-432, before surgery for gastric cancer . A randomized trial . Cooperative Study Group of Preoperative Intratumoral Immunotherapy for Cancer; Tanaka N et al.; BACKGROUND . The preoperative intratumoral injection with OK-432 (Picibanil, Chugai Pharmaceutical Co., Tokyo, Japan), an immunomodulatory agent prepared from an attenuated strain of streptococcus pyogenes, activates the regional immune system and causes degeneration of cancer tissue in carcinoma of the stomach . METHODS . A multi-institutional randomized trial of OK-432 to determine its clinical usefulness was conducted . Three hundred and ninety-five patients with gastric cancer were assigned randomly either to receive or not to receive a preoperative intratumoral injection of OK-432 . Among them, 277 patients with advanced cancer were treated by common postoperative chemoimmunotherapy consisting of mitomycin C, tegafur, and OK-432 . All patients were followed for at least 5 years . RESULTS . The adverse effects of OK-432 injected intratumorally predominantly were mild fever, anorexia, and abdominal pain, however, no treatment was required for these symptoms . Overall, there were no differences in outcome between the OK-432 and control groups . However, analysis based on stage showed that a preoperative intratumoral injection of OK-432 significantly improved the 5-year survival rate of patients with Stage III cancer (P = 0.0229), at 47.7% for the OK-432 group and 27.5% for the control group . In subset analysis, when the 5-year survival of patients with and without tumor infiltrating lymphocytes (TIL) was compared, OK-432 injected intratumorally had a significant positive effect on the group showing a moderate to marked number of TIL (P = 0.0438) . CONCLUSION . These results showed that the intratumoral injection of OK-432 may improve survival of patients with Stage III gastric cancer . Cancer 1994;3097-3103.

J Biol Chem, 1994 Dec 2, 269(48), 30682 - 7
Proteolytically active streptococcal pyrogenic exotoxin B cleaves monocytic cell urokinase receptor and releases an active fragment of the receptor from the cell surface; Wolf BB et al.; Urokinase plasminogen activator (u-PA) receptor (u-PAR) is a glycosyl-phosphatidylinositol-anchored membrane protein that promotes pericellular proteolysis and cellular migration . This investigation demonstrates that u-PAR is a substrate for the proteolytically active form of streptococcal pyrogenic exotoxin B (SPE B), a potent virulence factor secreted by Streptococcus pyogenes . Treatment of U937 monocyte-like cells with SPE B decreased specific 125I-labeled single-chain u-PA binding by up to 85% . Cysteine proteinase inhibitors neutralized SPE B without affecting the activity of phosphatidylinositol-specific phospholipase C . Due to decreased u-PA binding, SPE B-treated U937 cells expressed decreased activity against a u-PA-specific fluorogenic substrate and plasminogen . SPE B released single-chain u-PA that was noncovalently bound to U937 cells or cross-linked to cellular receptors with bis(sulfosuccinimidyl) suberate . The mass of the released u-PA-receptor complex was 100 kDa . Western blot analysis confirmed that the u-PA receptor that was cleaved by SPE B is u-PAR . After deglycosylation, the mass of SPE B-released u-PAR was 35 kDa, slightly smaller than the phosphatidylinositol-specific phospholipase C-derived form of this receptor . SPE B-released u-PAR retained the ability to bind u-PA, as determined by u-PA affinity chromatography . We conclude that SPE B may inhibit u-PA binding to monocytic cells by at least two mechanisms: (i) by decreasing the level of functional cell surface u-PAR and (ii) by releasing a soluble form of u-PAR that competes with the cellular receptor for ligand.

Carbohydr Res, 1994 Dec 2, 265(1), 97 - 111
Molecular recognition of antigenic polysaccharides: a conformational comparison of capsules from Streptococcus pneumoniae serogroup 9; Rutherford TJ et al.; Aqueous solution conformations of three antigenic bacterial capsular polysaccharides (CPS) from S . pneumoniae serogroup 9 were determined using a combination of NMR data (NOE build-up rates and conformation-dependent chemical shifts), simulated annealing, and molecular dynamics simulations . Each polymer adopts a flexible extended ribbon conformation in solution . Conformations of structural elements shared by each PS are indistinguishable . Differences in conformations are minor and localised at the sites of structural variations; there is no evidence of long-range stabilisation of a secondary structure . It is likely that antigenic specificity of Group 9 PS is dominated by local structural variation rather than by conformational differences.

Carbohydr Res, 1994 Dec 2, 265(1), 79 - 96
NMR assignment and conformational analysis of the antigenic capsular polysaccharide from Streptococcus pneumoniae type 9N in aqueous solution; Rutherford TJ et al.; Complete 1H and 13C NMR assignments, determined by one- and two-dimensional homo- and hetero-nuclear experiments, are reported for the antigenic capsular polysaccharide (CPS) from Streptococcus pneumoniae serotype 9N (S9 in American nomenclature) . Distance constraints derived from 1D NOE difference experiments were combined with energy minimisation (simulated annealing) and molecular dynamics (MD) calculations to determine the most favoured conformation of S9 in aqueous solution at 70 degrees C . NOE values simulated for several static conformational models using the NOEMOL program did not correlate well with experimental values, whereas time averaged interproton distances calculated from 500 ps of restrained MD (using the Tropp formalism to account for rapid internal mobility) were in close agreement with experimentally derived distance estimates.

J Osaka Univ Dent Sch, 1994 Dec, 34, 37 - 44
Characterization of coaggregation and fibrinogen-binding by Porphyromonas gingivalis; Nagata H et al.; We have examined whether the adhesin of Porphyromonas gingivalis which aggregates Streptococcus oralis contributes to its fibrinogen-binding . Various properties of coaggregation between P . gingivalis and S . oralis were compared with those of fibrinogen-binding to P . gingivalis cells . The coaggregation activity was measured by a turbidimetric method and the fibrinogen-binding activity was determined by using 125I-fibrinogen . Both the activities showed maximum values in the pH range from 5.0 to 6.0 and they were inhibited by arginine and lysine . Heating treatment of P . gingivalis 381 cells at 75 degrees C abrogated the activities . However, treatment of P . gingivalis 381 cells with proteinase K considerably reduced the fibrinogen-binding activity but not the coaggregation activity . Metal ions such as Zn2+ and Cu2+ inhibited the coaggregation activity but enhanced the fibrinogen-binding activity . The results also indicated that P . gingivalis strains 381, ATCC 33277 and SU-3 showed relatively higher activities both in coaggregation and fibrinogen-binding, whereas P . gingivalis strains W83, 51 and 165 showing lower fibrinogen-binding activity than P . gingivalis 381 did not coaggregate with S . oralis ATCC 9811 . These findings suggest that coadhesin of P . gingivalis with S . oralis is not be associated with its fibrinogen-binding.

Postgrad Med, 1994 Dec, 96(8), 75 - 6, 79-82, 87-9
Acute exacerbations of chronic bronchitis . Preventing treatment failures and early reinfection; Verghese A et al.; Although antimicrobial agents from a number of classes have been used with a good degree of clinical success for acute bacterial exacerbations of chronic bronchitis, the incidence of resistance by beta-lactamase-producing strains to certain penicillins and cephalosporins continues to increase and represents a growing clinical problem . There also have been reports of significant resistance by Streptococcus pneumoniae to tetracyclines and of treatment failures caused by this organism among patients receiving fluoroquinolones . The emergence of penicillin-resistant pneumococci in North America also is of concern . Although first-generation cephalosporins are no longer regarded as first-line therapy or optimal alternatives for acute exacerbations of chronic bronchitis, more recently developed agents of this class have better activity against the primary pathogens, and their efficacy and safety have been demonstrated in a number of clinical trials . Newer macrolide agents probably should be reserved for infections caused by atypical organisms.

Chest, 1994 Dec, 106(6), 1753 - 6
Comparison of Ballard catheter bronchoalveolar lavage with bronchoscopic bronchoalveolar lavage; Levy H; BACKGROUND: Bronchoscopic bronchoalveolar lavage (BAL) in mechanically ventilated patients requires a large endotracheal tube, physician expertise, expensive equipment, and support staff . METHODS: The Ballard BAL catheter is a disposable coude tip 16F device that can be attached to the endotracheal tube and ventilator circuit without loss of positive end-expiratory pressure (PEEP) and also allows supplemental delivery of oxygen between the 12F inner and outer catheters . The catheter is directed into the selected bronchus . The inner catheter with mushroom tip is then advanced until it wedges by feel . Thirteen patients at a tertiary care, university hospital, had BAL performed through both the bronchoscope and Ballard BAL catheter using five aliquots of 20 mL of normal saline solution each . The return was quantified and submitted for blinded, paired laboratory investigations, including Gram stain and quantitative culture, and special stains and cultures as clinically appropriate . RESULTS: The procedure was well tolerated in all patients with no difference between devices in oxygen saturations; however, air leaks occurred in patients undergoing bronchoscopy and compromised safety in one . Two patients required reintubation to facilitate passage of the bronchoscope . The bronchoscopic BAL return averaged 49 mL (range, 5 to 85 mL) while BAL catheter averaged 37 mL (range, 18 to 70 mL) both being sufficient for all desired investigations except one patient who had undergone bronchoscopy . All were of excellent quality based on microscopy . The BAL results were concordant in nine patients: two Pneumocystis carinii, one Candida, one Streptococcus agalactiae, one Streptococcus pneumoniae, and no infection in four . Diagnoses of tuberculosis and Enterococcus (confirmed by blood culture) were obtained by the Ballard BAL catheter only . Kaposi's sarcoma and metastatic histiosarcoma were visualized by bronchoscope only . Two patients had compassionate plea use of the Ballard BAL catheter because of a small endotracheal tube . Hemorrhage secondary to lupus was documented in one and nosocomial infection was excluded in the other . CONCLUSIONS: The Ballard BAL catheter allows easy, safe BAL, without loss of diagnostic yield, when visualization is not required in mechanically ventilated patients . The Ballard BAL catheter allows maintenance of PEEP when used with the supplied adapter and can be used with small endotracheal tubes.

Arch Otolaryngol Head Neck Surg, 1994 Dec, 120(12), 1342 - 6
Acute Streptococcus pneumoniae meningogenic labyrinthitis . An experimental guinea pig model and literature review; Blank AL et al.; OBJECTIVE: To create an experimental model of Streptococcus pneumoniae type 3 meningogenic labyrinthitis (a leading cause of deafness) similar to that in human disease . DESIGN: Cohort analytic study of guinea pigs that were inoculated intrathecally with varying dilutions of S pneumoniae type 3; the progress of the disease was compared with that in saline solution-inoculated control animals . SUBJECTS: Healthy adult Hartley guinea pigs without clinical evidence of middle ear disease that were conveniently sampled . INTERVENTIONS: Intrathecal inoculation of 10(4) to 10(6) colony-forming units of S pneumoniae type 3 into 13 guinea pigs; signs and symptoms of meningitis/labyrinthitis were observed for 15 days and compared with those in two saline solution-inoculated control animals . MAIN OUTCOME MEASURES: Morbidity--labyrinthitis, meningitis; end point--death . RESULTS: The 10(4) to 10(6) colony-forming units of S pneumoniae type 3 caused inflammation that extended from the meninges to the inner ear via the cochlear aqueduct within 3 days after inoculation; a dose of 10(7) killed animals within 12 hours after inoculation . Three of five animals that were inoculated with a 10(6) dose died 3 days after inoculation; two of three animals that were inoculated with a 10(5) dose lived to 15 days after inoculation . One of two animals that were inoculated with a 10(4) dose did not become infected . Inflammation extended to the middle ear by round-window destruction . Reactive bone formation simulated labyrinthine osteosclerosis . Observers assessed histologic slides "blindly." CONCLUSION: Guinea pigs can survive 15 days after intrathecal inoculation of a 10(5) dose, with morphologic features similar to those in human disease . This is an effective model for this study of meningogenic labyrinthitis.

Am J Orthod Dentofacial Orthop, 1994 Dec, 106(6), 583 - 7
Reduction of caries and of demineralization around orthodontic brackets: effect of a fluoride-releasing resin in the rat model; Dubroc GC Jr et al.; The effectiveness of fluoride in reduction of caries is well known . This study examined the ability of a fluoride-releasing resin to reduce caries, as well as demineralization around orthodontic brackets, by using the Sprague-Dawley rat as a model . Eighteen-day-old rats were infected with cariogenic Streptococcus sobrinus 6715 . After infection was confirmed, standard orthodontic techniques were used to bond miniature orthodontic brackets to the lingual surfaces of maxillary first molars, with either a fluoride-releasing resin (group I) or a conventional resin (group II) . A control group was infected but not bonded (group III) . Bonding was done at age 34 days . Rats were fed a cariogenic diet and were killed at age 72 days . Lingual surfaces of maxillary first molars were evaluated for area of demineralization, and mandibular molars were scored for caries . Mean percent area of demineralization for group I was 4.7%, for group II 35.7%, and for group III 0% . The difference between groups I and II was statistically significant (p < 0.01) . Mean mandibular molar enamel carious lesion unit count for group I was 9.8, for group II 16.3, and for group III 13.7 . Group I had significantly fewer lesions than groups II and III (p < 0.01), and group II had significantly more lesions than group III (p < 0.01) . These results indicate that a fluoride-releasing resin reduces demineralization at the site of application and reduces caries at distant sites in the experimental rat model.

J Med Microbiol, 1994 Dec, 41(6), 414 - 22
Degradation of hyaluronate by Streptococcus intermedius strain UNS 35; Homer KA et al.; Streptococcus intermedius strain UNS 35, a brain abscess isolate, produced extracellular hyaluronidase when grown in brain heart infusion broth . Chemical assays with this enzyme indicated that hyaluronate depolymerisation resulted in the formation of carbohydrate moieties with N-acetylglucosamine at the reducing terminal and containing an unsaturated carbon-carbon double bond . The nature of the products of this hyaluronidase were investigated further by high-field (400 MHz) proton (1H) NMR spectroscopy . Treatment of hyaluronate with the enzyme resulted in a series of new, sharp resonances in spectra (acetamido methyl group singlets located at 2.03 and 2.07 ppm, sugar ring proton multiplets in the 3.5-4.2 ppm chemical shift range, and doublets at 5.16 and 5.87 ppm) characteristic of low-M(r) oligosaccharide species, predominantly those containing glucuronosyl residues with delta 4,5-carbon-carbon double bonds . Comparison of spectra acquired from hyaluronidase-treated samples with that of an authentic sample of 4-deoxy-L-threo-hex-4-enopyranosyluronic-acid-N-acetylglucosamine (delta UA GlcNAc) indicated that this disaccharide was a major product arising from the actions of this enzyme . When used in minimal media, hyaluronate supported growth of S . intermedius, with lactate as the major metabolic end-product.

J Exp Med, 1994 Dec 1, 180(6), 2277 - 86
Protective humoral response against pneumococcal infection in mice elicited by recombinant bacille Calmette-Guérin vaccines expressing pneumococcal surface protein A; Langermann S et al.; Pneumococcal surface protein A (PspA), a cell-surface protein present on all strains of pneumococci, has been shown to elicit protective antibody responses in mice in the absence of capsular polysaccharide . Whereas PspA is polymorphic, considerable cross-reactivity and cross-protection have been demonstrated among PspA proteins of pneumococci exhibiting different capsular and PspA serotypes . A gene segment encoding the nonrepetitive variable NH2-terminal portion of PspA has been cloned into three distinct recombinant Bacille Calmette-Guerin (rBCG) vectors, allowing for expression of PspA as a cytoplasmic or secreted protein, or a chimeric exported membrane-associated lipoprotein . All rBCG-PspA strains elicited comparable anti-PspA ELISA titers, ranging from 10(4) to 10(5) (reciprocal titers) in both BALB/c and C3H/HeJ mice . However, protective responses were observed only in animals immunized with the rBCG-PspA vaccines expressing PspA as a secreted protein or chimeric exported lipoprotein . In addition, anti-PspA immune sera elicited by the rBCG vaccines passively protected X-linked immunodeficient mice from lethal challenge with the highly virulent, encapsulated WU2 strain of Streptococcus pneumoniae and two additional virulent strains exhibiting heterologous PspA and capsular serotypes . These studies confirm previous PspA immunization studies showing cross-protection against heterologous serotypes of S . pneumoniae and demonstrate a potential for rBCG-based PspA vaccines to elicit protective humoral responses against pneumococcal disease in humans.

J Bacteriol, 1994 Dec, 176(23), 7206 - 12
Overproduction of a dextranase inhibitor by Streptococcus sobrinus mutants; Wanda SY et al.; An inhibitor of Streptococcus sobrinus endodextranase was detected in the extracellular fractions of UAB66 mutants identified following ethyl methanesulfonate mutagenesis as either devoid of dextranase activity (Dex-) or overproducing water-soluble glucan . The two groups of mutants had the same phenotype and displayed no dextranase activity in assays of extracellular fractions (H . Murchison, S . Larrimore, and R . Curtiss III, Infect . Immun . 34:1044-1055, 1981) and had been shown to be defective in adherence (Adh-) and capable of inhibiting adherence of wild-type strains during cocultivation in vitro (H . Murchison, S . Larrimore, and R . Curtiss III, Infect . Immun . 50:826-832, 1985) and in vivo in gnotobiotic rats (K . Takada, T . Shiota, R . Curtiss III, and S . M . Michalek, Infect . Immun . 50:833-843, 1985) . By analysis of proteins in Western blots (immunoblots) and following blue dextran-sodium dodecyl sulfate-polyacrylamide gel electrophoresis (BD-SDS-PAGE), it was demonstrated that these Dex- mutants did synthesize enzymatically active dextranase . From the results of mixing experiments, it was determined that these Dex- Adh- mutants produced enhanced amounts of a cell surface-localized or a cell-associated dextranase inhibitor (Dei) . Dei was heat stable but trypsin sensitive . By adding excess dextranase following BD-SDS-PAGE, Dei was detected as blue bands with apparent molecular masses of 43, 40, 37, 27, and 23 kDa . Dei competitively inhibits dextranase activity and is synthesized by wild-type S . sobrinus strains, with the amount varying depending upon growth medium and stage in the growth cycle . R . M . Hamelik and M . M . McCabe (Biochem . Biophys . Res . Commun . 106:875-880, 1982) previously described a Dei in a wild-type S . sobrinus strain.

Infect Immun, 1994 Dec, 62(12), 5683 - 8
Immunization of mice with pneumolysin toxoid confers a significant degree of protection against at least nine serotypes of Streptococcus pneumoniae; Alexander JE et al.; Pneumolysin is the thiol-activated cytolysin produced by Streptococcus pneumoniae . Mice were immunized with a genetically engineered toxoid version of pneumolysin, which was derived from a serotype 2 pneumococcus . The toxoid carried the mutation Trp-433-->Phe . Alum was used as the adjuvant . Immunized mice had significantly increased levels of anti-pneumolysin antibodies, principally immunoglobulin G1 . Mice were challenged intraperitoneally or intranasally with 12 strains covering capsular serotypes 1 to 6, 7F, 8, and 18C . Following challenge, the survival rate and/or the time of death of nonsurvivors (survival time) was significantly greater than that of sham-immunized mice for all nine serotypes . However, differences in the degree of protection were noted between different strains . The route of challenge also appeared to influence the degree of protection . Nevertheless, the significant, albeit in some cases partial, protection provided against all nine pneumococcal serotypes supports the conclusion that pneumolysin toxoids warrant consideration for inclusion in a human vaccine.

Infect Immun, 1994 Dec, 62(12), 5669 - 72
Stimulation of monocyte tissue factor expression in an in vitro model of bacterial endocarditis; Bancsi MJ et al.; The coagulation system plays a major role in the formation of the infected endocardial vegetation in bacterial endocarditis . Since monocytes can express tissue factor (TF) on their surfaces, they are thought to be responsible for the extrinsic activation of the coagulation cascade during this disease . The present study used an in vitro model in which fibrin plates, isolated adherent monocytes, and Streptococcus sanguis were used as an analog for endocardial vegetations . Adherence to fibrin by itself was found to stimulate TF expression on the monocytes, but stimulation by S . sanguis significantly increased TF expression, which was found to be maximal at a bacterium-to-monocyte ratio of 9 or more.

Infect Immun, 1994 Dec, 62(12), 5641 - 6
Bovine mammary epithelial cell invasion by Streptococcus uberis; Matthews KR et al.; Streptococcus uberis commonly causes bovine mastitis; however, the pathogenesis of this infection is poorly understood . In this study, the ability of S . uberis to invade mammary epithelial cells in culture was investigated . Two strains of S . uberis isolated from bovine mammary secretions were capable of invading bovine mammary epithelial cells in vitro at different levels, suggesting strain differences in invasiveness . Invasion required microfilaments but not microtubular cytoskeletal elements . No morphological changes in epithelial cells were observed for up to 24 h postinfection, suggesting no cellular injury . Strains of S . uberis evaluated were genetically distinct and differed phenotypically in expression of potential virulence factors . Whether a single factor or combination of factors was responsible for differences in invasiveness was not addressed in this study . These data provide a foundation for a better understanding of the processes used by S . uberis to invade epithelial cells . Epithelial cell invasion may be a potentially important mechanism in the pathogenesis of S . uberis mastitis.

Infect Immun, 1994 Dec, 62(12), 5470 - 6
Immunological characteristics of a synthetic peptide associated with a catalytic domain of mutans streptococcal glucosyltransferase; Smith DJ et al.; The immunogenicity of a multiple antigenic peptide construct consisting of four copies of the synthetic 21-mer peptide DANFDSIRVDAVDNVDADLLQ was measured . The composition of this peptide was derived from a sequence in the N-terminal region of mutans streptococcal glucosyltransferases (GTFs) containing an aspartic acid implicated in catalysis . The peptide (CAT) construct was synthesized as a tetramer on a lysine backbone and subcutaneously injected into Sprague-Dawley rats for polyclonal antibody formation or intraperitoneally injected into BALB/c mice, and then spleen cell fused with Sp2/0Ag14 murine myeloma cells for monoclonal antibody formation . The resulting rat antisera and mouse monoclonal antibodies reacted with CAT and with native GTF isozymes from Streptococcus sobrinus and Streptococcus mutans (in enzyme-linked immunosorbent assay and Western blot {immunoblot} analyses) . Functional inhibition of the water-insoluble glucan synthetic activity of S . sobrinus GTF-I was demonstrated with an immunoglobulin M anti-CAT monoclonal antibody (> 80% inhibited) and with rat sera (approximately 17% inhibited) . The monoclonal antibody preparation also modestly inhibited the water-soluble glucan synthetic activity of an S . mutans GTF mixture . These results suggest that the CAT peptide contains B-cell epitopes that are similar to those of intact mutans streptococcal GTFs and has the potential to elicit antibody that can inhibit GTF function . Thus, sequences within this peptide construct may have value for inclusion in a synthetic dental caries vaccine.

Infect Immun, 1994 Dec, 62(12), 5220 - 6
Calcium-binding properties of SSP-5, the Streptococcus gordonii M5 receptor for salivary agglutinin; Duan Y et al.; Streptococcus gordonii M5 expresses a lectin on its surface (SSP-5) which binds to human salivary agglutinin (SAG) . This interaction requires sialic acid residues of SAG and divalent cations and may mediate the colonization of oral tissues by this organism . In this report, we show that the binding of SAG to SSP-5 requires calcium and that SSP-5 is a high-affinity calcium-binding protein . SAG-mediated aggregation of S . gordonii M5 was inhibited by 1 mM EDTA, and the restoration of aggregation occurred only upon the readdition of calcium . To ascertain the level at which calcium exerts its effects, the calcium-binding properties of SSP-5 were evaluated by using a 45Ca binding assay . In addition, a kinetic analysis of calcium binding was carried out by using fura2, a fluorescent calcium-binding dye . These analyses showed that SSP-5 is a high-affinity calcium-binding protein that binds 1 mol of calcium per mol of protein and has a dissociation constant of 0.45 +/- 0.2 microM . The calcium-binding capacity of SSP-5 was also calculated independently to be 1.0 +/- 0.2 mol of Ca per mol of SSP-5 by column chromatography on Sephadex G-25 equilibrated with 10 microM 45Ca . To localize the calcium binding site of SSP-5, a series of C-terminal deletion mutants were expressed in Escherichia coli and evaluated for calcium-binding activity . Deletion of the 250 C-terminal residues of SSP-5 had little effect on calcium binding . However, deletion of residues 1168 to 1250 resulted in the loss of calcium-binding activity, suggesting that this region is important for calcium binding by SSP-5.

Nagoya J Med Sci, 1994 Dec, 57(3-4), 95 - 108
Cell surface glycoproteins: biochemical, immunological and molecular biological studies; Muramatsu T; This article briefly summarizes the author's contribution to the study of cell surface glycoproteins . At first, much effort was devoted to developing analytical methods, especially exoglycosidases and endoglycosidases . An endo-beta-N-acetylglucosaminidase found in Streptococcus pneumoniae was the first example of an endoglycosidase acting on glycoproteins . A combination of radioactive labeling, glycosidase digestion and lectin affinity chromatography enabled the characterization of carbohydrate moieties of cell surface glycoproteins derived from cultured cells . Application of the method to teratocarcinoma stem cells and preimplantation mouse embryos led to the discovery of marked changes in the carbohydrate moieties of cell surface glycoproteins during embryogenesis . Combining biochemical and immunohistochemical methods, an overall picture was obtained for carbohydrate changes in early embryogenesis of the mouse, and molecular biological approaches have been adopted to determine their biological significance . Furthermore, some core proteins carrying developmentally regulated carbohydrate markers were found and characterized by molecular cloning . One example of such a protein is embigin, which enhances integrin-mediated cell-substratum adhesion and established the existence of a new group in the immunoglobulin superfamily . Carbohydrate immunochemical markers useful in the analysis of mouse embryogenesis were also found to be effective in the classification of human carcinomas with respect to metastatic potential.

J Otolaryngol, 1994 Dec, 23(6), 450 - 3
Sinusitis in human immunodeficiency virus infection: typical and atypical organisms; Milgrim LM et al.; The majority of patients with human immunodeficiency virus (HIV) infection will develop acute sinusitis . This may be a single episode, or may be the beginning of a long course of recurrent sinusitis, of which the etiology is not yet well understood . A retrospective study of cultures from antral washings was conducted to determine the organisms that were more commonly isolated in patients with HIV infection and sinusitis . Forty-seven organisms were isolated from the sinus cultures of 41 HIV-positive patients . The most common organisms isolated were Streptococcus pneumoniae (19%), Streptococcus viridans (19%), and Pseudomonas aeruginosa (17%) . Pseudomonas aeruginosa is an atypical cause of acute sinusitis in the general population but was found to be an important pathogen in our HIV-infected patients . Other atypical organisms were also isolated, including Listeria monocytogenes and Candida albicans . It is important to recognize that atypical organisms must be considered if an HIV-infected patient with sinusitis does not respond to initial antibiotic therapy . A discussion follows emphasizing the need for prompt diagnosis and treatment of sinusitis in HIV infection.

J Appl Physiol, 1994 Dec, 77(6), 2593 - 9
Quantitation of neutrophil migration in acute bacterial pneumonia in rabbits; Doerschuk CM et al.; The circulating neutrophils must slow down, adhere to the vessel walls, and migrate out of the microvasculature into the tissue and air spaces to defend the lung against microorganisms . The present study was designed to provide quantitative information about each of these steps . Streptococcus pneumoniae was instilled into the left lower lobe of New Zealand White rabbits to induce a pneumonia, and this lobe was compared with the same region of the opposite lung . The distribution of blood flow was determined by using radiolabeled macroaggregated albumin, and the patterns of perfusion within the capillary bed were quantitated using Monastral blue . The number of neutrophils delivered to the pneumonic site was determined by multiplying the circulating neutrophil count and blood flow . The results show that retention of 51Cr-labeled neutrophils was increased in the pneumonic region 2, 4, and 8 h after instillation of the organisms . The number of intracapillary neutrophils was increased in the pneumonic regions at all time points and in the control regions at 1 and 4 h . Neutrophil migration occurred in the pneumonic site, but only 1-2% of the total neutrophils delivered to the region migrated out of the pulmonary vessels into the air space . We conclude that the circulating neutrophils undergo a generalized response that increases their margination throughout the lung, that increased margination in the pneumonic site changes the distribution of capillary flow, and that the majority of neutrophils delivered to a pneumonic site are returned to the circulation without migrating into the air space.

Pediatr Infect Dis J, 1994 Dec, 13(12), 1098 - 102
The changing face of neonatal infection: experience at a regional medical center; Philip AG; The incidence, etiology and timing of neonatal infection were assessed in a regional neonatal intensive care unit from 1983 through 1992 . Infection onset was considered as very early (< 24 hours), early (1 to 7 days) or late (8 to 60 days) . Case-fatality rates were determined for different weight groups and time periods (1983 to 1987 vs . 1988 to 1992) . Overall neonatal sepsis incidence changed very little, but there was a marked decrease in very early onset sepsis in 1988 to 1992 especially in very low birth weight (< 1500 g) infants, possibly attributable to increased use of prenatal antibiotics . There was an accompanying increase in late onset sepsis, primarily nosocomial infection associated with improved survival of tiny infants, most striking after exogenous surfactant became readily available . During 1988 to 1992, because of very few very early-onset cases, very low birth weight infants had overall case fatality rates of about 10%, which were the same as for larger infants . The predominant organism in very early onset infection was Group B Streptococcus (GBS) (27 of 58) and in late onset infection was coagulase-negative staphylococcus (57 of 103) . More cases of early onset GBS pneumonia were seen in the last 5 years . Neonatal meningitis was seen rarely during this decade, with only one case documented in the first 24 hours of life.

Eur J Clin Microbiol Infect Dis, 1994 Dec, 13(12), 1058 - 62
Possible prevention of in vitro selection of resistant Streptococcus pneumoniae by beta-lactamase inhibitors; Carsenti-Etesse H et al.; The development of resistance in vitro in five strains of Streptococcus pneumoniae (3 with full susceptibility and 2 with intermediate susceptibility to penicillin) was investigated by serial passages in the presence of subinhibitory concentrations of amoxicillin and ampicillin . At the end of passaging, MICs of antibiotics for all the strains increased by a factor of four or more, reaching at least intermediate levels . MICs of cephalosporins, ampicillin and amoxicillin increased for almost all variants obtained . Similar results were obtained with amoxicillin plus clavulanic acid at a ratio of 2:1 and at a constant concentration of 2 micrograms/ml, and with ampicillin plus sulbactam at a ratio 2:1 . In contrast, no significant modification of MIC was seen with ampicillin plus sulbactam at a constant concentration of 4 micrograms/ml sulbactam . These results suggest interaction of sulbactam with penicillin binding proteins as described previously for other bacterial species, and merit further investigation.

J Clin Microbiol, 1994 Dec, 32(12), 3056 - 8
Antibiotic resistance of clinical isolates of Streptococcus pneumoniae in Greece; Kanavaki S et al.; The antibiotic susceptibilities of 1,002 Streptococcus pneumoniae clinical isolates from patients with community-acquired pneumonia were determined over an 18-month period . Resistance rates were 14% for penicillin, 20% for erythromycin, 26% for tetracycline, and 1% for chloramphenicol . Resistance to non-beta-lactam antibiotics was associated with penicillin resistance at statistically levels.

J Clin Microbiol, 1994 Dec, 32(12), 2948 - 52
Pneumococci in nasopharyngeal samples from Filipino children with acute respiratory infections; Lankinen KS et al.; The presence of Streptococcus pneumoniae in the upper respiratory tract was studied in 318 Filipino children less than 5 years old with an acute lower respiratory tract infection . Nasopharyngeal samples were obtained from 292 children . With both quantitative bacterial culture and detection of capsular polysaccharide antigens by coagglutination, counterimmunoelectrophoresis, and latex agglutination, pneumococci were found in 160 (70%) of the 227 samples eligible for analysis . Culture was positive in 115 samples and antigen was positive in 140 samples . The culture isolation rate was significantly lower if the patient had received antimicrobial agents in the 48 h prior to the sampling . The seven most common types or groups of pneumococci were 6, 14, 19, 23, 15, 7, and 11, which together accounted for 64% of all pneumococcal findings.

Jpn J Antibiot, 1994 Dec, 47(12), 1685 - 90
{Antibacterial activities of a carbapenem antibiotic, biapenem (L-627), against penicillin-resistant Streptococcus pneumoniae}; Meguro H et al.; Antibiotic susceptibilities were evaluated for 48 strains of Streptococcus pneumoniae collected in 1992-1993 at Ichihara City of Chiba Prefecture . Twenty two (46%) of the 48 strains were benzylpenicillin (PCG) insensitive or resistant (PRSP) judged from the MICs of PCG to higher than 0.1 microgram/ml . MICs of piperacillin and cefotaxime increased as the MICs of PCG increased . However, elevations of MICs of imipenem and biapenem (L-627) were small in spite of the increases of MICs of PCG . L-627 was effective in a case of purulent meningitis due to PC-insensitive S . pneumoniae . Thus, L-627 is a candidate to be used in treatment of PRSP infections including purulent meningitis.

Kansenshogaku Zasshi, 1994 Dec, 68(12), 1533 - 7
{Three interesting pediatric cases with penicillin-resistant Streptococcus pneumoniae infection}; Terada K et al.; Since penicillin-resistant Streptococcus pneumoniae first recognized in 1967, the rate of penicillin-resistant strains has been increasing worldwide . There have been up to 50% from pediatric specimens in Japan . We reported three pediatric cases with penicillin G resistant Streptococcus pneumoniae infection to show some important clue from these cases for clinical practice against resistant pneumococcal infection . The first case was a typical acute mastoiditis, although we have experienced only masked mastoiditis recently . The second case was meningitis with septicemia, which did not show any abnormality in the first obtained cerebrospinal fluid . The third case was recurrent bronchitis in a child with cerebral palsy . The minimum inhibition concentrations of these isolated strains were 0.25 microgram/ml in the second case an 2.0 microgram/ml in the first and third cases.

Helv Chir Acta, 1994 Dec, 60(6), 931 - 4
{Diarrhea and peritonitis in infection caused by type A beta hemolytic streptococcus}; Gelshorn C et al.; During the last years the cases of severe group A streptococcus infection have increased . The clinical manifestation of this streptococcal toxic shock syndrome is similar to the better known toxic shock syndrome (TSS) provocated by staphylococcus . Shock, bacteremia and acute respiratory distress syndrome are common features, and death has been associated with this infection in 30% of patients . We present the case of a 46-year-old man who fell gravely ill with sepsis, diarrhoe, scarlatina rash, desquamation of hands and feet and acute abdomen caused by group A streptococcus infection . Finally we discussed the possible port of entry of this infection, the different clinical manifestation and the concepts of treatment.

Oral Microbiol Immunol, 1994 Dec, 9(6), 359 - 63
Effect of binding of fibrinogen to each bacterium on coaggregation between Porphyromonas gingivalis and Streptococcus oralis; Nagata H et al.; Fibrinogen inhibits the coaggregation between Porphyromonas gingivalis and Streptococcus oralis . In this study, we determined which bacterium interacts with fibrinogen in this inhibitory process . Although preincubation of each bacterium with fibrinogen did not inhibit coaggregation, its activity was completely eliminated by the addition of protease inhibitors such as N-ethylmaleimide (NEM), p-chloromercuriphenyl sulfonate and N alpha-p-tosyl-L-lysine chloromethyl ketone to the preincubation mixture with fibrinogen and P . gingivalis . However, the inhibition of coaggregation was not found after preincubation of S . oralis with fibrinogen in the presence or absence of the protease inhibitors . Labelled materials were recovered from the extract of P . gingivalis cells incubated with radioiodinated fibrinogen in the presence of NEM but not in the absence of NEM . In the binding experiment, P . gingivalis showed a much higher binding activity to fibrinogen than S . oralis . These findings suggest that fibrinogen and its fragment(s) may mask directly or indirectly the aggregation site with S . oralis on the P . gingivalis cells in its inhibitory process of coaggregation.

J Nihon Univ Sch Dent, 1994 Dec, 36(4), 235 - 40
Amphiphilic property of chlorhexidine and its toxicity against Streptococcus mutans GS-5; Koontongkaew S et al.; The toxicity of chlorhexidine digluconate against Streptococcus mutans GS-5 was comparatively determined by measuring its bactericidal activity, and its inhibitory effect on microbial dehydrogenases was studied by the resazurin reduction method . Both methods indicated that chlorhexidine within the range 0.75-5.00 mg/l was highly toxic to Streptococcus mutans, probably due to inhibition of dehydrogenase activity, and the extent of toxicity was closely associated with concentration . In an attempt to better understand the relationship between the amphiphilic nature of chlorhexidine and its toxicity against Streptococcus mutans, the effect of solvent polarity on dehydrogenase inhibition was investigated . A decrease in solvent polarity, induced by inclusion of 5% acetone in the reaction mixture, did not enhance the toxicity of chlorhexidine . This implies that the antimicrobial action of chlorhexidine is mainly attributable to its hydrophilicity, and that the nature of the lipophilic groups is only of secondary importance.

Nippon Jibiinkoka Gakkai Kaiho, 1994 Dec, 97(12), 2259 - 65
{Superoxide production by neutrophils in patients with recurrent tonsillitis}; Yokoyama Y et al.; Superoxide anion (O2-) production by peripheral blood polymorphonuclear leukocytes (PMNs) stimulated with phorbol myristate acetate (PMA) was measured by the cytochrome C method in 57 patients with recurrent tonsillitis . There was no significant correlation between superoxide production and episodes of acute tonsillitis, serum C-reactive protein levels, or peripheral white blood cell count . However, the superoxide production by PMNs was inversely correlated with serum anti-streptolysin-O titers (r = -.38, p = .008) . Furthermore, the mean +/- SD superoxide levels produced by PMNs from patients with high serum ASO titers (> 71 U/ml), 69.58 +/- 30.56 nM/10(6) cells, was significantly lower than that of patients with low serum ASO titers (< 71 U/ml), 89.83 +/- 38.90 nM/10(6) cells (p = 0.037), and that of healthy adult controls, 102.27 +/- 44.67 nM/10(6) cells (p = 0.012) . In addition, the effect of Streptococcus pyogenes on superoxide production by PMNs was studied in vitro . Superoxide production by PMNs preincubated with 600 micrograms/ml culture supernatant of Streptococcus pyogenes T4 (not detected) and T12 (34.82 +/- 31.40 nM/10(6) cells) was significantly lower than that of PMNs preincubated with culture medium (136.09 +/- 70.41 nM/10(6) cells; p < 0.05, each) . Inhibition of superoxide production by PMNs by preincubation with culture supernatant of Streptococcus was increased by the protein in the culture supernatant in a concentration-dependent manner . These findings suggest that frequent and/or persistent streptococcal infections may reduce the superoxide production by PMNs, leading to recurrent episodes of tonsillitis.

Nippon Rinsho, 1994 Dec, 52(12), 3309 - 18
{Toxic shock like syndrome due to S . pyogenes (TSLS)}; Murai T; Resurgence of severe infection, caused by Streptococcus pyogenes was observed in the USA from the middle of the 1980s . Toxic Shock like Syndrome due to Streptococcus pyogenes (TSLS) has been one of the most life-threatening diseases with soft tissue infections, such as necrotizing fasciitis, myositis, bacteremia and shock . Patients with TSLS has been reported in Europe, USA, Canada, etc . The first report of TSLS in Japan was described by Y . Shimizu and his colleague, Asahi General Hospital, Chiba, 1992 . Since then more cases of TSLS, diagnosed by CDC's Criteria, have been found in various parts of Japan, including Chiba prefecture . They are characterised by rapid development of shock and death . Some of the isolated strains from blood or tissues have been identified as S . pyogenes, M3, M1 with SPEA (Streptococcal pyrogenic exotoxin A).

J Antibiot (Tokyo), 1994 Dec, 47(12), 1493 - 506
Amides of de-acetylglucosaminyl-deoxy teicoplanin active against highly glycopeptide-resistant enterococci . Synthesis and antibacterial activity; Malabarba A et al.; Removal, by selective reduction, of the acetylglucosamine from teicoplanin A2-2 (CTA/2) produced the 34-de(acetylglucosaminyl)-34-deoxy pseudoaglycone (II) . This compound was more active in vitro than CTA/2 against coagulase-negative staphylococci (CNS) . Amide derivatives obtained by condensation of the carboxyl group of II with primary amines were particularly active against Streptococcus pyogenes and had some in vitro activity against VanA enterococci highly resistant to both teicoplanin and vancomycin . Among them, a carboxamide (VII) with a branched tetramine also had better activity than the corresponding amide of teicoplanin against CNS . In contrast, the dimethylamide (VIII) of II had little activity against VanA enterococci . While the overall structure of the heptapeptide backbone of the secondary carboxamides of II is the same as in CTA/2 and its amide derivatives, in deoxy pseudoaglycone II and its tertiary amide VIII the 51,52-peptide bond undergoes a conformational change from the original cisoid to the transoid orientation . This difference between the secondary amides of II and dimethylamide VIII is reflected in their different antibacterial spectrum . The direct synthesis of the amides of deoxy pseudoaglycone II from parent CTA/2-amides by reaction with sodium borohydride is also described.

Acta Orthop Scand, 1994 Dec, 65(6), 625 - 8
Soft tissue infections from drug abuse . A clinical and microbiological review of 145 cases; Henriksen BM et al.; We evaluated clinical and microbiological aspects in 145 hospitalizations of 89 intravenous drug abusers with acute soft tissue infections at the injection site . There were 58 superficial abscesses, 27 deep abscesses, 57 cellulitis with or without concomitant ulcer, 1 purulent arthritis, 1 tenosynovitis and 1 incompletely categorized abscess . The commonest location was the groin . Serious complications occurred in 17 cases, including 4 lower-extremity amputations due to arterial lesions . There was a predominance of polybacterial infections (53 percent polybacterial, 38 percent monobacterial, 9 percent sterile) . The commonest bacteria isolates were Streptococcus species with a preponderance of oropharyngeal bacteria, Staphylococcus aureus, and anaerobes, especially Bacteroides species . Typical intestinal bacteria were rare . In addition to surgical treatment we recommend that aerobic and anaerobic culturing with susceptibility tests always are carried out, that primary antibacterial therapy should consist of an antistaphylococcal agent, such as dicloxacillin plus metronidazole, and that free injection paraphernalia with disinfection swabs are easily available.

J Endod, 1994 Dec, 20(12), 595 - 7
A comparison of the apical seals achieved using retrograde amalgam fillings and the Nd:YAG laser; Wong WS et al.; The purpose of this in vitro study was to compare the apical seals achieved using retrograde amalgam fillings or the Nd:YAG laser . Freshly extracted teeth were randomly separated into groups that would have their apices treated either with a Nd:YAG laser or retrograde amalgam . After instrumentation and obturation, bacterial reservoirs were prepared in the coronal portion of canals . Teeth to receive retrofillings had their apices prepared and amalgams placed . Teeth to be lasered had no apical preparations . Teeth and culture media were then sterilized by irradiation . Streptococcus salivarius was deposited in the opened bacterial reservoirs . At intervals, culture media with an indicator in culture chambers was observed for color change . Specimens that demonstrated color change were cultured for S . salivarius . Under the conditions of this in vitro study, no statistically significant difference was found in bacterial leakage between the laser-treated group and the retrograde amalgam group.

Microb Pathog, 1994 Dec, 17(6), 361 - 74
Receptor specificity of adherence of Streptococcus pneumoniae to human type-II pneumocytes and vascular endothelial cells in vitro; Cundell DR et al.; The adherence of S . pneumoniae to human type-II pneumocytes and endothelial cells (EC) is critical to the pathogenesis of pneumococcal pneumonia and bacteremia . We established that the preferred target cell to which pneumococci adhere in the lung is the type-II lung cell (LC) and have developed an in vitro adherence assay to determine the molecular details of this interaction . Pneumococcal receptors on cultured human LC and EC appeared to be glycoproteins since treatment of the monolayers with tunicamycin significantly impaired bacterial adherence . Inhibition of adherence to LC and EC occurred following incubation with several carbohydrates including GalNAc, mannose and GalNAc beta-4Gal- and GalNAc beta 1-3Gal-containing glycoconjugates . Pneumococci could bind directly to these immobilized sugars and their addition to adherent pneumococci could elute the bacteria from LC and EC . Combinations of glycoconjugates indicated that two independent classes of pneumococcal receptor existed on both cell types . These were defined by the minimal receptor units GalNAc beta 1-4Gal and GalNAc beta 1-3Gal which participate in pneumococcal cell wall and protein-dependent mechanisms of adherence, respectively.

An Med Interna, 1994 Dec, 11(12), 595 - 7
{Neck pyomyositis associated with polymicrobial sepsis of sinusal origin}; Toral Revuelta JR et al.; Spontaneous pyomyositis (primary pyomyositis) is an infrequent disease in non-tropical countries, caused by bacterial infection of skeletal muscle . Although pyomyositis is associated in many cases to septicemia, the occurrence of that disease as a secondary manifestation of bacteremia is very unusual, requiring a high-grade index of suspicion to diagnose it in the early stages . We present one case of cervical pyomyositis, caused by Fusobacterium necrophorum and group F streptococcus, during the course of a sepsis of sinusal origin, that was treated without surgical therapy . This so uncommon form of presentation of Fusobacterium septicemia, its diagnosis and treatment are discussed.

Hepatogastroenterology, 1994 Dec, 41(6), 568 - 70
OK-432 chemical pleurodesis for the treatment of persistent chylothorax; Nakano A et al.; A 52-year-old woman with thoracic esophageal carcinoma was admitted to our hospital . Standard radical esophagectomy was carried out via a right posterolateral thoracotomy and laparotomy . A drainage tube was removed from the right side of the chest on the 9th postoperative day . Three days later a chest roentgenogram showed massive left pleural effusion, and a tube was inserted into the left pleural cavity . The volume of the effusion was 900 ml/day and chylothorax was diagnosed . Conservative therapy was applied for 30 days, but chyle leakage persisted . Intra-pleural infusion of OK-432, a Su-strain of Streptococcus pyogenes, and doxycycline hydrochloride was carried out to seal the leakage point . The effusion stopped immediately after the procedure . There were no major side effects . This procedure should be considered the treatment of choice for patients with persistent chylothorax not responding to initial conservative management.

Arch Oral Biol, 1994 Dec, 39(12), 1063 - 9
The effect of milk and casein proteins on the adherence of Streptococcus mutans to saliva-coated hydroxyapatite; Vacca-Smith AM et al.; Experiments sought to determine the nature of the binding of milk proteins to hydroxyapatite (HA) and to saliva-coated hydroxyapatite (sHA), and to determine the effect of milk and casein on the adherence of Streptococcus mutans GS-5 to sHA . The binding of radiolabelled alpha-casein to HA was reduced when incubated simultaneously with parotid saliva, and enhanced in the presence of milk . The binding of beta- and kappa-casein to HA was unaffected by the presence of parotid saliva and enhanced by the presence of milk . The in vitro bacterial adherence of Strep . mutans GS-5 to sHA beads was reduced when beads were coated with milk instead of buffer, or when bacteria were added to sHA in the presence of milk instead of buffer . Casein proteins (alpha, beta, kappa) added to sHA simultaneously with bacteria inhibited the adherence of Strep . mutans GS-5 to sHA . kappa-Casein, when bound to sHA, inhibited streptococcal adherence to sHA; alpha- and beta-casein, when bound to sHA, had no effect on streptococcal adherence . Fractionation of kappa-casein by anion-exchange chromatography revealed the anti-adherence activity of kappa-casein was mediated primarily by a 40,000 mol . wt . glycoprotein-containing fraction . These data show that milk, particularly kappa-casein fractions, can modulate the adherence of Strep . mutans GS-5 to SHA surfaces in vitro.

Clin Investig, 1994 Dec, 72(12), 1037 - 40
Pneumococcal parotitis and cervical lymph node abscesses in an HIV-infected patient; Stellbrink HJ et al.; The case of a 33-year-old patient with rapid onset of bilateral parotid gland and lymph node abscesses is described . The patient was positive for human immunodeficiency virus 1 and presented with a history of interstitial lymphocytic pneumonia and pneumococcal meningitis prior to admission . The patient received cotrimoxazole as primary prophylaxis against Pneumocystis carinii pneumonia . Fine needle aspiration from the abscesses yielded Streptococcus pneumoniae . Penicillin G treatment in combination with surgical drainage of the lesions led to healing with minimal residual lymph node enlargement . No relapse was noted until 12 months after presentation.

Antimicrob Agents Chemother, 1994 Dec, 38(12), 2730 - 7
Pharmacokinetic and pharmacodynamic activities of ciprofloxacin against strains of Streptococcus pneumoniae, Staphylococcus aureus, and Pseudomonas aeruginosa for which MICs are similar; Hyatt JM et al.; The serum bactericidal activity of ciprofloxacin against strains of Streptococcus pneumoniae, Staphylococcus aureus, and Pseudomonas aeruginosa for which MICs are similar (0.4 microgram/ml) was assessed with serum ultrafiltrates from five healthy volunteers receiving ciprofloxacin at 400 mg intravenously every 8 h . In addition, human serum was supplemented with ciprofloxacin to achieve a mean steady-state concentration (Css) that might be achieved in patients with renal failure, with total clearances of 3 to 4 liters/h (elimination rate constant, 0.08 h-1) . The area under the inhibitory titer curve from 0 to 24 h (AUIC24) and the area under the bactericidal titer curve from 0 to 24 h (AUBC24) were both measured and predicted as the area under the concentration-time curve from 0 to 24 h (AUC24)/MIC and AUC24/MBC, respectively . We previously demonstrated that a breakpoint AUC24/MIC of 125 for ciprofloxacin had a significantly higher probability of treatment success than lower values, with 250 to 500 being optimal . Volunteer sera (mean Css, 1.55 to 2.48 micrograms/ml) achieved AUC24/MICs of 90 to 145 . Supplemented serum (mean Css, 6.00 to 7.42 micrograms/ml) achieved AUC24/MICs of 350 to 450 . Correlation coefficients for measured and predicted values of AUC24/MIC and AUC24/MBC were 0.826 and 0.941, respectively . The mean percent errors were not significantly different from zero for either AUIC24 or AUBC24 values (P > 0.1, P > 0.4) . Time-kill curve studies were performed with low (1.55 to 2.48 micrograms/ml), intermediate (6.00 to 7.42 micrograms/ml), and high (15 to 25 micrograms/ml) concentrations of ciprofloxacin for the three organisms . At low concentrations (3 to 6 times the MIC) AUC24/MICs were <125 for two of five volunteers and the killing rates were considerably more rapid for P . aeruginosa than for S . pneumoniae or S.aureus . Intermediate concentrations (15 to 18 times the MIC) achieved optimal AUC24/MICs, and the killing rates were similar for the three organisms . A paradoxical decrease in the killing rate was seen at high concentrations (35 to 60 times the MIC) . At clinically achievable concentrations, ciprofloxacin killed P . aeruginosa more rapidly than it did either S . pneumoniae or S . aureus.

Southeast Asian J Trop Med Public Health, 1994 Dec, 25(4), 664 - 71
Risk factors of streptococcal colonization in school age children; Likitnukul S et al.; We studied the factors influencing the colonization of Streptococcus in school age children aged 6-11 years from 2 low socioeconomic schools of the Bangkok Metropolitan area . 4,055 throat swab cultures were performed . Beta hemolytic Streptococcus (BHS) and beta hemolytic Streptococcus group A (BHSA) were isolated in 1,747 (43%) and 744 (18%) respectively . 1,547 questionnaires were returned from the children . Of these, 750 and 570 were found to have BHS and BHSA in the throat, respectively . Among the risk factors, considered, teeth brushing of one time or none per day was significant for BHS positive in the throat as compared with the BHS negative group, while personal hygiene such as sharing glass with other, playing in dirty water, poor housing sanitation and low family income was significantly associated with the BHSA positive group . With the combination of certain clinical manifestations, these factors may increase the accuracy of predicting streptococcal infection.

Rev Med Chil, 1994 Dec, 122(12), 1385 - 92
{Streptococcus pneumoniae septicemia . Analysis of 40 cases}; Noriega LM et al.; Sepsis due to Streptococcus pneumoniae has a high mortality . We report a retrospective review of 40 episodes of S pneumonia sepsis in adult patients during a two year period in a general hospital, that represented 11.3% of all sepsis observed in such hospital . Ninety two percent of infections were community acquired and in 95%, the portal of entry was the respiratory tract . Eighty five percent of patients had at least one risk factor such as alcohol abuse, unconsciousness or chronic pulmonary disease . Nine patients had suppurative complications (empyema in 4 cases, spontaneous bacterial peritonitis in 2, septic arthritis in 2 and meningitis in 1 case) and 12 (30%) died . The potential benefit of antipneumococcal vaccine as prevention should be considered in high risk subjects.

Zentralbl Veterinarmed B, 1994 Dec, 41(10), 685 - 8
Susceptibility of Streptococcus suis to various antimicrobial agents; Tarradas MC et al.; A study was performed to determine the susceptibility of 59 S . suis strains, isolated from sick and healthy carrier swine, to a range of antimicrobial agents . The beta-lactamic group proved more active both in Kirby-Bauer and MCI tests . Trimethoprim-sulfamethoxazole emerged as an alternative drug in chemoprevention and treatment of S . suis infections.

Pulm Pharmacol, 1994 Dec, 7(6), 377 - 81
Pulmonary penetration of dirithromycin in patients suffering from acute exacerbation of chronic bronchitis; Cazzola M et al.; The aim of this study was to evaluate the concentrations of dirithromycin, a new macrolide antibiotic, in bronchial secretions (BS), bronchial mucosa (BM), epithelial lining fluid (ELF) and serum in 25 patients with acute exacerbation of chronic bronchitis after a 5-day, once-daily, dirithromycin regimen . All patients received dirithromycin, 500 mg (two 250 mg tablets) given orally once daily at 08.00 fasted, for 5 consecutive days . They were divided into five groups (n = 5 in each group) according to sampling time (24, 48, 72, 96 and 120 h, after the last dose) . Mean serum concentrations remained low throughout the study (0.44 microgram/ml at 24 h, 0.31 microgram/ml at 48 h, 0.33 microgram/ml at 72 h, 0.12 microgram/ml at 96 h and 0.11 microgram/ml at 120 h, respectively), although they were higher than the MICs for Moraxella catarrhalis for up to 72 h and than that for Streptococcus pneumoniae for up to 120 h after the last dose . By contrast, in all other samples, mean concentrations were higher than the MICs for many relevant respiratory pathogens for at least 3 days, and higher than that for S . pneumonia and M . catarrhalis for up to 120 h (mean concentrations measured 2.67, 2.15, 1.74, 0.27 and 0.17 micrograms/ml, respectively, in BS; 2.59, 2.59, 1.96, 0.41 and 0.27 micrograms/g, respectively, in BM; 2.21, 2.25, 1.57, 0.22 and 0.15 micrograms/ml, respectively, in ELF) . These findings demonstrate that dirithromycin is concentrated in each of these potential sites of infection for up to 3 days after a 5-day course of therapy . Therefore, short-term therapy with dirithromycin may be useful for many respiratory infections.

Pediatr Res, 1994 Dec, 36(6), 776 - 83
Effect of nitric oxide synthase inhibition during group B streptococcal sepsis in neonatal piglets; Gibson RL et al.; Nitric oxide (NO), an important vasodilatory modulator of systemic and pulmonary vascular tone, is synthesized from L-arginine by the enzyme NO synthase in vascular endothelial and smooth muscle cells . L-Arginine analogs, such as N omega-nitro-L-arginine methyl ester (L-NAME), are competitive antagonists of NO synthase and inhibit NO synthesis . Group B streptococcus (GBS) causes pulmonary hypertension, hypoxemia, lung vascular injury, and reduced cardiac output in both human newborns and neonatal piglets . Lung vascular injury associated with prolonged GBS infusion in piglets may attenuate NO production and thus promote severe pulmonary hypertension . We studied the effect of the NOS inhibitor, L-NAME and the precursor of NO, L-arginine, on pulmonary and systemic hemodynamics during late-phase GBS sepsis in the piglet model . Neonatal piglets were anesthetized, ventilated with room air, and randomized to receive a continuous infusion of saline (n = 5) or GBS (n = 5) for 4 h . After 3 h of infusion, both groups received a bolus of L-NAME (3 mg/kg) . Hemodynamic and gas exchange indices were measured at baseline, 30 min, and 3 h of infusion, and 30 min and 1 h after L-NAME treatment . L-NAME treatment caused 1) significant increases in mean pulmonary arterial pressure, pulmonary vascular resistance, mean systemic arterial pressure, and systemic vascular resistance for both groups; 2) a similar percentage of increase in pulmonary vascular resistance for the two groups; 3) greater reduction in cardiac output and SV in the GBS compared with the control group; and 4) no significant alterations in arterial partial pressure of oxygen or the difference between alveolar and arterial partial pressure of oxygen for either group.(ABSTRACT TRUNCATED AT 250 WORDS)

J Clin Microbiol, 1994 Dec, 32(12), 3046 - 8
Heterogeneity of rRNA gene restriction patterns of multiresistant serotype 6B Streptococcus pneumoniae strains; Harakeh H et al.; Three multiresistant serotype 6B Streptococcus pneumoniae strains were isolated from the middle ear fluids of children undergoing tympanostomy in Atlanta . Because multiresistant 6B pneumococci have been reported to spread from a single clone, the three isolates were compared with 13 other multiresistant 6B pneumococci by hybridization of endonuclease-restricted DNA fragments with a digoxigenin-labeled cDNA probe complementary to 16 and 23S rRNAs (ribotyping) . The ear isolates were heterogeneous, whereas six of the other pneumococcal isolates were alike, indicating a need for additional studies to determine the possibility of clonal spread.

J Clin Microbiol, 1994 Dec, 32(12), 2953 - 8
rRNA gene restriction patterns of Streptococcus pyogenes: epidemiological applications and relation to serotypes; Bruneau S et al.; The use of rRNA gene restriction fragment length polymorphism analysis (ribotyping) to subtype Streptococcus pyogenes strains was investigated . Sixty-eight S . pyogenes strains, including 17 reference strains and 51 isolates from blood, acute or chronic pharyngitis, and food-borne outbreaks, were characterized by determination of both their rDNA restriction fragment length polymorphism profiles and their serotypes (T and M) . Total DNA was cleaved with five selected restriction enzymes and then probed with a digoxigenin-labeled stretch of 1,063 bp hybridizing with 16S rRNA genes . Fifteen and nine distinct patterns were generated with SacI and XhoI, respectively, and five patterns were generated with each of the three additional restriction enzymes . With the combination SacI-XhoI, a total of 21 distinct ribotypes were obtained among the 68 isolates . This number was not increased by the results obtained with the other restriction enzymes . All strains tested were typeable . All isolates from each food-borne outbreak belonged to the same ribotype, and all isolates (pre- and posttreatment) from each child with chronic pharyngitis also belonged to the same ribotype, suggesting antibiotic treatment failures . A discriminatory index was calculated for the 47 isolates which were epidemiologically unrelated, using the Hunter-Gaston formula . This index reached 0.955 when the combination SacI-XhoI was used, showing the good discriminatory power of this typing method . Therefore, ribotyping proved to be a molecular method of interest to subtype S . pyogenes . Moreover, there was some correlation between ribotyping and serotyping, as several ribotypes were related to a unique distinct M serotype.

Onderstepoort J Vet Res, 1994 Dec, 61(4), 341 - 9
A rapid method to quantify bacterial contamination on hatching eggs . 1 . Correlation of optical density with initial bacterial count; Pienaar AC et al.; The use of optical-density (OD) readings after a 6-h incubation period, as a suitable method to quantify the bacterial contamination on hatching eggs, was established by the use of pure cultures of five bacterial isolates found to be the most prevalent on the hatching eggs examined . These isolates were identified as Micrococcus luteus, Staphylococcus gallinarum, Streptococcus epidermidis, Pseudomonas cepacei and Bacillus cereus . It was established that the OD reading was repeatable when the same inoculum was used to inoculate five different cultures, which were incubated for 6 h at 37 degrees C . This repeatability was not affected by bacterial isolate, or bacterial concentration of the inoculum, or when mixed bacterial cultures were used . A direct relationship was established between the OD reading (at 540 nm) after 6 h and the log of the bacterial concentration at the start of incubation . The OD reading after 6 h of incubation is a repeatable, rapid and simple method to quantify the bacterial concentration at the start of the incubation period.

J Mol Biol, 1994 Nov 11, 243(5), 906 - 18
The third IgG-binding domain from streptococcal protein G . An analysis by X-ray crystallography of the structure alone and in a complex with Fab; Derrick JP et al.; Protein G is a cell surface-associated protein from Streptococcus that binds to IgG with high affinity . We have determined the X-ray crystal structures of the third IgG-binding domain (domain III) alone to a resolution of 1.1 A (final R-factor of 19.3%), and in complex with an Fab fragment to 2.6 A (final R-factor of 16.8%) . The structure of domain III is similar to the lower-resolution crystal structures of protein G domains determined previously by other investigators, but shows some minor differences when compared with the equivalent NMR structures . Domain III binds to the immunoglobulin by formation of an antiparallel interaction between the second beta-strand in domain III and the last beta-strand in the CH 1 domain . There is also a minor site of interaction between the C-terminal end of the alpha-helix in protein G and the first beta-strand in the CH 1 domain . Previous studies by NMR on the interactions between protein G and IgG have concluded that different portions of the protein G domain are involved in binding to the Fab and Fc portions . The results presented here support these findings and permit a detailed analysis of the recognition of Fab by protein G; formation of the complex buries a large water-accessible area, of a magnitude comparable with that found in antibody/antigen interactions . The majority of hydrogen bonds between the two proteins involve main-chain atoms from the CH 1 domain . The CH 1 domain residues that are in contact with protein G are shown to be highly conserved in alignments of mouse and human gamma chain amino acid sequences . We conclude that the binding site for protein G on Fab is relatively invariant across different species and gamma chain subclasses, providing an explanation for the widespread recognition of Fab fragments from mouse and human antibodies by protein G . The solution of the crystal structures of domain III alone and bound to Fab has demonstrated that there is no major structural change apparent in either protein on formation of the complex.

J Biol Chem, 1994 Nov 4, 269(44), 27466 - 72
Oligosaccharide-receptor interaction of the Gal alpha 1-4Gal binding adhesin of Streptococcus suis . Combining site architecture and characterization of two variant adhesin specificities; Haataja S et al.; The sugar binding specificities of two groups of Streptococcus suis, a pig pathogen that causes meningitis also in man, were determined . Both the group represented by a recently characterized strain inhibitable by galactose and N-acetylgalactosamine (type PN) and the group inhibitable by galactose (type PO) were found by hemagglutination and solid-phase binding inhibition experiments to recognize the disaccharide Gal alpha 1-4Gal of the P1 and Pk blood group antigens . Both types preferred the disaccharide in terminal position . PN showed some, whereas PO showed almost no, binding to the globoside oligosaccharide containing an additional GalNAc beta 1-3 residue . The complete hydrogen bonding patterns were determined by using deoxy and other synthetic derivatives of the receptor disaccharide, and the constructed models of the interactions were compared with that of Escherichia coli PapG396 adhesin . The essential hydroxyls for binding were the HO-4', HO-6', HO-2, and HO-3 hydroxyls on the beta' alpha-side of the Gal alpha 1-4Gal molecule . Type PO adhesin also formed weak interactions with the hydroxyls HO-6 and HO-3' . The mechanism differed from that of E . coli, which binds to a cluster of five hydroxyls (HO-6, HO-2', HO-3', HO-4', and HO-6') and thus to a different part of the receptor disaccharide . These results represent the first example of the comparison of the saccharide receptor hydrogen bonding patterns of two bacterial organisms of different origin and show that the same saccharide may be recognized by two different binding mechanisms.

Clin Diagn Lab Immunol, 1994 Nov, 1(6), 667 - 9
Placental transfer of immunoglobulin G subclasses; Garty BZ et al.; The concentrations in cord blood of total immunoglobulin G (IgG) and the four subclasses of IgG were measured in 34 fetuses at a mean gestational age of 25 weeks (range, 18 to 35 weeks) . The blood samples were obtained by percutaneous umbilical blood sampling, and results were compared with the respective IgG subclass concentrations of the mothers . The efficiency of transplacental transfer of the different IgG subclasses was determined . Transfer of IgG1 and IgG4 was found to be significantly more efficient than that of IgG3 and IgG2 . IgG2 was the subclass least efficiently transferred from mother to fetus . These differences may partly explain the susceptibility of newborns to various pathogens, such as streptococcus group B.

Australas Radiol, 1994 Nov, 38(4), 310 - 2
Leaking mycotic abdominal aortic aneurysm; Sing TM et al.; A case of leaking mycotic abdominal aortic aneurysm is reported, with a brief review of the literature . A 58 year old female presented with shoulder and abdominal pain associated with diarrhoea, vomiting and fever with leucocytosis . Computed tomography of the abdomen showed pooling of contrast in the retroperitoneum anterior to a non-dilated abdominal aorta . There was considerable retroperitoneal blood accumulating in a mass-like lesion in the right lower abdomen and pelvis obstructing the right renal collecting system . Laparotomy revealed a 4 cm diameter saccular aneurysm of the abdominal aorta, with a 1 cm diameter neck . Culture of the thrombus grew Streptococcus pyogenes.

FEMS Microbiol Lett, 1994 Nov 1, 123(3), 349 - 54
Analysis of a primer-independent GTF-I from Streptococcus salivarius; Banas JA et al.; A glucosyltransferase (GTF) gene, designated gtfL, from Streptococcus salivarius was cloned and expressed in Escherichia coli and its nucleotide sequence determined . The GTF-L enzyme catalysed the synthesis of water-insoluble glucan in a primer-independent manner . The nucleotide sequence and derived amino acid sequence of GTF-L were similar in size and domain structure to previously sequenced glucosyltransferases . However, a 464-bp region of high variability was identified which could be selectively amplified from strains of S . salivarius by the polymerase chain reaction and could therefore form the basis for species identification . No sequence-specific motifs related to the solubility and linkage of the glucan product or its need for a dextran primer could be ascertained.

FEMS Microbiol Lett, 1994 Nov 1, 123(3), 331 - 4
Fluoride inhibits the glucan-binding lectin of Streptococcus sobrinus; Cox SD et al.; The glucan-binding lectins of Streptococcus cricetus AHT and Streptococcus sobrinus 6715 were reversibly inhibited by sodium fluoride . Fluoride was superior to chloride, bromide, iodide and thiocyanate in preventing glucan-mediated aggregation of the bacteria . Fluoride was also an effective inhibitor of the sucrose-dependent adhesion of S . sobrinus to glass surfaces . The inhibition of glucan-binding lectin activities may be one of the mechanisms of action of fluoride in preventing dental disease.

Circulation, 1994 Nov, 90(5), 2525 - 8
Endocarditis risk of the USCI PDA umbrella for transcatheter closure of patent ductus arteriosus; Latson LA et al.; BACKGROUND--The USCI PDA Umbrella is a device to close patent ductus arteriosus (PDA) by a transcatheter technique . Human clinical trials have shown excellent efficacy in reducing or eliminating the PDA shunt, but concerns remain about the risk of infection with this device . The purpose of this study was to evaluate the risk of infection using an animal model . METHODS AND RESULTS--Susceptibility to developing endocarditis was tested by injecting a single intravenous dose of group L streptococcus . Ten piglets with a closed ductus served as controls . Two of these developed valvular vegetations . PDA was produced in 19 animals by balloon dilation of the ductus . Seven of 7 animals with PDA at the time of bacterial injection developed endarteritis of the ductus and valvular vegetations . A PDA Umbrella was placed in the remaining 12 animals, and bacteria were injected 2 weeks after device implantation . Infection was evident in the PDA Umbrella only in the single animal in which the Umbrella had embolized and been left in the left pulmonary artery . Three of the remaining 11 piglets had a significant residual leak, and all developed infection in the ductus and an additional valve . Similar to the control group, none of the animals with complete (n = 8) or nearly complete (n = 2) closure of the ductus by the PDA Umbrella had infection in or around the ductus, and only 1 had a valvular vegetation . CONCLUSIONS--In this animal model, presence of a significant PDA shunt (with or without a PDA Umbrella present) results in significantly increased susceptibility to endarteritis and endocarditis . The PDA Umbrella device does not appear to be susceptible to direct infection as early as 2 weeks after implantation if it is properly located in the ductus arteriosus . Animals with no shunt or a trivial shunt are no more susceptible to developing endocarditis 2 weeks after PDA Umbrella implantation than are controls.

Clin Infect Dis, 1994 Nov, 19(5), 884 - 90
Predictive factors for invasive disease due to penicillin-resistant Streptococcus pneumoniae: a population-based study; Nava JM et al.; A prospective population-based study was carried out to determine predictive factors associated with penicillin-resistant pneumococcal invasive disease . A total of 374 patients (250 males and 124 females; mean age, 50.3 +/- 27 years) with invasive pneumococcal infection were admitted to one of the five hospitals in El Valles County (an industrial area with 800,000 inhabitants in the province of Barcelona, Spain) over a period of 5 years . Of the 374 episodes, 21 (5.6%) were due to highly penicillin-resistant pneumococci and 67 (17.9%) to intermediately penicillin-resistant pneumococci . Multivariate analysis showed a statistically significant association between infection with intermediately penicillin-resistant pneumococci and an age of 0-4 years (odds ratio {OR} = 5.3; 95% confidence interval {CI} = 2.2-12.6), the presence of an immunosuppressive underlying disease (OR = 3.0; 95% CI = 1.5-6.0), and the previous use of beta-lactam antibiotics (OR = 2.1; 95% CI = 1.0-4.5) . Infection with highly penicillin-resistant pneumococci was associated only with the previous use of beta-lactam antibiotics (OR = 5.9; 95% 95% CI = 2.2-15.8) . Highly resistant strains were of serotypes 6, 9, 14, 15, 19, and 23, of which all but serotypes 9 and 15 are included in the newly formulated conjugated vaccine.

Mol Microbiol, 1994 Nov, 14(4), 773 - 83
Multiple roles for DNA polymerase I in establishment and replication of the promiscuous plasmid pLS1; Diaz A et al.; The polymerase activity of DNA polymerase I is important for the establishment of the pLS1 replicon by reconstitutive assembly in Streptococcus pneumoniae after uptake of exogenous pLS1 plasmid DNA . In polA mutants lacking the polymerase domain, such establishment was reduced at least 10-fold in frequency . Chromosomally facilitated establishment of pLS1-based plasmids carrying DNA homologous to the host chromosome was not so affected . However, both types of plasmid transfer gave mostly small colonies on initial selection, which was indicative of a defect in replication and filling of the plasmid pool . Once established, the pLS1-based plasmids replicated in polA mutants, but they showed segregational instability . This defect was not observed in strains with the wild-type enzyme or in an S . pneumoniae strain that encodes the polymerase and exonuclease domains of the enzyme on separate fragments . The role of DNA polymerase I in stably maintaining the plasmids depends on its polymerizing function in three separate steps of rolling-circle replication, as indicated by the accumulation of different replication intermediate forms in polA mutants . Furthermore, examination of the segregational stability of the pLS1 replicon in an Escherichia coli mutant system indicated that both the polymerase and the 5'-to-3' exonuclease activities of DNA polymerase I function in plasmid replication.

Vaccine, 1994 Nov, 12(15), 1419 - 22
Adjuvant Quil A improves protection in mice and enhances opsonic capacity of antisera induced by pneumococcal polysaccharide conjugate vaccines; DeVelasco EA et al.; The adjuvant effect of Quil A on the primary antibody response of mice to pneumococcal capsular polysaccharide conjugates was examined . Quil A increased the anti-capsular polysaccharide antibody titres, the protection against Streptococcus pneumoniae, and the opsonic capacity of the antibodies as measured in a newly developed in vitro phagocytosis assay, using the mouse macrophage cell line J774.

Vet Microbiol, 1994 Nov, 42(2-3), 111 - 9
Immunity in pigeons against homologous and heterologous serotypes of Streptococcus bovis after infection; De Herdt P et al.; Groups of 20, 20 and 10 pigeons were intravenously inoculated with 1 x 10(9) CFU of a Streptococcus bovis serotype 1, 2 and 3 strain, respectively . Groups which received the highly virulent serotypes 1 or 2 strains were treated with antibiotics starting from 2 days post inoculation in order to prevent the development of clinical signs . Pigeons inoculated with the low virulence S . bovis serotype 3 strain were left untreated . Another group of 10 non-inoculated pigeons was used as challenge control . Four weeks later, pigeons were challenged intravenously with S . bovis serotype 1 . Morbidity after challenge infection was 19%, 36% and 70% in groups previously inoculated with serotypes 1, 2 and 3, respectively, whereas it was 100% in the control group . Results demonstrate that pigeons developed significant protective immunity to S . bovis serotype 1 septicaemia following infection with S . bovis serotype 1 and 2 strains but not after infection with the serotype 3 strain . Protection did not correlate with the presence of antibodies as detected in ELISA.

Acta Otolaryngol, 1994 Nov, 114(6), 620 - 5
Cochlear implantation in children: labyrinthitis following pneumococcal otitis media in unimplanted and implanted cat cochleas; Dahm MC et al.; Pneumococcal otitis media is frequent in young children and could lead to labyrinthitis post-implantation . To assess the risk, and methods of minimizing it by a graft to the round window around the electrode entry point, we have used a cat animal model of pneumococcal otitis media . Twenty-one kittens were used in the study . Thirty-two cochleas were implanted when the kittens were 2 months of age . Fourteen cochleas were implanted without using a graft (12 were available for study); 9 had a fascial graft, and 9 a Gelfoam graft (7 were available for study) . The implanted kittens had their bullae inoculated with Streptococcus pneumoniae 2 months after implantation and were sacrificed 1 week later . There were also 9 unimplanted control ears which were inoculated when the animals were 4 months of age . Labyrinthitis occurred in 44% of unimplanted control, 50% of implanted ungrafted, and 6% of implanted grafted (fascia and Gelfoam) cochleas . There was no statistically significant difference between the unimplanted control and the implanted cochleas (p < 0.05) . There was, however, a difference between the implanted-ungrafted and implanted grafted cochleas, but not between the use of fascia and Gelfoam to graft the round window entry point . As a result, the data indicates that cochlear implantation does not increase the risk of labyrinthitis following pneumococcal otitis media, but it is desirable to use fascia as a graft to the round window around the electrode entry point.

J Perinatol, 1994 Nov-Dec, 14(6), 473 - 8
Streptococcus mitis infection in newborns; Adams JT et al.; Although neonatal infections caused by Streptococcus viridans have been suggested to be less severe than those caused by classic neonatal pathogens, little is known about neonatal infections caused by specific species within this group of bacteria . We report six infants who had S . mitis isolated from blood culture . All were infected at < or = 3 days of age; five of the mothers had perinatal risk factors for neonatal sepsis . Five infants were preterm and three had birth weights < or = 2500 gm . Hematologic abnormalities were common . Two died as a result of the infection . Antibiotic susceptibility testing of four isolates revealed resistance to penicillin and ampicillin in three and resistance to gentamicin in two . In vivo resistance was not observed . S . mitis is not part of normal skin flora, should not be assumed to be a contaminant, and can cause severe neonatal disease . If S . mitis or S . viridans are recovered from a normally sterile body site and the patient fails to improve with penicillin therapy, it seems prudent to switch to vancomycin until susceptibility results are available.

Diagn Microbiol Infect Dis, 1994 Nov, 20(3), 175 - 9
In vitro activity of FK-037 . A parenteral cephalosporin; Segreti J et al.; The in vitro activity of FK-037, a new extended spectrum cephalosporin, was determined against 398 recent clinical isolates consisting of ceftazidime-susceptible and -resistant, aerobic Gram-negative rods, penicillin-susceptible and resistant Streptococcus pneumoniae, methicillin-resistant Staphylococcus aureus, methicillin-susceptible S . aureus, methicillin-susceptible coagulase-negative staphylococci, and methicillin-resistant coagulase-negative staphylococci . Comparative drugs included ceftazidime, imipenem, and amikacin . Susceptibility testing was performed using a broth microdilution method . FK-037 showed greater activity than ceftazidime against ceftazidime-susceptible, aerobic Gram-negative rods . FK-037 showed enhanced activity compared with ceftazidime against Gram-positive organisms, including penicillin-resistant S . pneumoniae . Mutational frequencies for representative Gram-negative rods were comparable for FK-037 and ceftazidime.

Antimicrob Agents Chemother, 1994 Nov, 38(11), 2655 - 9
In vitro killing activities of antibiotics at clinically achievable concentrations in cerebrospinal fluid against penicillin-resistant Streptococcus pneumoniae isolated from children with meningitis; Doit CP et al.; We evaluated the in vitro killing activities of ceftriaxone, imipenem, vancomycin, gentamicin, fosfomycin, and rifampin, alone and in combination, against 26 Streptococcus pneumoniae strains (penicillin G MICs, > 0.125 to 2 micrograms/ml) isolated from the cerebrospinal fluid of children with meningitis . The antibiotics were tested at clinically achievable concentrations in cerebrospinal fluid . After 5 h of incubation, imipenem was the most effective drug . None of the combinations had synergistic activity . Killing by beta-lactam antibiotics or vancomycin was enhanced by the addition of gentamicin, reduced by the addition of rifampin, and unaffected by the addition of fosfomycin.

J Appl Physiol, 1994 Nov, 77(5), 2071 - 8
Streptococcus pneumoniae-induced pulmonary hypertension and systemic hypotension in anesthetized sheep; Charan NB et al.; Because some patients with Streptococcus pneumoniae bacteremia may present with shock, we reasoned that this organism may produce substances that cause shock . To test this hypothesis, type III pneumococcus supernatant, suspended in 10 ml of sterile water, was infused over 1 min in 8 adult anesthetized sheep . Normal saline was used as a control and had no effect on any of the hemodynamic parameters . Infusion of supernatant resulted in a precipitous fall in cardiac output from a control value of 4.25 +/- 0.54 to 2.80 +/- 0.43 (SE) l/min, a fall in mean systemic arterial pressure from 70 +/- 4 to 49 +/- 8 mmHg, and an increase in the mean pulmonary arterial pressure from 13 +/- 2 to 23 +/- 4 mmHg within 1 min after the infusion was completed . The peak hemodynamic effects were observed at approximately 3 min and returned to normal within 10 min after the infusion was completed . The thromboxane B2 level increased from a control value of 10 +/- 5 to 156 +/- 43 pg/ml at 3 min after the infusion was completed and decreased to 63 +/- 34 pg/ml at 20 min . A second identical dose of pneumococcal supernatant, repeated within 2 h of the first dose, had no effect on hemodynamic variables . Pretreatment with indomethacin, 5 mg/kg body wt, completely blocked the hemodynamic effects of pneumococcal supernatant (n = 3 sheep) . Thus, we conclude that S . pneumoniae supernatant contains substances that cause septic shock syndrome through the synthesis of arachidonic acid metabolites and that a sublethal dose of the supernatant causes rapid tachyphylaxis.

Allerg Immunol (Paris), 1994 Nov, 26(9), 341 - 4
{Therapeutic strategy for sore throat: current role for targetted antibiotic therapy}; Begue P; The beta-haemolytic streptococcus A, which is responsible for almost all bacterial sore throats in children and young adults, is the target for the first antibiotic treatment . What is really at stake for the treatment is to prevent the serious complications linked with this germ, acute articular rheumatism (RAA) and glomerulonephritis . The recurrence of RAA seen in the United States from 1985, has started many investigations as much for epidemiology as for therapy . Some authors have questioned the treatment with penicillin because of the rise in numbers of carriers of streptococcus A after treatment . They have suggested the use of compounds with a greater spectrum of activity . However, work in the international literature re-states the benefits of a targetted antibio-therapy in this context . Is it appropriate to use a wide spectrum antibiotic to treat an infection of monobacterial target, taking into account the bacteriological and clinical efficacy of penicillin, the only available treatment that has shown its capacity to prevent RAA, with a treatment length of 10 days and which seems to be constant with time? Because of this, faced with the ecological risks of a multi-use of wide range compounds, with a treatment that has not been validated in France, phenoxymethylpenicillin, Oracilline, penicillin V, the antibiotic targetted to sore throat and the streptococcal risk, is correct now for 1994.

East Afr Med J, 1994 Nov, 71(11), 712 - 5
An intervention to reduce the risk of mother-to-infant HIV transmission: results of a pilot toxicity study; Taha TE et al.; Although unproven, vaginal cleansing with antiseptics during labour could be a practical approach to reducing the rate of transmission of HIV infection from mother to infant . Before initiating a large scale clinical trial of the antiseptic chlorhexidine, we conducted a study to assess possible toxic effects as well as beneficial outcomes in 160 women volunteers: 40 non-pregnant chlorhexidine washed, 40 pregnant not washed, 40 pregnant saline washed, and 40 pregnant chlorhexidine washed . The wash was easily administered by the nurse-midwives . The participants generally felt better after the procedure, and had no complaints or adverse reactions in the subsequent 24 hours . Bacteriologically, the procedures lowered the carriage of Group B streptococcus and Staphylococcus aureus, but did not affect the frequency of T . vaginalis detection . No clinical problems were seen, and therefore the larger clinical trial of efficacy will proceed . Results of this trial are expected in late 1995.

J Gen Intern Med, 1994 Nov, 9(11), 650 - 2
Pneumonia in a nursing home; Drinka PJ et al.; The authors studied nursing home residents serologically to determine whether atypical organisms were causes of radiologic pneumonia . The study was conducted at the Wisconsin Veterans Home, a facility with on-site microbiology and x-ray . Over one year, serologic examinations for Legionella, Mycoplasma, and Chlamydia were conducted for the residents who had pneumonia . Cultures and mortality were reviewed . Fifty-six episodes were studied (mean resident age 78 years) . There was no fourfold titer change . Seventeen quality sputum specimens revealed Streptococcus pneumoniae (5), normal flora (4), Hemophilus influenzae (4), Moraxella catarrhalis (3), Staphylococcus aureus (1), and beta-hemolytic Streptococcus, not group A (1) . The two-month mortality was 21% . This study did not result in serologic confirmation of atypical organisms' causing pneumonia . Antibiotic choice should be based on coverage of prevalent organisms, including Hemophilus influenzae, Moraxella, and Staphylococcus, as well as clinical features.

J Clin Microbiol, 1994 Nov, 32(11), 2667 - 70
Comparison of PCR assay with bacterial culture for detecting Streptococcus pneumoniae in middle ear fluid of children with acute otitis media; Virolainen A et al.; We have studied etiological diagnosis of acute otitis media (AOM) by comparing a newly developed pneumococcal PCR for Streptococcus pneumoniae to bacterial culture with 180 middle ear fluid (MEF) samples of 125 children with 125 episodes of AOM . For pneumococcal PCR assay, DNA from MEF samples was extracted by phenol-chloroform . The outer primers used amplified a 348-bp region of the pneumolysin gene, and the inner primers amplified a 208-bp region . S . pneumoniae was cultured in 33 (18%) samples, and pneumolysin PCR was positive for 51 (28%) of 180 MEF samples . Only 2 of 21 PCR-positive, S . pneumoniae culture-negative samples were positive for other otitis pathogens . By combining MEF culture and PCR results, 54 (30%) of 180 MEF samples had evidence of pneumococcal etiology . In conclusion, pneumolysin PCR is a sensitive and specific new method to study pneumococcal involvement in MEF samples of children with AOM.

Br J Ophthalmol, 1994 Nov, 78(11), 847 - 9
Suppurative keratitis caused by Streptococcus pneumoniae after cataract surgery; Charteris DG et al.; Six elderly patients are described (age range 76-86 years) in whom a characteristic peripheral suppurative keratitis developed 1-36 months after uncomplicated cataract surgery . A corneal section had been used in all patients and four or five interrupted nylon sutures were present at the time of onset . Streptococcus pneumoniae was cultured from a corneal scrape in all cases . Treatment with appropriate antibiotics resulted in slow resolution though supplementary topical steroids were necessary in five of the six patients, and corneal opacification persists in all cases.

Cornea, 1994 Nov, 13(6), 521 - 6
Penetrating keratoplasty in infants with congenital glaucoma; Ariyasu RG et al.; The efficacy of corneal transplantation in infants with corneal opacity secondary to congenital glaucoma has not been established . We retrospectively reviewed our results of nine penetrating keratoplasties performed on eight eyes of six infants who had multiple risk factors for poor prognosis: age < 2 years at the time of grafting; uncontrolled glaucoma in four eyes; concurrent lensectomy, retinal, or glaucoma surgery in five eyes; aphakia in five eyes; and an acute perforation in one eye . Six of the nine grafts (67%) remained clear during a mean follow-up of 24 months (30 months in eyes with clear grafts) . Development of ambulatory vision or better occurred in six of eight (75%) eyes after corneal transplantation and treatment of refractive errors and amblyopia . Graft failure occurred in three eyes--two from corneal decompensation, and one from homograft rejection . Complications included one total retinal detachment, one case of Streptococcus pneumoniae keratitis, and three cases that lost intraocular pressure control, requiring further glaucoma surgery . We conclude that useful vision can be achieved after penetrating keratoplasty even in some high-risk infants with congenital glaucoma.

Kansenshogaku Zasshi, 1994 Nov, 68(11), 1428 - 32
{Fulmonant group A streptococcal infection accompanied by massive pulmonary hemorrhage and subsequent asphyxia: a case report}; Nakada H et al.; A case of fulminant group A streptococcal infection occurring in a 6-year-old Japanese child is reported . She was accompanied by massive pulmonary hemorrhage and subsequent asphyxia . She initially had pharyngalgia with fever . The cephalosporin antibiotic was given orally for 3 days . Three days after that recurrence of fever and pharyngalgia was noted . Twelve hours later tachypnea and a sudden onset of hemoptysis was noted . She manifested DOA (dead on arrival) and died in the emergency room . Autopsy revealed the presence of numerous cocci in the vessels and massive pulmonary hemorrhage . Streptococcus pyogenes was isolated from the blood . The serotype of this group A streptococcal organism was typed as M4, T4, which produces exotoxin type B and C, which was sensitive to the penicillins.

Kansenshogaku Zasshi, 1994 Nov, 68(11), 1338 - 51
{An epidemiological study of penicillin-resistant Streptococcus pneumoniae in Japan}; Konno M et al.; In order to investigate penicillin resistance (Pcr) in Streptococcus pneumoniae from clinical sources in Japan, a total 1,127 strains of S . pneumoniae was collected at random from 36 institutions participating to "Working group for Pcr S . pneumoniae" around the country in 1993-1994 . These strains were isolated more frequently from sputum (38.2%), throat (31.4%), nasal discharge (16.4%), and otorrhea (5.7%) . A small number of isolates from blood (19 strains; 1.8%), cerebrospinal fluid (11 strains; 1.0%), and pleural fluid (2 strains; 0.2%) were included respectively . Patients from whom S . pneumoniae was isolated have mostly been associated with children < or = 12 years of age and adults 60 < or = years olds . These isolates were tested for susceptibility to penicillin G, ampicillin, oxacillin, cefixime, cefdinir, imipenem, panipenem, erythromycin, clindamycin, minocycline, and vancomycin by an agar dilution method using Mueller Hinton agar supplemented with 10% sheep blood . Strains with the MICs > or = 0.125 micrograms/ml for penicillin G were defined as a Pc resistance . Of the 1,127 strains, 471 strains (41.8%) were identified as a Pc resistance . Pcr S . pneumoniae were almost resistant to other beta-lactams, including ampicillin, oxacillin, ceftizoxime, cefixime, cefdinir . Although, the MICs of imipenem and panipenem ragned from 0.004-2.0 micrograms/ml with 2 peaks distributions, these antibiotics inhibited the growth of most of Pcr S . pneumoniae at the lowest concentrations of < or = 0.5 microgram/ml . Only vancomycin resistant strain was not detected in these isolates . Most of the Pcr strains were simultaneously resistant to macrolides and minocycline . Further more, isolation frequencies of Pcr S . pneumoniae in west Japan, were relatively high compared with those of east Japan.

Enferm Infecc Microbiol Clin, 1994 Nov, 12(9), 452 - 4
{Pneumothorax in patients with AIDS}; Rivero A et al.; METHODS: From January 1986 to 31 November 1993, 354 cases of AIDS (CDC criteria 1987) were diagnosed . The possible existence of spontaneous pneumothorax at any time during the evolution and its presumed cause were evaluated . RESULTS: During the period studied, 7 (1.9%) of AIDS patients presented pneumothorax . The existence of a pulmonary infection was proven in 6: 3 pneumonia by Pneumocystis carinii, 2 bacterial pneumonia (Streptococcus pneumoniae and Pseudomonas sp.) and 1 tuberculosis . One patient presented a Pneumocystis carinii pneumonia 3 months prior to the pneumothorax . In the study period 88 (22.8%) of the AIDS patients presented pneumonia by Pneumocystis carinii and 181 (51.1%) presented tuberculosis . The rate of pneumothorax in patients with a history or presence of pneumonia by Pneumocystis carinii was of 4.5% and 0.5% in patients with tuberculosis . CONCLUSIONS: The development of pneumothorax is relatively frequent in patients with AIDS in our area . As found in other series, its most frequent cause was Pneumocistis carinii pneumonia, despite the high incidence of tuberculosis.

Can J Microbiol, 1994 Nov, 40(11), 930 - 6
Cysteine protease activity of streptococcal pyrogenic exotoxin B; Ohara-Nemoto Y et al.; Streptococcal pyrogenic exotoxin B (SPE B) was purified and its protease and mitogenic activities were investigated . The apparent molecular mass of SPE B purified in the presence of iodoacetic acid was 42 kDa, whereas 29-kDa SPE B was predominant without the reagent . A polyclonal antibody raised against the 29-kDa species reacted with both species, indicating that the 42-kDa species was a precursor of the 29-kDa entity . Both the 42- and 29-kDa species enhanced {3H}thymidine incorporation into human peripheral blood mononuclear cells, whereas neither had any effect on T cell depleted mononuclear cells . The 29-kDa SPE B possessed caseinolytic activity, with an optimal pH of 8, and the activity was specifically suppressed by the antibody . A group of cysteine protease inhibitors, but no serine-, metallo-, or acidic-protease inhibitors, limited the protease activity, whereas dithiothreitol increased the activity . The DNA sequence around a putative active cysteine residue was identical among the speB genes from Streptococcus pyogenes R70, NY-5, and T19 . Taken together, these results indicate that SPE B is identical to a cysteine protease, streptopain (EC 3.4.22.10).

Clin Exp Rheumatol, 1994 Nov-Dec, 12 Suppl 11, S23 - 5
Setting the scene: a historical and personal view of immunologic diseases, autoimmunity and ANA; Friou GJ; Dr . Friou reviews here his research experiences in immunology beginning over fifty years ago, and dealing with his early background experience with group A streptococcus, antihyaluronidase, and rheumatic fever, and cell mediated responses in Boeck's sarcoid . Details of his introduction of the immunofluorescent technique of Harvard Prof . Albert Coons into the SLE-ANA area, with the complexities and difficulties of early involvement with the technique are described . The simple, but extremely clever experiment of Prof . Miescher of Geneva which created an ideal situation for the application of immunofluorescence to the SLE area is described . Technical details of the earliest immunofluorescent ANA studies are presented, together with firm data that these early studies, which included many human sera and studies of the nature of the antibody target, had been completed by February 21, 1957, well in advance of any other laboratory . Important subsequent related studies from international laboratories are reviewed.

J Med Assoc Thai, 1994 Nov, 77(11), 572 - 9
Surveillance of antimicrobial resistance of Streptococcus pneumoniae and Hemophilus influenzae in Thailand; Bamrungtrakul T et al.; Resistance patterns of S . pneumoniae and H . influenzae to standard antibiotics in Thailand is not on the rise when compared to previous reports . There is no need at present to change standard antibiotic therapy recommendations for pneumonia by the National ARI . The use of antibiotics for the treatment or prophylactic purposes should be judicious to limit the spread of antimicrobial resistance . This study is the main part of a National surveillance for antimicrobial resistance of S . pneumoniae and H . influenzae . The surveillance programme should be continued to evaluate trends in order to up-date guidelines for the selection of antibiotics of the ARI programme in the future.

Zentralbl Veterinarmed B, 1994 Nov, 41(9), 608 - 17
Biochemical traits and antimicrobial susceptibility of Streptococcus suis isolated from slaughtered pigs; Prieto C et al.; A total of 522 Streptococcus suis isolates were recovered from the tonsils of slaughtered pigs by culturing on media containing different specific antisera . The serogroup reactions were determined by coagglutination . The most frequently isolated serotype was serotype 4 (representing 28.7% of the isolates), followed by serotype 3 (24.9%) and serotype 2 (22.6%) . Typable isolates were examined by growth in 6.5% NaCl, amylase activity, acetoin production, susceptibility to optochin and production of acid from mannitol, melibiose, raffinose, salicin, sorbitol and trehalose . Finally, all isolates were tested for antimicrobial susceptibility against ampicillin, cephalotin, lincomycin, neomycin, penicillin, spiramycin and trimethoprim-sulphamethoxazole using the disk-diffusion technique . All isolates were amylase-positive and acetoin-negative, and failed to grow in 6.5% NaCl broth . Nine isolates were optochin-susceptible . Moreover, 10 isolates produced acid from mannitol, 21 produced acid from sorbitol, and 36 and 37 did not produce acid from salicin and trehalose, respectively . Six salicin- and trehalose-negative isolates and two mannitol- and sorbitol-fermenting isolates were found . Biochemical differences between serotypes were not observed . The most active drugs against S . suis were the beta-lactam antibiotics, although only 83.3%, 70% and 78.5% of isolates were susceptible to ampicillin, cephalotin and penicillin, respectively . Half of the isolates were resistant to trimethoprim-sulphamethoxazole, and resistance to lincomycin, neomycin and spiramycin appeared to be very high.

Zentralbl Veterinarmed B, 1994 Nov, 41(9), 561 - 6
Epizootic pneumonia in nutria; Martino P et al.; This report highlights current knowledge regarding the aetiology, diagnosis and management of nutria (Myocastor coypus Molina 1792) with spontaneous infectious pneumonia . Bacteriological evidence supports the view that Streptococcus zooepidemicus could be the specific pathogen, although other bacteria were also isolated . Attempts at virus isolation were unsuccessful . Pneumonia has rapidly become established as one of the major, life-threatening bacterial diseases, ranking in importance with gastroenteritis infections.

J Anim Sci, 1994 Nov, 72(11), 3019 - 31
Nutrient transport by ruminal bacteria: a review; Martin SA; Fermentation pathways have been elucidated for predominant ruminal bacteria, but information is limited concerning the specific transport mechanisms used by these microorganisms for C, energy, and N sources . In addition, it is possible that changes in ruminal environmental conditions could affect transport activity . Five carrier-mediated soluble nutrient transport mechanisms have been identified in bacteria: 1) facilitated diffusion, 2) shock sensitive systems, 3) proton symport, 4) Na+ symport, and the 5) phosphoenolpyruvate phosphotransferase system (PEP-PTS) . Several regulatory mechanisms are also involved at the cell membrane to coordinate utilization of different sugars . Recent research has shown that predominant ruminal bacteria are capable of transporting soluble nutrients by several of the mechanisms outlined above . Megasphaera elsdenii, Selenomonas ruminantium, and Streptococcus bovis transport glucose by the PEP-PTS, and S . ruminantium and S . bovis also possess PEP-PTS activity for disaccharides . Glucose PTS activity in S . bovis was highest at a growth pH of 5.0, low glucose concentrations, and a dilution rate of .10 h-1 . The cellulolytic ruminal bacterium Fibrobacter succinogenes uses a Na+ symport mechanism for glucose transport that is sensitive to low extracellular pH and ionophores . Sodium also stimulated cellobiose transport by F . succinogenes, and there is evidence for a proton symport in the transport of both arabinose and xylose by S . ruminantium . A chemical gradient of Na+ seems to play an important role in AA transport in several ruminal bacteria . Studying nutrient transport mechanisms in ruminal bacteria will lead to a better understanding of the ruminal fermentation.

Microb Pathog, 1994 Nov, 17(5), 355 - 60
Identification of a molecule of Porphyromonas gingivalis that binds to Streptococcus gordonii; Lamont RJ et al.; The molecules that mediate the adherence of Porphyromonas gingivalis, a periodontal pathogen, to Streptococcus gordonii, a commensal plaque organism, were investigated . Outer membrane proteins of P . gingivalis were labelled with biotin, extracted by EDTA and reacted with S . gordonii cells . Interactive porphyromonas components were identified by SDS-PAGE of the S . gordonii cells followed by electroblotting and visualization of the adsorbed porphyromonas molecules with streptavidin-alkaline phosphatase . A P . gingivalis molecule of 35 kDa bound to S . gordonii . Monospecific polyclonal antibodies to the 35 kDa protein inhibited binding of P . gingivalis to S . gordonii by 71% . The antibodies also reacted with the P . gingivalis fimbriae, indicating that the 35 kDa molecule is antigenically related to, or associated with, the fimbriae.

Microb Pathog, 1994 Nov, 17(5), 323 - 37
Localization of protection-eliciting epitopes on PspA of Streptococcus pneumoniae between amino acid residues 192 and 260; McDaniel LS et al.; Pneumococcal surface protein A (PspA) is a virulence factor of Streptococcus pneumoniae that can elicit a protective antibody response . The pspA gene of strain Rx1 encodes a 65 kDa molecule composed of 588 amino acids . The N-terminal 288 amino acids are highly charged, and predict an alpha-helical coiled-coil protein structure . All monoclonal antibodies (MAbs) to PspA, obtained by screening against whole pneumococci, bind to the alpha-helical region of PspA, suggesting that this region is surface exposed . The C-terminal 217 amino acids of PspA contain the surface anchor of PspA and does not appear to be alpha-helical . In the middle of the molecule is a proline-rich region that is thought to traverse the cell wall . In this study we have mapped the immunogenic epitopes detected by 9 MAbs that were made against strain Rx1 PspA . Five of the MAb also react with the PspA of mouse virulent strain WU2 . All epitopes were found in one of two portions of the alpha-helical region . One comprised the first 115 amino acids, and the other was within amino acids 192 and 260 . The five MAbs that recognize WU2 PspA, but not the remaining four MAbs, were protective against strain WU2 . The epitopes detected by four of the five protective MAbs mapped to region 192 to 260 of Rx1 PspA . The existence of protective epitopes in this region was confirmed by demonstrating that mice immunized with the cloned fragment containing these residues were protected from fatal infection with WU2 . Since amino acids 192 to 260 are in the region of PspA anticipated to be adjacent to the cell wall, and probably well covered by capsule, the means by which antibodies to the region lead to protection is not obvious.

Res Virol, 1994 Nov-Dec, 145(6), 369 - 77
Rapid and constant detection of HIV antibody response in saliva of HIV-infected patients; selective distribution of anti-HIV activity in the IgG isotype; Lu XS et al.; Anti-HIV antibodies can be specifically detected with a sensitivity and a specificity of 100% in the saliva of all HIV-infected patients . A saliva collection device facilitates the sampling procedure, and if a rapid test is used, the diagnosis of infection can be established in as little as 10 min . The analysis of a group of CDC stage IV AIDS patients showed a decrease in lactoferrin (produced by the oral mucosa) in comparison with HIV-negative controls, associated with an increase in albumin (filtering from plasma), indicating an alteration of the mucosal barrier . The salivary anti-HIV-gp160 activity was largely carried by the IgG isotype whereas the salivary antibacterial activity (anti-Streptococcus sobrinus; anti-LPS from Escherichia coli) remained located in the IgA isotype as usually observed with all infectious agents . Salivary IgG carried a specific anti-gp160 activity 25-fold higher than that of serum IgG . Thus, significant local synthesis of specific IgG by oral mucosa was revealed as a characteristic of HIV infection.

J Antimicrob Chemother, 1994 Nov, 34(5), 785 - 90
Comparison of antibiotic combinations against penicillin-resistant pneumococci; Cassinat B et al.; The isolation rate of penicillin resistant pneumococci is increasing in France . To date, cefotaxime and ceftriaxone are the two drugs recommended for the treatment of severe infections and oral third generation cephalosporins are frequently employed for the treatment of non-invasive pneumococcal diseases . In this study, we determined the bacteriostatic activity of 21 antibiotic combinations against 13 clinical isolates of Streptococcus pneumoniae with MICs > or = 0.1 mg/L penicillin and 13 strains that were susceptible.

J Endocrinol Invest, 1994 Nov, 17(10), 821 - 4
Bilateral massive adrenal hemorrhage due to sepsis: report of two cases; Piccioli A et al.; Two cases (a 57-year-old man and an 18-year-old girl) of bilateral massive adrenal hemorrhage (BMAH) due to sepsis (Streptococcus pneumoniae and Neisseira meningitidis, respectively) are reported . At admission, the man presented with fever, severe hypotension, hyperazotemia, acidosis, normonatremia and hypocoagulability, while the girl with severe hypotension, fever, hyponatremia, and hypocoagulability . A diagnostic protocol based on a very quick method for cortisol measurement is proposed, in an attempt to reach an earlier diagnosis of BMAH during sepsis.

Intensive Care Med, 1994 Nov, 20 Suppl 4, S30 - 4
Antibiotic treatment of burned patients: an Italian multicentre study; Donati L et al.; Antibiotic therapy in burn centres with highly specialized ICUs has reduced the mortality and morbidity in burn and trauma but, in spite of constantly improving supportive surgical and resuscitation methods, infection remains a major problem . Indeed, the clinical experience, as recorded in Europe and the USA, using different antimicrobial drugs and regimens, emphasizes a constantly evolving pattern of pathogenic microorganisms in the wound and in the rest of the patient's body, and their increasing chemoresistance . We report the preliminary results of 559 patients in a large controlled multicentre clinical study (mean age 41.4 +/- 17.8 years and burns covering a mean body surface area of 35.7%), with the collaboration of 13 of the 15 major Italian burn centres . The antibiotic treatment consisted of prophylactic administration of pefloxacin (800 mg i.v . OD for 4 days) for all patients as a first treatment while waiting for an antibiogram, and chemotherapy with teicoplanin (800 mg i.v . OD) together with netilmicin (300 mg i.m . OD) in one or more cycles . At random, half of the patients received thymostimulin (70 mg i.m . OD pro die for the first month and every other day thereafter until discharge from hospital) . Of the bacterial pathogens involved in septic complications, 63.3% were Gram-positive (Staphylococcus spp . and Streptococcus spp.) . The mortality rate was 15.5% . Pefloxacin chemoprophylaxis was successful in 19.4% of patients and cure or improvement was seen with combination chemotherapy in 66.7% of patients, mainly with only one treatment cycle . The incidence of mortality and sepsis was not significantly influenced by treatment with thymostimulin.

J Am Vet Med Assoc, 1994 Nov 1, 205(9), 1308 - 11
Eosinophilic keratoconjunctivitis in a horse; Ramsey DT et al.; An 11-year-old Quarter Horse gelding was evaluated because of a persistent, raised band of 1- to 2-mm subepithelial plaques of the left cornea . Cytologic examination of corneal scrapings revealed numerous eosinophils and segmented neutrophils, with few mast cells, plasma cells, and lymphocytes . Bacteriologic culture yielded sparse growth of alpha-hemolytic Streptococcus and Staphylococcus spp . Histologically, the plaques consisted of subepithelial foci of fragmented and degenerated collagen fibers infiltrated by eosinophils and neutrophils, with few lymphocytes, plasma cells, and macrophages . Plaques were surrounded by a layer of brightly eosinophilic, acellular, granular material . Distribution of inflammatory cells in the conjunctiva was similar to cells in the cornea . After reepithelialization of the cornea, corticosteroid ointment was administered topically . Twenty-eight days after treatment with corticosteroids, the plaques had completely resolved . Histologic and cytologic diagnoses in this horse were similar to reports of eosinophilic keratitis in cats.

Arch Oral Biol, 1994 Nov, 39(11), 973 - 8
The effect of ovariectomy and high-sucrose diet on dentine formation and caries in growing rats; Hietala EL et al.; Ovariectomized (Ovx) or sham-operated (Cnt) and tetracycline-labelled growing rats were fed either a commercial powdered standard rat diet (Ovx and Cnt) or a high-sucrose diet (Ovxsuc and Cntsuc) . All animals were inoculated in the mouth with Streptococcus sobrinus . At 11 weeks of age the areas of caries lesions and dentinal apposition of the first and second molars and the areas of the pulpal cross-section of the incisors were determined . The area of dentinal apposition was largest in Cnt animals, the difference being statistically significant only in comparison with the Cntsuc animals . No such difference between the diets was found among the Ovx animals . The cross-section of the pulpal chamber was smallest in the Ovxsuc rats and largest in the Cnt animals, but no statistically significant differences were found between the groups . The caries lesions were significantly larger in Ovx, Ovxsuc and Cntsuc animals than in Cnt ones . Ovariectomy thus increased caries progression in growing rats, but the effect on dentine formation remained negligible . In this respect there is a difference between primary and secondary dentinogenesis.

Mol Gen Mikrobiol Virusol, 1994 Nov-Dec, (6), 33 - 6
{Plasmids from certain strains of Streptomyces chrysomallus}; Konoshenko GI; Plasmid content has been studied in a number of Streptomyces chrysomallus strains producers of actinomycin C . The plasmids pSCH2 and pSCH3 have been isolated from nocardia-like mutants of Streptococcus chrysomallus BKM Ac-590 that are producing antibiotics macrotetrolides, bacteriocins and an inducer analogous to A-factor in addition to actinomycin . The size of the plasmids is 13.4 and 15.1 kb as found by restriction analysis . Plasmids differ in deletion and content in the cultures . The ability of the strains to produce antibiotics depends on plasmid content.

S Afr Med J, 1994 Nov, 84(11), 743 - 6
Comparison of the composition and opsonic activities of imported and South African-manufactured intravenous and intramuscular immunoglobulin preparations; Theron AJ et al.; We compared the composition and opsonic activities for two common microbial pathogens (Staphylococcus aureus and Streptococcus pyogenes) of various imported intravenous (IV) (Sandoglobulin, Octagam and Gammagard) and intramuscular (IM) (Beriglobin and Globuman Berna) immunoglobulin (Ig) preparations with those of the corresponding locally manufactured products, Polygam (IV) and Intragam (IM) . When tested at equivalent concentrations (1 g/100 ml) the total IgG and IgG subclass concentrations of the various IV and IM preparations were similar . All the test preparations (IV and IM) possessed similar opsonic activity for S . aureus and S . pyogenes . These findings demonstrate that, in respect of IgG content and protective biological activity, Intragam and Polygam, the locally manufactured IM and IV Ig preparations, respectively, compared extremely favourably with the corresponding imported products.

FEMS Microbiol Lett, 1994 Oct 15, 123(1-2), 207 - 12
Alternative strategies of 2-deoxyglucose resistance and low affinity glucose transport in the ruminal bacteria, Streptococcus bovis and Selenomonas ruminantium; Cook GM et al.; Streptococcus bovis and Selenomonas ruminantium grew in the presence of the glucose analog, 2-deoxyglucose (2-DG), but the cells no longer had high affinity glucose transport . In S . bovis, 2-DG resistance was correlated with a decrease in phosphoenolpyruvate (PEP)-dependent glucose phosphotransferase (PTS) activity . The 2-DG-selected S . bovis cells relied solely upon a low affinity, facilitated diffusion mechanism of glucose transport and a 2-DG-resistant glucokinase (ATP-dependent) . The glucokinase activity of S . ruminantium was competitively inhibited by 2-DG, and the 2-DG selected cells continued to use PEP-dependent PTS as a mechanism of glucose transport . In this latter case, the 2-DG selected cells switched from a mannosephosphotransferase (enzyme II) that phosphorylated glucose, mannose, and 2-DG, but not alpha-methylglucose to a glucosephosphotransferase (enzyme II) that phosphorylated glucose and alpha-methylglucoside but not 2-DG or mannose . The glucosephosphotransferase (enzyme II) had a very low affinity for glucose and the transport kinetics were similar to the facilitated diffusion system of S . bovis.

Gene, 1994 Oct 11, 148(1), 97 - 100
Identification of a Vibrio cholerae ToxR-activated gene (tagD) that is physically linked to the toxin-coregulated pilus (tcp) gene cluster; Hughes KJ et al.; The toxin-coregulated pilus (TCP)-encoding gene cluster (tcp) specifies a type-IV pilus that is a major colonization determinant of Vibrio cholerae . We have identified a gene 200 bp upstream from the tcp cluster that requires ToxR for expression . We have designated this gene tagD (ToxR-activated gene) and have shown that tagD is encoded on a 600-nt transcript . The deduced tagD product is a 164-amino-acid polypeptide (20 kDa) . Interestingly, TagD shares a high degree of similarity to a protein of Streptococcus sanguis 12 that is thought to play a role in fimbriae synthesis or assembly . The high degree of similarity between tagD and the Ss 12 protein provides preliminary evidence that tagD represents an additional member of the tcp cluster.

Microbiology, 1994 Oct, 140 ( Pt 10), 2639 - 48
Vesicles prepared from Streptococcus mutans demonstrate the presence of a second glucose transport system; Buckley ND et al.; Streptococcus mutans, an important aetiological agent of dental caries, is known to transport glucose via the phosphoenolpyruvate (PEP) phosphotransferase system (PTS) . An alternative non-PTS glucose transport system in S . mutans Ingbritt was suggested by the increased ATP-dependent phosphorylation of glucose and the presence of higher cellular concentrations of free glucose in cells grown in continuous culture under PTS-repressed conditions compared to those resulting in optimal PTS activity . A method was developed for the preparation of membrane vesicles in order to study this system in the absence of PTS activity . These vesicles had very low activity of the cytoplasmic enzymes, glucokinase, pyruvate kinase and lactate dehydrogenase . This, coupled with the lack of glycolytic activity and the inability to transport glucose, suggested that the vesicles would also be deficient in PTS activity because of the absence of the general soluble PTS proteins, Enzyme I and HPr, required for the transport of all PTS sugars . Freeze-fracture electron microscopy and membrane H(+)-ATPase analysis indicated that over 90% of the vesicles had a right-side-out orientation . Vesicles from cells grown in continuous culture under PTS-dominant and PTS-repressed conditions both exhibited glucose counterflow . This indicates the presence of a constitutive non-PTS carrier in the organism capable of transporting glucose and utilizing ATP for glucose phosphorylation . Analysis of growth yields of cells grown under PTS-repressed and PTS-optimal conditions suggests that ATP, or an equivalent high energy molecule, must be involved in the actual transport process . This analysis is consistent with an ATP-binding protein model such as the Msm transport system reported by R . R . B . Russell and coworkers (J Biol Chem 267, 4631-4637), but it does not exclude the possibility of a separate permease for glucose.

Planta Med, 1994 Oct, 60(5), 460 - 3
Antibacterial and molluscicidal phenolic acids from Spondias mombin; Corthout J et al.; Spondias mombin L . (Anacardiaceae), used in traditional medicine because of its antimicrobial properties, was found to contain a series of 6-alkenyl-salicylic acids . They were isolated from the ethanolic extract of leaves and stems of Spondias mombin by a combination of chromatographic methods . Their structure was determined by NMR and MS techniques as (17:3), (17:2) and (17:1) pelandjuaic acid {or 6-(8'Z,11'Z,14'Z-heptadecatrienyl)-salicylic acid, 6-(8'Z,11'Z-heptadecadienyl)-salicylic acid, and 6-(10'Z-heptadecenyl)-salicylic acid, respectively}, 6-(12'Z-non-adecenyl)-salicylic acid, and 6-(15'Z-heneicosenyl)-salicylic acid, the two last compounds being new ones . These phenolic acids were shown to have a pronounced antibacterial effect against Bacillus cereus, Streptococcus pyogenes, and Mycobacterium fortuitum (minimal bactericidal concentration in a concentration range of 3-25 micrograms/ml), and a molluscicidal effect against the snail Biomphalaria glabrata, an intermediate host in the schistosome life cycle . Because of their high molluscicidal activity (LC90 down to 1-3 ppm), these long-chain salicylic acid derivatives may be important tools in the prevention of schistosomiasis.

Kansenshogaku Zasshi, 1994 Oct, 68(10), 1264 - 70
{An evaluation of pathogens in patients with bronchopulmonary infection by transtracheal aspiration: December 1978-March 1993}; Konishi M et al.; We performed transtracheal aspiration (TTA) in 1165 patients, who were suspected to have bronchopulmonary infection, from December 1978 to March 1993 . We isolated pathogens from TTA in 806 patients (69.2%) . We isolated H . influenzae (62 cases), S . pneumoniae (39 cases) and M . catarrhalis (24 cases) in patients with acute bronchitis, S . pneumoniae (65 cases), alpha-Streptococcus sp . (52 cases), H . influenzae (32 cases) and S . aureus (29 cases) in patients with pneumonia or lung abscess and H . influenzae (174 cases), S . pneumoniae (84 cases), P . aeruginosa (81 cases) and M . catarrhalis (42 cases) in patients with chronic lower respiratory tract infection . Anaerobic bacteria isolated from TTA included Peptostreptococcus sp . (19 cases), Bacteroides sp . (19 cases) and others . Mycoplasma pneumoniae was isolated from TTA in 8 patients with pneumonia without other organisms . Virus isolated from TTA included Rhinovirus (6 cases) and others . These results suggest that various pathogens affect the pathogenesis of bronchopulmonary infection . Therefore, we must diagnose the bronchopulmonary infection by the correct methods such as TTA.

Compendium . 1994 Oct;15(10):1282, 1284, 1286 passim; quiz 1294.
Dental caries vaccines: science and status; Gregory RL; Dental caries, caused by the etiologic agent Streptococcus mutans, is considered the most common human infectious disease . Development of a vaccine has been under investigation for more than 25 years . Possible approaches include immunizing patients using an oral vaccine containing components of the causative bacterium and by intramuscular injection . Although both approaches have proved promising, several considerations have delayed further development of a vaccine . This article reviews the scientific results and status of the various vaccines.

Enferm Infecc Microbiol Clin, 1994 Oct, 12(8), 390 - 2
{Bacteremia and recurrent arthritis caused by Streptococcus pyogenes in a heroin addict with AIDS}; Santos J et al.; BACKGROUND: Streptococcus pyogenes is a bacteria which, at present, is seldom isolated in blood and articular fluid . An intravenous drug addict with human immunodeficiency virus infection, with bacteremia and arthritis by S . pyogenes, associated with tuberculosis is presented . METHODS: Blood and articular fluid cultures were collected in the usual and Lowenstein-Jensen media . RESULTS: The patient improved with penicillin and tuberculostatic drugs . Nine months after this episode, the patient reinitiated intravenous drug addiction, and developed another presentation of bacteremia and arthritis by S . pyogenes . CONCLUSIONS: Heroin addict patients constitute a risk group for bacteremias ans severe infections by S . pyogenes.

Enferm Infecc Microbiol Clin, 1994 Oct, 12(8), 385 - 9
{Efficacy of gentamycin combined with beta-lactam antibiotics against penicillin-resistant and non-resistant Streptococcus agalactiae}; Villar H et al.; BACKGROUND: Evaluation of the incidence, tolerance and the bactericidal activity against penicillin, ampicillin, cefotaxime, gentamicin and the combination of penicillin plus gentamicin, ampicillin plus gentamicin, cefotaxime plus gentamicin and cefotaxime plus ampicillin in 22 clinical isolates of Streptococcus agalactiae . METHODS: Killing curves were performed . The concentrations of antibiotics was selected taking into account its level in cerebrospinal fluid . RESULTS: We detected 5 (22.7%) tolerant strains to penicillin and ampicillin and 2 of them (9.0%) were also tolerant to cefotaxime . Bactericidal activity was seen in a 100% of the strains against the association penicillin plus gentamicin, ampicillin plus gentamicin and cefotaxime plus gentamicin, being greater than the bactericidal activity against cefotaxime (77.3%), penicillin, ampicillin and cefotaxime plus ampicillin (54.5% respectively) . CONCLUSIONS: Considering the high incidence of tolerance and the deficient bactericidal activity of the beta-lactam antibiotics against tolerant and no tolerant strains, it seems necessary to include gentamicin in the treatment of Streptococcus agalactiae severe infections . Several studies of experimental models must be performed to verify in vivo, the in vitro results.

Arch Dis Child, 1994 Oct, 71(4), 318 - 22
Invasive group A streptococcus carriage in a child care centre after a fatal case; Engelgau MM et al.; After a fatal case of invasive group A streptococcal disease, serotype T-1, in a child care centre, group A streptococcal T-1 prevalence was measured and risk factors for carriage were determined . A total of 87% (224/258) had throat culture tests . Group A streptococcus was isolated from 57 (25%), and of the 50 isolates serotyped, 38 (76%) were T-1 . Group A streptococcal T-1 prevalence was 18% (38/217) and six of nine rooms had children with group A streptococcal T-1 isolates . The risk of group A streptococcal T-1 carriage was increased for children who shared the index case's room (odds ratio (OR) = 2.7; 95% confidence interval (CI) = 0.8 to 9.4) and for each additional hour per week in child care (OR = 1.03; 95% CI = 1.001 to 1.061); and decreased in children taking antibiotics in the preceding four weeks (OR = 0.2; 95% CI = 0.1 to 0.9) . Carriage of the invasive group A streptococcal strain could not be determined by identified risk factors alone.

J Dent, 1994 Oct, 22(5), 279 - 82
Action of sodium fluoride on phagocytosis by systemic polymorphonuclear leucocytes; Gutierrez J et al.; Alterations in phagocytosis appear to be important in the onset and development of periodontitis . We investigated new substances that may be of use in the treatment of periodontitis . In a preliminary study, we tested the effect of sodium fluoride on phagocytosis by circulating polymorphonuclear leucocytes (PMNs) in 10 replicate assays using blood from six healthy subjects . Sodium fluoride was tested at concentrations of 1.0 micron to 4.0 microns against Streptococcus oralis, Streptococcus mutans, Streptococcus sobrinus and Streptococcus sanguis . The phagocytic index against all microorganisms increased significantly at all concentrations of sodium fluoride assayed; this effect was dose dependent . Sodium fluoride appeared to stimulate phagocytosis via two mechanisms: an apparent increase in bacterial susceptibility to phagocytosis, and direct stimulation of phagocytosis by PMNs.

Cancer Immunol Immunother, 1994 Oct, 39(4), 269 - 74
Adjuvant immunotherapy with intrapleural Streptococcus pyogenes (OK-432) in lung cancer patients after resection; Lee YC et al.; A prospective randomized study to evaluate the effect of adjuvant intrapleural OK-432 immunotherapy after resection of lung tumor was conducted in 93 patients with primary lung cancer . Among them, 46 patients had had intrapleural OK-432 injection, 47 had not . In the meantime, serial measurements of serum immunosuppressive acidic protein, of serum interleukin-2 receptor and of the subpopulation of the peripheral blood cells and lymphocytes were performed in all these patients . Patient characteristics in these two groups (sex, age, histological type, pathological stage, type of operation, and performance status) were compatible . The results showed that adjuvant intrapleural OK-432 injection after resection had no beneficial effect on a patient's survival time . Patients who received intrapleural OK-432, had an increase in blood leukocytes, granulocytes and monocytes and serum immunosuppressive acidic protein level . But the cell numbers of total T cells, suppressor/cytoxic cells, helper/inducer cells and natural killer cells of peripheral blood were decreased in the OK-432 positive group . Over half of the patients had transient 1- or 2-day febrile reactions after intrapleural OK-432 injection . It was concluded that neither clinical observation nor immunological monitoring of peripheral blood could demonstrate a beneficial effect from intrapleural OK-432 immunotherapy after complete resection of the tumor.

Biopolymers, 1994 Oct, 34(10), 1327 - 38
Measurement of long-range2 13C-1H coupling constants of 95% uniformly 13C-labeled polysaccharide from Streptococcus mitis J22; Gitti R et al.; The coaggregation of Streptococcus mitis strain J22 in the early stages of dental plaque formation has been shown to result from interaction of cell wall polysaccharides with lectins on the surface of other oral bacterial species . This bacterium was grown in a medium containing 13C as the sole carbon source . We have isolated the lectin receptor polysaccharide from this strain with full enrichment in 13C and have determined a number of two-bond and three-bond 13C-1H coupling constants from measurements of the offsets in two-dimensional homonuclear nmr spectra {exclusive correlated spectroscopy (E-COSY) method} . A scheme for reliable extraction of these coupling constants from homonuclear Hartmann-Hahn and nuclear Overhauser effect spectroscopy spectra is tested in model compounds . We interpret the three-bond coupling across the glycosidic linkage in terms of dihedral angles in order to provide conformational information to supplement molecular modeling and nuclear Overhauser effect data . We show that the E-COSY method works well even for coupling constants smaller than the nmr line width and that a number of the 3JCH across the glycosidic linkage are in the range of 1-2 Hz, which is much smaller than many previously reported values.

J Med Microbiol, 1994 Oct, 41(4), 231 - 5
Detection of Streptococcus mutans by PCR amplification of spaP gene; Ono T et al.; Synthetic oligonucleotide primers were used in the polymerase chain reaction (PCR) to amplify a sequence of the spaP gene, which encodes the surface protein antigen I/II of Streptococcus mutans . A DNA fragment of c . 192 bp was amplified from lysed S . mutans cells or isolated DNA . With S . mutans cells, the lower limit of detection was 4-40 cfu . With these primers, 13 reference and 50 clinical strains of S . mutans were identified . Amplification of the 192-bp product was not demonstrated when 41 strains of other streptococcal and non-streptococcal species were tested . The spaP gene PCR has potential for the rapid diagnosis of S . mutans infections.

J Bacteriol, 1994 Oct, 176(20), 6375 - 83
Molecular characterization of cap3A, a gene from the operon required for the synthesis of the capsule of Streptococcus pneumoniae type 3: sequencing of mutations responsible for the unencapsulated phenotype and localization of the capsular cluster on the pneumococcal chromosome; Arrecubieta C et al.; The complete nucleotide sequence of the cap3A gene of Streptococcus pneumoniae, which is directly responsible for the transformation of some unencapsulated, serotype 3 mutants to the encapsulated phenotype, has been determined . This gene encodes a protein of 394 amino acids with a predicted M(r) of 44,646 . Twelve independent cap3A mutations have been mapped by genetic transformation, and three of them have been sequenced . Sequence comparisons revealed that cap3A was very similar (74.4%) to the hasB gene of Streptococcus pyogenes, which encodes a UDP-glucose dehydrogenase (UDP-GlcDH) that catalyzes the conversion of UDP-glucose to UDP-glucuronic acid, the donor substances in the pneumococcal type 3 capsular polysaccharide . Furthermore, a PCR-generated cap3A+ gene restored encapsulation in our cap3A mutants as well as in a mutant previously characterized as deficient in UDP-GlcDH (R . Austrian, H . P . Bernheimer, E.E.B . Smith, and G.T . Mills, J . Exp . Med . 110:585-602, 1959) . These results support the conclusion that cap3A codes for UDP-GlcDH . We have also identified a region upstream of cap3A that should contain common genes necessary for the production of capsule of any type . Pulsed-field gel electrophoresis and Southern blotting showed that the capsular genes specific for serotype 3 are located near the genes encoding PBP 2X and PBP 1A in the S . pneumoniae chromosome, whereas copies of the common genes (or part of them) appear to be present in different locations in the genome.

Epidemiol Infect, 1994 Oct, 113(2), 321 - 34
Clonal analysis and virulence of Australian isolates of Streptococcus suis type 2; Mwaniki CG et al.; Multilocus enzyme electrophoresis was used to divide 124 Australian isolates of Streptococcus suis type 2 into 17 electrophoretic types (ETs) . Isolates in ET 1 were the most frequent cause of disease amongst Western Australian pigs, but isolates of ET 8 were more commonly associated with disease in other Australian states . Multiple isolates from 10 of 19 farms all belonged to the same ET, whilst isolates from the other farms belonged to between 2 and 4 different ETs . Some isolates could be differentiated further by DNA restriction endonuclease analysis, whilst others with the same restriction pattern were located in different, but closely-related ETs . Fourteen isolates were tested for their virulence in mice . Most caused disease if given in high numbers, but isolates in ET 1 were virulent at lower dose rates . This virulent clone also was distinguished by the fact that 80% of isolates produced extracellular factor (EF).

J Immunol, 1994 Oct 1, 153(7), 3189 - 98
Quantitation of ICAM-1 expression in mouse lung during pneumonia; Burns AR et al.; In the systemic circulation, neutrophil emigration into sites of acute inflammation is mediated through the leukocyte adhesion complex, CD11/CD18 . ICAM-1 is an inducible endothelial ligand for CD11a/CD18 and CD11b/CD18 . Streptococcus pneumoniae elicits neutrophil emigration through a CD18-independent mechanism whereas Escherichia coli endotoxin elicits emigration through a CD18-dependent mechanism in rabbit lungs . To determine whether ICAM-1 is up-modulated in the lung during CD18-independent and CD18-dependent emigration, ultrastructural immunogold-labeling studies were performed on BALB/c mice given airway instillates of S . pneumoniae or E . coli endotoxin . Ultrathin cryosections of frozen lung tissue were immunogold labeled with the mAb YN1/1.7.4 against the murine homologue of human ICAM-1 . Gold particles on the plasma membranes of alveolar endothelial and epithelial cells were quantitated by transmission electron microscopy . Capillary endothelial ICAM-1 expression did not change during neutrophil emigration toward S . pneumoniae, a CD18-independent pathway in rabbits . In contrast, ICAM-1 expression increased 4.2-fold in response to E . coli endotoxin (known to elicit CD18-dependent emigration in mice), suggesting that the mechanism of adhesion may be regulated by the expression of endothelial rather than neutrophil adhesion molecules . Constitutive expression of ICAM-1 on alveolar epithelial cells was 22-fold greater than on capillary endothelium . Epithelial expression was mainly restricted to type I pneumocytes, whereas type II pneumocytes, the precursors of type I cells, expressed little or no ICAM-1 . However, during pneumonia, type II but not type I pneumocytes showed increased ICAM-1 expression, suggesting that ICAM-1 expression represents an early differentiation even in response to epithelial injury.

Pathology, 1994 Oct, 26(4), 487 - 9
Evaluation of new Granada medium (modified) for the antenatal screening of group B streptococcus; Kelly VN et al.; New Granada medium (NGM), modified by the substitution of trimethoprim for methotrexate, was compared to a selective Todd-Hewitt broth (NPC broth) and direct plating onto Edwards medium for assessment of genital carriage of group B streptococcus in pregnant women . Whilst NGM was found to be less sensitive (85%) than NPC broth (95%) and more sensitive than Edwards medium (67%), its use reduced the direct laboratory cost of screening by approximately 41% and also improved the time to report a result by 24 hrs.

Can J Vet Res, 1994 Oct, 58(4), 299 - 301
Immunization of mice against Streptococcus suis serotype 2 infections using a live avirulent strain; Quessy S et al.; In this study, the IgG response of mice injected with two virulent strains and one avirulent Streptococcus suis capsular type 2 strain was compared by Western blotting . The serum from mice immunized against the avirulent strain could recognize most proteins of the various strains tested and similar results were obtained with serum from mice injected with virulent strains . The live avirulent strain was injected twice (days 0 and 10) to groups of five mice, and four virulent strains from different geographical origins were used to challenge the animals . All mice, except one in one group, survived the challenge . These results suggest that a live avirulent strain could be used for immunization of swine, the natural host.

Eur J Epidemiol, 1994 Oct, 10(5), 621 - 3
Prevalence of antimicrobial resistance of Streptococcus pneumoniae in southwest Germany as determined by the E test; Abb J et al.; We have studied the prevalence of anti-microbial resistance of Streptococcus pneumoniae in Southwest Germany . One hundred seventy-four clinical isolates of pneumococci collected from hospitalized patients between October 1992 and April 1994 were used for MIC determinations . MICs for penicillin, ceftriaxone, erythromycin, and rifampicin were assessed by the E test . Eleven of the 174 strains (6.3%) were intermediately resistant to penicillin (MIC between 0.1 and 1.0 microgram/ml) and four of the 174 strains (2.3%) were intermediately resistant to ceftriaxone (MIC between 0.1 and 1.0 microgram/ml) . All four isolates with a reduced susceptibility to ceftriaxone also demonstrated intermediate resistance to penicillin . Six of the 174 strains (3.5%) were highly resistant (MIC > or = 8 micrograms/ml) to erythromycin . Resistance to rifampicin was not observed . Our results demonstrate that pneumococcal resistance to penicillin and erythromycin has increased markedly in Germany over the last decade . Our findings underline the need for continuous surveillance of antimicrobial resistance of Streptococcus pneumoniae.

Pediatr Infect Dis J, 1994 Oct, 13(10), 873 - 8
Invasive pneumococcal disease in a pediatric population, Auckland, New Zealand; Voss L et al.; Streptococcus pneumoniae is one of the major invasive pathogens in childhood . The increasing worldwide prevalence of penicillin-resistant strains makes management of invasive infections difficult and underscores the need for effective vaccines . Currently available vaccines are of limited value in the pediatric age group . Trials are taking place to evaluate conjugated pneumococcal vaccines and in view of this it is important to establish local epidemiology of pneumococcal disease . The aims of this population-based study were to review all of the cases of invasive pneumococcal disease occurring during a 9-year period (1984 to 1992) in Auckland, New Zealand . Through the use of laboratory records and hospital discharge codes, 413 isolates from 407 patients were found . Age-specific incidence for all invasive disease was 22.0/100,000 for children less than 15 years old but 56.0/100,000 for children less than 5 years old (chi 2 Yates corrected 18.20; P = 0.001) . Two-thirds were less than 2 years old . The rates were higher in Maori and Pacific Island children than in Caucasian children . A total of 70 isolates from 68 patients with meningitis occurred . The majority were less than 5 years old (incidence of meningitis was 10.0/100,000) and 84% were less than 2 years old . The overall mortality from meningitis was 4.3% . Of the 129 isolates serogrouped or serotyped, 14, 6 and 19 accounted for 23%, 16% and 16%, respectively, of cases . Although 98% of serotypes identified would be covered by the currently available 23-valent vaccine, two-thirds of the children affected by these isolates would be unprotected because of poor immunogenicity of polysaccharide vaccines in children less than 2 years old.

Antimicrob Agents Chemother, 1994 Oct, 38(10), 2280 - 6
Identification of antimicrobial peptides by using combinatorial libraries made up of unnatural amino acids; Blondelle SE et al.; The use of water-soluble synthetic peptide combinatorial libraries permits the systematic examination of tens to hundreds of millions of peptides in existing microdilution assays . In the present study, we prepared and determined the antistaphylococcal activities of two new synthetic peptide combinatorial libraries (one N-acetylated, the other not) composed of tetrapeptides having one position defined and the remaining three positions made up of mixtures of L-, D-, and unnatural amino acids (a total of 58 different amino acids) . These libraries, when used in conjunction with an iterative selection process, allowed for the development of a series of individually defined tetrapeptides with high levels of activity against Staphylococcus aureus . The activities of the final individual peptides against two additional strains of gram-positive bacteria (methicillin-resistant S . aureus and Streptococcus sanguis), a gram-negative bacterium (Escherichia coli), as well as the yeast Candida albicans were also determined . Cell viability assays showed that the identified peptides are bacteriostatic against both S . aureus and E . coli.

J Dairy Sci, 1994 Oct, 77(10), 3192 - 7
Efficacy of two barrier teat dips containing chlorous acid germicides against experimental challenge with Staphylococcus aureus and Streptococcus agalactiae; Boddie RL et al.; Two postmilking teat dips were tested for efficacy against Staphylococcus aureus and Streptococcus agalactiae using experimental challenge procedures recommended by the National Mastitis Council . Both dips contained chlorous acid as the primary germicidal agent and lactic acid or mandelic acid as the chlorous acid activator . The dip activated with mandelic acid significantly reduced new IMI by Staph . aureus and Strep . agalactiae . The IMI rate was reduced 68.7% for Staph . aureus and 56.4% for Strep . agalactiae . The dip activated with lactic acid significantly reduced new Staph . aureus IMI by 69.3% but did not significantly reduce new Strep . agalactiae IMI (35.2% reduction) through the full 11-wk study period . Teat skin condition did not change from pretrial status after using either teat dip during the study.

J Dairy Sci, 1994 Oct, 77(10), 2959 - 64
Proliferation of a bovine mammary epithelial cell line in the presence of bacterial virulence factors; Matthews KR et al.; Effects of bacterial virulence factors on bovine mammary cell structure and function are not well defined . In this study, we evaluated the influence of specific bacterial virulence factors on proliferation of a bovine mammary epithelial cell line . The MAC-T cells were cultured in the presence of medium only, Staphylococcus aureus alpha-toxin, Staph . aureus beta-toxin, Escherichia coli endotoxin, Streptococcus uberis capsule, or hyaluronidase . Cells were cultured in the presence of virulence factors for 48 h at 37 degrees C . The MAC-T cell proliferation was inhibited by all concentrations of endotoxin and alpha-toxin and by most concentrations of hyaluronic acid capsule and hyaluronidase > 7.8 micrograms/ml . Staphylococcus aureus beta-toxin had no effect on MAC-T cell proliferation . Virulence factors produced by mastitis pathogens may influence mammary epithelial cell proliferation in vivo, which could be important during the periparturient period, when mammary tissue undergoes rapid differentiation and growth.

Ethiop Med J, 1994 Oct, 32(4), 265 - 8
Adult pneumococcal meningitis with no inflammatory cells in the CSF; Zenebe G; An 18 year old male patient was admitted to the Medical Intensive Care Unit of the Tikur Anbessa Hospital in October 1988 . He was in deep coma and had findings consistent with a left lobar pneumonia . Lumbar puncture revealed a turbid CSF . Gram stain on both centrifuged and uncentrifuged specimens revealed plenty of gram positive diplococci with no single inflammatory cell . CSF culture proved the organism to be Streptococcus pneumoniae . The patient was put on combination of high doses of intravenous sodium-penicillin and chloramphenicol with all appropriate supportive management . However, the patient died only after three hours of stay in the hospital . The condition of diminished to absent inflammatory response in the CSF associated with pneumococcal meningitis in adults is discussed with a review of the literature.

West J Med, 1994 Oct, 161(4), 383 - 9
Community-acquired pneumonia in adults; Sue DY; Although the frequency of community-acquired pneumonia caused by Streptococcus pneumoniae continues to be high, studies show that Mycoplasma pneumoniae, Chlamydia pneumoniae, or Legionella pneumophila are the etiologic agents in 20% to 40% of community-acquired pneumonia in adults . The clinical presentation of pneumonia caused by these organisms may be indistinguishable from pneumonia due to S pneumoniae . Separation of cases of pneumonia due to S pneumoniae as typical and that caused by M pneumoniae, C pneumoniae, or L pneumophila as atypical is unwarranted and unhelpful in planning therapy . As many as 35% to 50% of patients do not have an etiologic agent identified . Community-acquired pneumonia can have high morbidity and mortality in patients who are older, have underlying lung disease, diabetes mellitus, or other comorbid conditions, or who have decreased immune function regardless of the specific etiologic agent . In choosing appropriate empiric antimicrobial therapy in hosts who are not immunocompromised, erythromycin and other macrolide antibiotics have the advantage of being effective against a wide range of pathogens likely to be encountered, including S pneumoniae, M pneumoniae, and L pneumophila, and of having some benefit against C pneumoniae . In other patients, the selection of antibiotic therapy can be based on age, clinical suspicion, epidemiologic data, and laboratory test results . Antimicrobial therapy can be directed at specific organisms when and if they are identified.

J Clin Microbiol, 1994 Oct, 32(10), 2572 - 5
Pneumococcal resistance to antimicrobial agents in the province of Québec, Canada; Jette LP et al.; The serogroup/serotypes (SGTs) and antimicrobial susceptibilities to 10 antimicrobial agents of 110 clinical strains of Streptococcus pneumoniae were determined . Strains intermediately resistant or highly resistant to penicillin G (80 of 110) belonged predominantly to SGTs 23 (45.0%), 19 (13.7%), 6 (10.0%), 9 (6.2%), and 14 (3.7%) . The MICs of all cephalosporins, tetracycline, trimethoprim-sulfamethoxazole, and chloramphenicol increased along with the MICs of penicillin G . However, erythromycin resistance and clindamycin resistance were observed more frequently among the intermediately penicillin-resistant strains . Multiple resistance was observed for 32 strains, of which 25 were highly resistant to penicillin G and belong to SGT 23F . All strains were susceptible to vancomycin.

Clin Infect Dis, 1994 Oct, 19(4), 781 - 3
Lung abscess due to Streptococcus mitis: case report and review; Carrascosa M et al.; Streptococcus mitis is a bacterium traditionally regarded as a normal commensal of the oropharynx, skin, and intestinal and genital tracts . To our knowledge, we describe the first case of bilateral lung abscesses caused by S . mitis in an immunocompetent host . The abscesses were successfully treated with clindamycin and gentamicin . Our case illustrates that S . mitis should be considered a cause of pulmonary abscesses.

Clin Infect Dis, 1994 Oct, 19(4), 704 - 13
Bacteremia involving the "Streptococcus milleri" group: analysis of 19 cases; Jacobs JA et al.; During a 3-year study period, 19 patients at the University Hospital of Maastricht developed bloodstream infections with species of the "Streptococcus milleri" group, for an incidence of 0.33 per 1,000 admissions . The patients' median age was 48 years; the male-to-female ratio was 2.8 . Eleven patients (57.9%) had underlying diseases, among which malignancy was predominant . Local trauma to the mucosal barrier was an important risk factor . An associated site of infection was found most frequently in the abdominal and thoracic cavities (nine and five cases, respectively) . Bacteremia was polymicrobial in four of 19 episodes . The 20 infecting S . milleri strains were identified to the species level; Streptococcus anginosus was the most prevalent (16 strains) . Eight strains carried Lancefield group C . The isolates were sensitive to most antibiotics . Abscess formation was documented in nine cases (47.3%); repeated drainage procedures were required in half of these episodes . Mortality was high (five of 19 patients, or 26.3%).

Phytochemistry, 1994 Oct, 37(3), 889 - 91
Anti-oral microbial activity of isoflavonoids in root bark of Ormosia monosperma; Iinuma M et al.; From the root bark of Ormosia monosperma, 10 isoflavonoids including two new compounds 7,4'-dihydroxy-6",6"-dimethylpyrano-(2",3":5,6)-8-(3-methyl-1,3- butadienyl)isoflavone, named ormosidin, and dalbergion 4'-O-beta-D-glucopyranoside, were isolated . These structures were confirmed by spectroscopic analysis . 2,3-Dihydroauriculatin, one of the compounds isolated, showed moderate activities against oral-microbial organisms (Streptococcus mutans, Prophyromonas gingivalis and Actinomyces actinomycetemcomitans).

Zentralbl Veterinarmed B, 1994 Oct, 41(7-8), 453 - 9
Relation between encapsulation and various properties of Streptococcus suis; Wibawan IW et al.; Encapsulation is thought to be a critical virulence factor for Streptococcus suis . In this study, encapsulation of a selected S . suis culture could be stimulated by cultivation conditions . After cultivation of the S . suis culture in fluid media supplemented with serum, the culture grew with short chains and a uniform turbidity of the growth medium . Autoclave extracts of this culture reacted with capsular type-1-specific antiserum . After cultivation of the S . suis culture in fluid media without serum, the bacteria generally formed longer chains, grew in fluid medium as granular sediment with clear supernatant, and were non-typeable . In addition, the unencapsulated variant appeared to have a more hydrophobic surface and adhered significantly more to HeLa cells . In contrast to the unencapsulated variant, the encapsulated S . suis was phagocytosed to a lesser extent by polymorphonuclear leucocytes . These findings might help to elucidate the role of encapsulation in infections with this bacterial organism.

Can J Vet Res, 1994 Oct, 58(4), 259 - 62
Genomic relatedness among reference strains of different Streptococcus suis serotypes; Harel J et al.; Hybridization studies using genomic DNA and a rDNA probe revealed genetic relatedness among reference strains of different Streptococcus suis serotypes . Although most serotype 22 isolates are biochemically atypical, the reference strain of capsular type 22 is genetically related to other S . suis serotypes, but not to Streptococcus pneumoniae . Using DNA digested with BamHI and BglII for ribotyping, some S . suis reference strains had common patterns, but this analysis mainly revealed variations in patterns of S . suis strains of different serotypes.

Hybridoma, 1994 Oct, 13(5), 403 - 8
Production and partial characterization of monoclonal antibodies against erythrogenic toxins type A and C from Streptococcus pyogenes; Wollweber L et al.; Hybridoma cell lines producing monoclonal antibodies against streptococcal erythrogenic toxins type A and C were established from fusions of immunized BALB/c mice splenocytes with P3X63-Ag8.653 myeloma cells . Six MAbs recognize ETA and 11 MAbs bind to ETC . Two MAbs (designated ETA-2 and ETC-10) were produced in ascitic fluid and further characterized . ETA-2 (IgG2a) binds to ETA with an affinity constant of 1.8 x 10(10) M-1 and ETC-10 (IgG1) binds to ETC with an affinity constant of 3.5 x 10(9) M-1 . The specificities of the MAbs were evaluated by ELISA and immunoblotting . Both MAbs ETA-2 and ETC-10 are useful in developing specific double-sandwich ELISAs, in which the MAbs were used as solid-phase capture antibodies for the quantitative determinations of ETA and ETC.

J Immunol, 1994 Oct 1, 153(7), 3177 - 88
Quantitation of L-selectin and CD18 expression on rabbit neutrophils during CD18-independent and CD18-dependent emigration in the lung; Burns AR et al.; In the systemic circulation, the leukocyte adhesion molecule, L-selectin facilitates the initial adhesion of the neutrophil to the inflamed endothelium, whereas CD11/CD18 is essential to transendothelial migration . Previous work from our laboratory showed that neutrophil emigration in the lung occurs through either a CD18-independent or CD18-dependent mechanism, depending on the inflammatory stimulus . This study quantitated and compared the surface expression of L-selectin and CD18 on neutrophils in the lungs of rabbits during emigration toward Streptococcus pneumoniae (a CD18-independent stimulus) and Escherichia coli endotoxin (a CD18-dependent stimulus) . Ultrathin frozen lung tissue sections were immunogold labeled for 1-selectin and CD18, and gold particles were quantitated on intravascular, interstitial, and airspace neutrophils by transmission electron microscopy . The results show that CD18-independent neutrophil emigration was associated with L-selectin down-modulation (78%) and CD18 up-modulation (260%) on intravascular neutrophils, before emigration . A similar alteration in the expression of L-selectin and CD18 was observed during CD18-dependent neutrophil emigration, but only on neutrophils that emigrated into the interstitium and airspace . In emigration induced by either stimulus, alterations in L-selectin and CD18 expression were restricted to the inflammatory focus and emigrated airspace neutrophils consistently expressed greater levels of CD18 than intravascular and interstitial neutrophils . We conclude that before emigration, L-selectin and CD18 expression on intravascular neutrophils is altered only during CD18-independent emigration and only on those neutrophils within the inflammatory focus . The increased CD18 expression on airspace neutrophils may facilitate bacterial phagocytosis.

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