Streptococci

Pneumologie, 1993 Nov, 47(11), 626 - 30
{Effect of a filter system on measurement data and bacterial contamination in lung function studies}; Strauss R et al.; 80 measurements of the airway resistance of 20 patients did not yield any significant differences with or without using a bacterial filter (Pall PF 30) (p = 0.1213) . Likewise, lung function tests conducted in 61 further patients did not reveal any relevant changes caused by introducing the filter, in respect of the lung function parameters VKin, FEV1, PEF, FEF25, FEF50, FEF75 and TLCO . In these studies the flow receptors were examined for contamination by bacteria . The introduction of the bacterial filter reduced the total count of identified germs from 108, 615 to 307, i.e . by 99.7 per cent, the greatest contamination being found in those parts that were close to the patient (57.6% with filter, 97.1% without filter) . Germs of the resident flora of the mouth and pharynx were identified, and occasionally also potential infectious agents such as staphylococcus aureus and streptococcus pneumoniae . The use of a filter system results in a marked decrease in the exposition to germs in lung function tests, without exercising any adverse effect on the measurement data (cross-contamination risk: 0.00078%) . This is also achieved--albeit to a lesser extent--by changing those parts of the flow receptor that are close to the patient (cross-contamination risk: 0.0841%) . Hence, the use of a filter system appears particularly meaningful in patients with considerable immunodeficiency (advanced stages of HIV infection).

Jpn J Antibiot, 1993 Nov, 46(11), 953 - 8
{Pharmacokinetic, bacteriological and clinical studies on S-1108 in children}; Tajima T et al.; Pharmacokinetic, bacteriological and clinical studies on S-1108 were performed in children . The results were as follows: 1 . A total of 11 patients were treated with S-1108 . Each dose was 3 mg/kg, orally administered 3 times daily for 4-14 days . The clinical efficacies of S-1108 in 10 patients with bacterial infections (1 with bacteremia, 4 with pneumonia, 1 with acute maxillary sinusitis, 1 with scarlet fever and 2 with streptococcal pharyngitis) were evaluated as excellent in 8 patients and as good in 2 patients with an efficacy rate of 100% . Only one patient with staphylococcal scalded skin syndrome due to methicillin resistant Staphylococcus aureus (MRSA) who received gamma-globulin was not evaluated . Fourteen causative strains of 5 species were found in 10 patients . Three strains of Streptococcus pneumoniae out of 5, 2 of 3 Branhamella catarrhalis strains, none of Staphylococcus aureus and all 3 strains of Streptococcus pyogenes were eradicated . No adverse reaction was observed in any of the 11 patients . 2 . MICs of S-1108 against 5 clinically isolated S . pneumoniae from cases of infections were examined . All of them were relatively highly resistant to penicillins . S-1108 was compared with cefteram pivoxil, cefpodoxime proxetil, cefaclor and cefixime, and it showed better antibacterial activity or than other cephems . 3 . Double peaks were obtained in plasma levels of S-1108 orally administered at a dose of 3 mg/kg at 30 minutes after meal and were 1.03 microgram/ml and 0.74 microgram/ml at 1 and 4 hours after administration, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

J Infect, 1993 Nov, 27(3), 317 - 23
Investigation of milk-borne Streptococcus zooepidemicus infection associated with glomerulonephritis in Australia; Francis AJ et al.; An outbreak of infection due to Streptococcus zooepidermicus is reported . The index case was a patient who suffered an episode of septicaemia complicated by glomerulonephritis . Two other persons in his family were found to be asymptomatic throat carriers . The source of the outbreak was unpasteurised milk from a house cow on the farm where the family lived . Molecular studies confirmed that the strains isolated from the index case, the other family members and the cow's milk were identical . Although a renal biopsy was not performed, the diagnostic criteria for poststreptococcal glomerulonephritis were satisfied . The organism is an uncommon human pathogen that sometimes causes outbreaks of severe infection which may be associated with glomerulonephritis.

J Infect, 1993 Nov, 27(3), 277 - 9
Meningitis due to penicillin resistant Streptococcus pneumoniae occurring in a patient on long term ampicillin prophylaxis; Chadwick PR et al.; A patient with persistent dural fistula, CSF rhinorrhoea and a history of recurrent bacterial meningitis developed meningitis with a penicillin-resistant strain of Streptococcus pneumoniae while on prophylactic ampicillin . The microbiological aspects of management are discussed.

Neurologia, 1993 Nov, 8(9), 317 - 9
{Thalamic abscess . A stereotaxically treatable lesion}; Gelabert Gonzalez M et al.; Solitary abscesses of the thalamus are an infrequent entity which carry serious problems with regard to treatment . We present a patient with an unknown septic focci who developed a right thalamic abscess due to Streptococcus constellatus and was treated by stereotaxic drainage for the suppuration and antibiotics . The patient was clinically and radiologically (CAT) controlled up until total cure of the lesion . Complications included dissemination of the infection to the meningeal space and a residual coreic picture controlled with tetrabenzine . The authors believe that evacuation by stereotaxic punction should be included among the therapeutic options available for deeply localized cerebral abscesses.

Arch Oral Biol, 1993 Nov, 38(11), 985 - 95
Effects of low fluoride concentrations on formation of caries-like lesions in human enamel in a sequential-transfer bacterial system; Wahab FK et al.; Human enamel surfaces were exposed to sequential batch cultures of Streptococcus mutans NCTC 10832 in a sucrose-rich medium containing 0-5 mg/l added fluoride (F) . In 10-day experiments, subsurface lesion formation was partly inhibited by 1 mg/l F and completely by 2 and 5 mg/l F, but small lesions formed in 2 mg/l F in 21-day experiments . Analysis of the spent media, together with analogous, bacteria-free experiments, suggested that lesion inhibition involved two main effects . First, inhibition of bacterial acid production reduced the pH fall, resulting in reduced undersaturation with respect to hydroxyapatite and consequently reduced rate of demineralization . Secondly, interaction of F with enamel mineral resulted in a small increase in reprecipitation during periods of supersaturation and a much larger reduction in demineralization during periods of undersaturation . It is concluded that, at low F concentrations, inhibition of bacterial acid production is a major factor in lesion inhibition, which may contribute significantly to caries prevention in vivo where plaque fluid F levels are raised by frequent topical applications.

Am J Vet Res, 1993 Nov, 54(11), 1803 - 7
Sensitivity and specificity of bronchoalveolar lavage and protected catheter brush methods for isolating bacteria from foals with experimentally induced pneumonia caused by Klebsiella pneumoniae; Hoffman AM et al.; One indication for referral of horses to veterinary hospitals is for diagnosis of the microbiologic cause of pneumonia, particularly when the initial treatment fails . Although endoscopic methods have long been available for microbiologic sample collection, accuracy of these methods under these conditions have not been studied in detail . We compared the bacteria isolated from samples obtained by bronchoalveolar lavage (BAL) with those obtained by protected catheter brush (PCB) from foals with unilateral pneumonia induced by inoculation with Klebsiella pneumoniae . As part of previously described clinical trials, foals were administered antimicrobial therapy IM (n = 15) or vehicle IM (n = 7), and collection of distal airway secretion samples was conducted during the treatment period . Sensitivity and specificity of the sample collection methods were assessed by comparison of the isolates from BAL or PCB samples with isolates from tissue of the inoculated lung lobe, which was the most severely affected lung region . Sensitivity and specificity of BAL for recovery of K pneumoniae (challenge strain) and Streptococcus zooepidemicus (common secondary pathogen) was 90 and 69%, respectively, compared with 76 and 85%, respectively, for the PCB method . Sensitivity was significantly (P = 0.03) higher for BAL (100%) than for PCB (69%) for recovery of K pneumoniae (P = 0.03) from lungs . However, difference in the sensitivity of these methods for recovery of S zooepidemicus was not significant . In conclusion, BAL was a more reliable method for recovery of bacteria from the lungs in chronically infected foals that received antimicrobial treatment.

Respir Med, 1993 Nov, 87(8), 595 - 601
Comparative bronchoalveolar concentrations of ciprofloxacin and lomefloxacin following oral administration; Baldwin DR et al.; In a comparative study, the concentrations of two fluoroquinolone antimicrobials, ciprofloxacin and lomefloxacin, were measured in serum, bronchial mucosal biopsies, epithelial lining fluid (ELF) and alveolar macrophages (AM) . Thirty-four subjects received either ciprofloxacin 250 mg b.d . (17 subjects) or lomefloxacin 400 mg o.d . for 4 days prior to sampling by bronchoscopic bronchial biopsy and bronchoalveolar lavage . Both ciprofloxacin and lomefloxacin showed favourable accumulation in the sites of infection with bronchial biopsy concentrations of 1.6 and 1.7 times those of serum respectively; ELF concentrations of 2.1 and 1.9 times serum; and AM concentrations of 11.8 and 20.1 times serum respectively . The MIC90 for most of the common chest pathogens was reliably exceeded by both agents except for that of Streptococcus pneumoniae.

J Photochem Photobiol B, 1993 Nov, 21(1), 81 - 6
Effect of extracellularly generated singlet oxygen on gram-positive and gram-negative bacteria; Valduga G et al.; In the separated surface-sensitizer system, a photosensitizer is physically separated from the substrate by a thin air layer under such conditions that only singlet oxygen can reach and oxidize the substrate, preventing the competition by type I photosensitized processes . This method has been used to study the reaction of singlet oxygen with Gram-positive (Streptococcus faecium) and Gram-negative (Escherichia coli) bacterial strains . Studies on cell samples exposed to singlet oxygen for different periods of time show a drastic decrease in survival for S . faecium, while E . coli becomes sensitive only when the integrity of the outer membrane is altered by treatment with CaCl2 or tris(hydroxymethyl)aminomethane-ethylenediaminetetraacetic acid (Tris-EDTA) . Biochemical and ultrastructural analyses suggest that the cytoplasmic membrane and the genetic material are the main sites damaged by singlet oxygen.

J Gen Intern Med, 1993 Nov, 8(11), 626 - 34
Infections due to antibiotic-resistant gram-positive cocci; Caputo GM et al.; Gram-positive cocci are becoming increasingly resistant to traditionally used antimicrobial agents . Staphylococcus aureus, coagulase-negative staphylococci, the enterococcus, and Streptococcus pneumoniae are the most commonly encountered of such pathogens in clinical practice . Clinicians should be keenly aware of the usual types of infections that are caused by these organisms and the importance of documenting susceptibilities of infecting strains . The basic mechanisms of resistance should be familiar to clinicians so that an inappropriate empiric regimen will not be selected (e.g., addition of a beta-lactamase inhibitor for penicillin-resistant pneumococci) . Vancomycin remains the agent of choice, sometimes in combination with gentamicin and/or rifampin, for most cases of infection due to these resistant gram-positive organisms . Last, increased efforts toward prevention, such as strict adherence to infection control measures, selective use of broad-spectrum antibiotics, and increased use of pneumococcal vaccine, may be useful to help stem the rising tide of infections due to resistant gram-positive cocci.

Clin Infect Dis, 1993 Nov, 17(5), 913 - 24
A brief history of the pneumococcus in biomedical research: a panoply of scientific discovery; Watson DA et al.; Because of its prominence as a cause of disease in humans, Streptococcus pneumoniae has been the subject of intensive investigation at both the clinical level and the basic scientific level during the past century . In a number of instances, these studies have resulted in important progress toward the comprehension of basic biological principles . The areas advanced by studies of the pneumococcus include an understanding of the concept of pathogenesis of infectious disease; the development of Gram's stain for identification of bacteria in specimens from patients; the elucidation of the role of the bacterial capsule in resistance to phagocytosis by cells of the host's immune system; the demonstration that molecules other than proteins are capable of eliciting the host's humoral immune responses and later, by extension, that isolated bacterial exopolysaccharides can be used safely and effectively as vaccines in humans; the documentation of the efficacy of penicillin; the collection of conclusive evidence that DNA encodes genetic information; and the investigation of putative proteinaceous virulence factors.

Appl Environ Microbiol, 1993 Nov, 59(11), 3669 - 73
Molecular cloning and expression of two alpha-amylase genes from Streptococcus bovis 148 in Escherichia coli; Satoh E et al.; The alpha-amylase genes of Streptococcus bovis 148 were cloned in Escherichia coli MC1061, using pBR322 . The recombinant plasmids were classified into two groups on the basis of their restriction maps . Southern blot analysis did not show homology between the two types of alpha-amylase genes, and the two alpha-amylase genes existed on the chromosomal DNA of S . bovis 148 . The enzymatic properties and N-terminal amino acid sequences of the two purified enzymes produced by the cloned E . coli strains were quite different from each other . Particularly, one alpha-amylase (Amy I) was adsorbed on raw corn starch and hydrolyzed raw corn starch, and another (Amy II) was not adsorbed on raw corn starch and did not hydrolyze raw corn starch . Amy I was considered to be the same as the extracellular alpha-amylase of S . bovis 148 in raw starch absorbability, ability to hydrolyze raw corn starch, enzymatic characteristics, N-terminal amino acid sequence, and mode of action on soluble starch . Amy II showed a unique pattern of oligosaccharide production from soluble starch compared with the extracellular alpha-amylase of S . bovis 148 . Amy II was suggested to be an intracellular alpha-amylase of S . bovis 148.

Kansenshogaku Zasshi, 1993 Nov, 67(11), 1057 - 61
Internal bacterial flora of solid uterine cervical cancer; Mikamo H et al.; Twenty-five patients with uterine cervical cancer (Two cases stage O; four cases stage Ia; five cases stage Ib; one case stage IIa; ten cases stage IIb; two cases stage IIIa; one case stage IVa) served as the subjects . The bacterial flora inside the cervical cancers was investigated using the optimal technique . There was mixed abnormal aerobic and anaerobic bacterial flora in all subjects . The average number of bacterial species isolated from inside the cervical cancers was 6.3 . The predominant bacteria isolated were the aerobes, Staphylococcus haemolyticus, Streptococcus agalactiae, Escherichia coli and Gardnerella vaginalis, and Prevotella bivia . As the stages of cervical cancer progressed, G . vaginalis, B . distasonis and P . bivia were detected at higher rates and higher counts than other bacteria . These findings suggest that there is a relationship between G . vaginalis, B . distasonis and P . bivia and the onset and growth of cervical cancer.

J Clin Microbiol, 1993 Nov, 31(11), 2895 - 900
Population structure of Australian isolates of Streptococcus suis; Hampson DJ et al.; The genetic diversity of 109 isolates of Streptococcus suis, which were recovered mainly from Australian pigs, was examined by multilocus enzyme electrophoresis . The collection was genetically diverse . Sixty-five electrophoretic types (ETs) were recognized, with a mean genetic diversity per enzyme locus of 0.512, or 0.431 when the number of isolates in each ET was considered . Serotype diversity varied, being greatest for isolates of capsular serotype 15 (0.364), and then diminishing in the order of serotypes 9, 1, 4, 1/2, 2, 7, and 3 (0.120) . On average, isolates from these eight serotypes represented 4.13 separate clonal groups per serotype . This diversity indicated that serotyping of S . suis for subspecific differentiation is not a reliable technique for identifying specific strains and is not a good predictor of the genetic background of a given isolate . No tendency for isolates recovered from healthy pigs to be genetically distinct from those from diseases animals was found, nor were there consistent differences between isolates recovered from animals with different disease syndromes (meningitis, pneumonia, and septicemia) . Danish reference strains of serotypes 1, 2, and 7 each belonged to one of the same clonal groupings of these types found in Australia, but Danish strains of serotypes 3, 4, 6, and 8 and a strain of serotype 1 from the United Kingdom were each genetically distinct from the Australian isolates . Generally, isolates in the same ET belonged to the same serotype, but one ET contained isolates of types 6 and 6/16, and three were made up of isolates of types 2 and 1/2 . One isolate of serotype 2, which was recovered from a human with meningitis, belonged to the same ET as two isolates of serotype 2 that were recovered from pigs . The human infection was therefore likely to have been zoonotic.

Pediatr Pulmonol, 1993 Nov, 16(5), 303 - 10
Effect of amrinone during group B Streptococcus-induced pulmonary hypertension in piglets; Berger JI et al.; Intravenous infusion of group B Streptococcus (GBS) into neonatal animals produces pulmonary hypertension, ventilation/perfusion (VA/Q) mismatch, and an increase in serum levels of thromboxane B2 (TxB2) and tumor necrosis factor (TNF) alpha . The vasodilator amrinone (amr) is a cGMP-inhibited phosphodiesterase inhibitor and is reported to inhibit thromboxane A2 and TNF production . We hypothesized that infusion of amr would cause pulmonary vasodilation and reduce serum TxB2 and TNF levels in piglets with late phase GBS-induced pulmonary hypertension . The effect of amr on gas exchange was also determined . A continuous infusion of GBS was administered for 5 hr to 4 groups of anesthetized, mechanically ventilated neonatal piglets . An amr bolus of 8 mg/kg was given at 4 hr followed by a 1 hr continuous infusion of either 10 or 20 micrograms/kg/min of amr (amr 10 and amr 20, respectively) . Control piglets received a bolus and 1 hr infusion of amr carrier . The infusion of amr, but not of carrier reversed late phase GBS-induced pulmonary hypertension . Piglets infused with amr 20 showed transient selective pulmonary vasodilation, based on a reduced ratio of pulmonary to systemic vascular resistance (PVR/SVR ratio) value at 30 min but not at 1 hr, compared to pre-amr treatment values . The PVR/SVR ratio values for amr 10 and control group did not change after treatment with either amr or carrier . Treatment with amr 10 or 20 did not decrease serum TxB2 or TNF levels or increase VA/Q mismatch.(ABSTRACT TRUNCATED AT 250 WORDS)

J Periodontal Res, 1993 Nov, 28(6 Pt 1), 404 - 10
Production and characterization of monoclonal antibodies against bacterial lectin of Eikenella corrodens; Nakae H et al.; A lectin-like substance (EcLS) was purified from the Eikenella corrodens 1073 cell and monoclonal antibodies were produced against it to confirm the role of EcLS in adhesive properties of E . corrodens such as hemagglutination and coaggregation with oral bacteria . Four hybridoma clones were selected . Two of the antibodies were of the IgG1 isotype and the others were of the IgG2b isotype . These monoclonal antibodies inhibited both the hemagglutination of E . corrodens and the coaggregation with Actinomyces viscosus or Streptococcus sanguis . The reactivity of the monoclonal antibody to E . corrodens 1073 was significantly higher than that to E . corrodens 1080 of which adhesive activity was weaker than that of E . corrodens 1073 . These findings suggest the difference in adhesive properties is due to the difference in the amount of EcLS expressed on the cell surface . The immunoelectron microscopic study revealed that EcLS of E . corrodens 1073 was localized in the outer space of outer membrane, not in cell surface appendages such as fimbriae where bacteria possessed adhesin . These results suggest that coaggregation of E . corrodens with A . viscosus or S . sanguis was mediated by EcLS.

J Periodontal Res, 1993 Nov, 28(6 Pt 1), 396 - 403
Nifedipine-induced gingival overgrowth in the presence or absence of gingival inflammation in rats; Morisaki I et al.; One adverse effect of nifedipine, a long-acting vasodilator, is gingival overgrowth . Preexisting gingival inflammation and/or dental plaque has been suggested to be responsible for the progression of this side effect, but the precise mechanism is uncertain because of a lack of suitable animal models . A study was therefore done to establish an experimental model of gingival overgrowth in rats and to investigate the possible involvement of gingival inflammation and/or dental plaque in its development . Specific pathogen-free Fischer rats (male, 14 days old) were used . Gingival inflammation and dental plaque accumulation were induced by infection with Streptococcus mutans MT8148R . The nifedipine-treated rats (experimental group) were fed a caries-inducing diet containing nifedipine either with or without infection, while the nifedipine-untreated rats (control group) were fed the same diet, similarly with or without the infection . Marked gingival overgrowth was induced in the mandibular molar region of nifedipine-treated rats regardless of S . mutans infection, although the infection resulted in a further increase in the degree of gingival overgrowth . Histological examination of the gingival overgrowth revealed the presence of redundant subepithelial connective tissue in the treated rats, and inflammatory cell infiltration was apparent only in the tissue of the S . mutans-infected rats regardless of the nifedipine administration . These findings suggest that nifedipine induces gingival overgrowth in rats either in the presence or absence of gingival inflammation and/or dental plaque, although these factors can augment the effect of the drug.(ABSTRACT TRUNCATED AT 250 WORDS)

Prep Biochem, 1993 Nov, 23(4), 449 - 72
The histidyl-tRNA synthetase from Streptococcus equisimilis: overexpression in Escherichia coli, purification, and characterization; Menguito CA et al.; We describe the high-level expression of the Streptococcus equisimilis histidyl-tRNA synthetase gene (hisS) in Escherichia coli and the purification and characterization of the gene product . Due to a lack of an efficient E . coli ribosome binding sequence in the hisS gene, the coding region was fused in-frame to the expression vector pT7-7, thereby creating a fusion gene construct (pT7-7recIII), which is under the control of a strong bacteriophage T7 promoter . Another construct (pT-7recII) was used for low level expression of the native histidyl-tRNA synthetase (HisRS) . The plasmids were electroporated into E . coli HB101, which already contained pGP1-2 . After temperature induction, the fusion HisRS, which has an extra 15 amino acids between the initiator Met and the second amino acid, Lys, was expressed at a level of approximately 18% of total cell protein (approximately 50 mg/liter of bacterial culture) . The fusion HisRS was purified to > 99% by a combination of anion exchange and cation exchange chromatography of the S100 fraction . The predicted MWs of the native and fusion proteins are 47,932 and 49,717, respectively . The mass of the active fusion HisRS was estimated to be 94,000 Da by Sephacryl S-200 gel filtration chromatography and 108,200 Da by nondenaturing PAGE . Both methods show that the functional enzyme is a dimer of two identical subunits . SDS-PAGE analysis of purified fusion HisRS with or without reduction showed a single band of M(r) = 53.7 kDa.

Vet Clin North Am Food Anim Pract, 1993 Nov, 9(3), 537 - 49
Immunization and immunotherapy for mastitis; Tyler JW et al.; Immunization and immunotherapy for mastitis are active areas of investigation . The past decade has seen development of effective and economical R-mutant vaccines for gram-negative mastitis . These vaccines doubtless will prove beneficial on well managed dairies that have eradicated contagious mastitis pathogens . Development of vaccines for other mastitis pathogens has been noticeably slower . A commercially available Staphylococcus aureus vaccine appears to reduce the frequency and severity of clinical episodes, but probably has minimal impact on the incidence or prevalence of infection . This product has not been extensively studied . The recent recognition of virulence factors produced in vivo by Staphylococcus aureus may provide a breakthrough in the development and production of Staphylococcus aureus vaccines . Bacterins employing this principle presently are not commercially available, however . In the case of all contagious mastitis pathogens (Streptococcus agalactiae, Staphylococcus aureus, and Mycoplasma spp.), traditional control and eradication efforts (teat dip, dry cow therapy, culling programs) likely will prove preferable to long-term immunization . Ongoing research may provide more efficacious vaccines for these mastitis syndromes . Immunostimulants are an active area of research . Although leukopoietic factors appear promising as immunostimulants, no compound has clearly demonstrated efficacy in either the prevention or treatment of bovine mastitis.

Chest, 1993 Nov, 104(5), 1610 - 2
Severe pneumococcal pneumonia complicated by massive pulmonary gangrene; Hammond JM et al.; Massive pulmonary gangrene is a rare complication of pneumonia, particularly in the postantibiotic era . We report two cases of community-acquired Streptococcus pneumoniae pneumonia in young patients with a background of heavy alcohol abuse, but no other preexisting disease, which failed to respond to appropriate antibiotic therapy and intensive care . In both, there was extensive unilateral involvement, with initial dense consolidation followed by cavitation, but the previously reported classic later radiologic feature of coalescence into a large cavity with free-floating slough was not seen . Owing to ongoing sepsis with the development of multiple organ failure and the obvious failure of appropriate medical therapy, both patients underwent pneumonectomy with a successful outcome . These cases serve to emphasize the role of surgery in the management of massive pulmonary gangrene.

Rev Med Chil, 1993 Nov, 121(11), 1274 - 9
{Benzathine penicillin G and miocamycin in the treatment of children with streptococcal pharyngitis: a controlled therapeutic trial}; Lagos R et al.; The aim of this study was to compare the clinical and bacteriologic effectiveness of miocamycin (Miocamin, Merck) as compared to benzathine penicillin G in the treatment of streptococcal pharyngitis . One hundred forty nine patients (aged 2 to 15 years) with culture proven Group A streptococcal pharyngitis were randomly assigned to receive miocamycin (15 mg/kg/day bid per os) or one injection of 600,000 or 1,200,000 units of benzathine penicillin G . The clinical response was similar in both groups, in terms of fever duration (16 +/- 14 hours with miocamycin vs 13 +/- 13 hours with penicillin) and normalization of appetite (87.7% of children with miocamycin vs 95.8% of children with penicillin after three days) . Bacteriologic eradication of streptococcus was achieved in 66% of children treated with penicillin and 32% of those treated with miocamycin (p < 0.001) . We conclude that a single benzathine penicillin is more effective eradicating streptococcus pyogenes than miocamycin in children with streptococcal pharyngitis.

J Antimicrob Chemother, 1993 Nov, 32 Suppl B, 13 - 9
A comparative study of the in-vitro activity of cefepime and other antimicrobial agents against penicillin-susceptible and penicillin-resistant Streptococcus pneumoniae; Yee YC et al.; Using the national surveillance programme of USA hospitals, we selected 162 strains of Streptococcus pneumoniae for sensitivity testing using the NCCLS breakpoints for benzylpenicillin and the oxacillin discs screen test . Included in the group of isolates were 85 relatively penicillin-resistant and 33 penicillin-resistant strains . The activity of cefepime, a new cephalosporin, was compared with other cephalosporins and penicillins as well as some non-beta-lactam antimicrobials . Imipenem was the most active agent but, cefepime, cefotaxime, ceftriaxone and ciprofloxacin were only slightly less active . The least active agents were ceftazidime, cefuroxime, piperacillin/tazobactam and ticarcillin/clavulanate . Cefepime is a potential alternative treatment to penicillin, particularly when penicillin-resistant and relatively penicillin-resistant S . pneumoniae are encountered . The clinical importance of screening for penicillin resistance by the use of the oxacillin disc is emphasized.

Int Endod J, 1993 Nov, 26(6), 355 - 61
Antibacterial properties of eight dental cements; Coogan MM et al.; The antibacterial action of a light-cured glass polyalkenoate Vitrebond and an adhesive resin luting agent Panavia Ex was investigated and compared with six previously tested dental cements . The bacterial cultures used were six strains of Streptococcus mutans, six of Streptococcus sanguis and six cultures of carious debris from carious lesions . A modification of the agar diffusion method was used to test the antibacterial action of freshly mixed cements . In addition the cements were allowed to set and their antimicrobial action was tested by incubation for 5 days in sucrose broth inoculated with the test cultures . All the freshly mixed materials had an antibacterial action . A two-way analysis of variance and Tukey-Student range analysis showed that Vitrebond had a significantly greater zone of inhibition than Aquacem, IRM, Dycal, Dycal VLC, Ceramco and GC Elite (P = 0.001) . Freshly mixed Panavia Ex exhibited minimal antibacterial action . After 5 days the antibacterial properties of all the cements were reduced.

Arch Inst Cardiol Mex, 1993 Nov-Dec, 63(6), 485 - 91
{Calcified aortic stenosis due to healed experimental bacterial endocarditis}; Contreras Rodriguez R et al.; We studied the role of bacterial endocarditis in the development of aortic valve stenosis . A femoral arterio venous shunt was performed in nine dogs with the method previously proposed by Lillehei . We induced bacteremic infection with the administration of streptococcus mitis (1 x 10(10)) 10 ml once a day for 15 days these bacterium were sensible to penicillin . All dogs were treated with 1,000,000 U of benzatinic penicillin and sacrificed between 28-102 days after the bacterial inoculation ended . In one dog we observed bacterial endocarditis in the mitral and aortic valves and in other three dogs there was an aortic valve stenosis with calcium deposits in the body and in the free edges of the aortic valve with evident irregular stenosis as seen in man.

Infection, 1993 Nov-Dec, 21(6), 397 - 9
Group B streptococcal vertebral osteomyelitis in an adult; Elhanan G et al.; Group B beta-hemolytic streptococcus (Streptococcus agalactiae) vertebral osteomyelitis was diagnosed in a 65-year-old man . The patient received a 3-week course of in-hospital intravenous ampicillin followed by ceftriaxone and continued to receive ceftriaxone therapy on an ambulatory basis for 3 more weeks . Hospitalization and follow-up were uncomplicated with no neurological sequelae . Review of the medical literature documented only 15 cases of group B streptococcal osteomyelitis in adults and only three cases of vertebral osteomyelitis due to this pathogen . As in most adult patients with group B streptococcal infections, the patient had coexisting chronic conditions (chronic obstructive lung disease, diabetes mellitus) but bacteremia was not present . Although uncommon, group B streptococcus should be considered as an opportunistic pathogen in patients with debilitating conditions, but vertebral osteomyelitis is even rarer.

Zentralbl Hyg Umweltmed, 1993 Nov, 195(1), 27 - 36
Physical and microbiological quality of five different examination and surgical gloves before and after use in dental practice; Fiehn NE et al.; The purpose of the present study was to compare five different types of examination and surgical gloves physically and microbiologically before and after use in clinical dentistry . The prevalence of perforations was examined by the water inflation technique, and adhesion of bacteria to the glove surfaces was determined by use of a standard procedure with Streptococcus salivarius ATCC 13419 . The effect of handwashing with a non-medicated soap and disinfectant soaps was finally examined . About 3% of the unused latex--and Elastyren gloves had perforations, while 6-7% of the unused vinyl gloves showed pinholes . Ten handwashes with a non-medicated soap did not affect the physical integrity of any of the glove types, while the disinfectant soap BLIX deteriorates about one third of the Elastyren gloves after 10 washes . In contrast, another disinfectant soap Hibiscrub did not affect these gloves . After use in clinical dentistry all vinyl gloves had perforations, while the other four types seemed unchanged . S . salivarius adhered to unused gloves of all types except for the hypoallergenic latex glove Biogel D . Highest numbers of cultivable bacteria were found for the non-sterile latex gloves and Elastyren gloves . The bacterial contamination was easily removed from all types by handwashing . Repeated handwashing decreased the adherence of S . salivarius to the non-sterile latex gloves and Elastyren gloves . After use in dental practice the adherence of S . salivarius seemed to be unchanged in relation to the situation, when the gloves were only washed up to 10 times . For the Biogel D gloves an increase in adherence of S . salivarius from zero before clinical use to a level comparable with the other glove types after clinical use was observed . Based on the findings in this study and compared with previous studies general recommendations for use of gloves in dental practice are formulated.

J Reprod Fertil, 1993 Nov, 99(2), 307 - 13
Multiple site electromyography recordings of uterine activity following an intrauterine bacterial challenge in mares susceptible and resistant to chronic uterine infection; Troedsson MH et al.; The electrical myometrial activity of three mares with a documented increased susceptibility to chronic uterine infection (CUI) and three mares considered to be resistant to CUI was investigated . Electrodes were surgically implanted in the myometrium of the mares and electrical activity was monitored by a Grass polygraph . Oestrus was determined by transrectal ultrasonography of the reproductive tract and teasing of the mares with a stallion . Findings were confirmed by blood progesterone concentrations < 0.1 ng ml-1 . At the third day of oestrus or when a follicle > 35 mm was detected, the uterus was infused with a genital strain of 5 x 10(6) Streptococcus zooepidemicus . Myometrial electrical activity was monitored for 1-4 h before the bacterial infusion and continued until a visual stabilization of the activity occurred . No statistically significant differences in electrical myometrial activity were detected between susceptible and resistant mares before the infusion of bacteria into the uterus . A visible increase in myometrial electrical activity was seen in all mares following the bacterial infusion . However, the myometrial response of susceptible and resistant mares was different . Resistant mares demonstrated a greater myometrial activity (P < 0.001) than did susceptible mares . These differences were observed in frequency (P < 0.005) as well as duration (P < 0.001) and intensity (P < 0.001) of the uterine activity . Differences were most marked between 10 and 20 h after the intrauterine inoculation of bacteria . It was concluded from this study that myometrial activity is an important part of the uterine defence mechanism in mares.(ABSTRACT TRUNCATED AT 250 WORDS)

J Okla State Med Assoc, 1993 Nov, 86(11), 547 - 9
Pneumococcal septicemia and pneumonia in the neonatal period; McCaffree MA et al.; Infections due to Streptococcus pneumoniae are extremely rare in the neonatal period . A newly born infant with pneumococcal septicemia and pneumonia is described.

Mikrobiol Z, 1993 Nov-Dec, 55(6), 62 - 6
{The antimicrobial action of a liposomal preparation lipin}; Nasr-Alla N; A possibility of the use of lipine, liposomal drug, to decrease manifestations of the basic inflammatory effect: tissue edema in the region of pathological focus, as well as the drug effect on the growth of pathogenic microflora (gonococcus, Staphylococcus aureus) inoculated in the patients with gonorrheal and bacterial urethritis and urethroprostatitis has been experimentally studied . The laboratory experiments were carried out on the mature white mice . The inflammatory edema of hindlimb soft tissues was evoked by the subplantar administration of 0.1 ml of 2% formalin solution . The extent of edema development was determined by oncometry 1, 2, 4, 8 and 24 h after formalin administration . Lipine was 2.5 and 10 times dissolved by physiological solution and subplantarily administered to the animals (10 mice in each group) in a dose of 0.1 ml 1 h before administration of formalin solution . Physiological solution was used in the control group instead of lipine . It is established that the preliminary introduction of lipine decreased (more than by 50%) the degree of development of the tissue edema as compared to the control group . Bactericide properties of lipine have been studied on the suspensions of diurnal cultures of gonococcus and Staphylococcus aureus . The investigations were carried out by the methods of serial dissolutions (lipine concentration in the suspension on physiological solution was 1, 5, 10, 20 and 30 mg/ml) . The results of observations have shown that the incubation of the agent of urogenital infections (gonococcus, streptococcus aureus) with lipine vesicules lead to partial or even complete suppression of the bacterial growth.(ABSTRACT TRUNCATED AT 250 WORDS)

Dent Mater, 1993 Nov, 9(6), 338 - 43
Antibacterial effectiveness of dentin bonding systems; Prati C et al.; This study examined the antibacterial activities of several commercially available glass ionomer cements, dentin bonding systems and luting agents by employing both agar plate diffusion (APD) and growth inhibition (GI) methods . Amalgam and resin composites were also tested as control materials . In both methods (APD and GI), cylindrical specimens were used . Four bacteria strains were tested: Streptococcus mutans, S . salivarius, S . mitis and S . sanguis . These studies were performed using standardized innoculums with selective media, and the assayed materials were directly applied on the assay cultures and plates . The results of agar plate assay were in accordance with the results of growth inhibition method . The glass ionomer cements showed marked antibacterial activity . On the contrary, amalgam, composites, luting agents and dentinal bonding systems did not affect bacterial growth . The sensitivity of the growth method showed that all the strains were inhibited in the same way by each inhibitory material . The data suggest that the use of glass ionomer cements as cavity liners/bases may reduce the consequences of microleakage due to its antibacterial properties.

J Hosp Infect, 1993 Nov, 25(3), 173 - 82
Clustering of group A streptococcal infections on a burns unit: important lessons in outbreak management; Ridgway EJ et al.; In a 12-month period 37 patients and four members of staff on a burns unit were infected or colonized by Streptococcus pyogenes (Group A streptococcus) . One patient became septicaemic and died . Serotyping revealed five distinct clusters against a low background level of infection . Infection control measures included isolation, screening of patients, staff and environment and the use of prophylactic antibiotics for uninfected patients . We discuss the role of staff and patient carriers and the environment as a continuing source of infection, and the importance of serotyping in outbreak epidemiology.

Infect Immun, 1993 Nov, 61(11), 4590 - 8
A protein fragment of streptococcal cell surface antigen I/II which prevents adhesion of Streptococcus mutans; Munro GH et al.; Attachment of Streptococcus mutans to the tooth surface involves a cell surface protein with an M(r) of 185,000, termed streptococcal antigen (SA) I/II . Four overlapping fragments of the gene encoding SA I/II were amplified by polymerase chain reaction, cloned, and expressed in Escherichia coli . The recombinant polypeptides were assayed for adhesion-binding activity to salivary receptors and for recognition by a panel of monoclonal antibodies (MAbs) raised against SA I/II . Two of the MAbs which are known to prevent colonization of S . mutans in vivo bound the recombinant polypeptide comprising residues 816 to 1161 . In vitro adhesion of S . mutans to saliva-coated hydroxyapatite beads was also inhibited specifically by a polypeptide (residues 816 to 1213) encompassing the same region . The evidence from the MAbs preventing colonization of S . mutans and the adherence inhibition assay suggests that an adhesion-binding activity resides within the portion of SA I/II comprising residues 816 to 1213, which is highly conserved among oral streptococcal species.

Microb Pathog, 1993 Nov, 15(5), 327 - 46
A conserved Streptococcus pyogenes extracellular cysteine protease cleaves human fibronectin and degrades vitronectin; Kapur V et al.; Streptococcus pyogenes secretes an extracellular cysteine protease that cleaves human interleukin 1 beta precursor to form biologically active IL-1 beta, a major cytokine mediating inflammation and shock . To further investigate the potential role of the cysteine protease in host-parasite interactions, the enzyme was purified to apparent homogeneity and tested for ability to degrade several human extracellular matrix proteins . Purified protease cleaved fibronectin, apparently at specific sites, and rapidly degraded vitronectin . In contrast, the protease did not have substantial activity against laminin . The cysteine protease also cleaved fibronectin from human umbilical vein endothelial cells grown in vitro . Allelic variation in the cysteine protease structural gene was studied in 67 strains expressing 39 M protein serotypes and five provisional M serologic types, and representing 50 phylogenetically distinct clones identified by multilocus enzyme electrophoresis . The gene is well conserved and allelic variation is due solely to accumulation of point mutations . Based on predicted amino acid sequences, one mature cysteine protease variant would be made by clones expressing serotypes M2, M3, M4, M5, M6, M9, M10, M11, M12, M14, M18, M22, M23, M25, M27, M41, M49, M56, M59, two provisional M types, and two clones non-typeable for M protein . Moreover, 33 of the 39 speB alleles identified encode one of three mature protease variants that differ from one another at only one or two amino acids clustered in a ten-amino acid region . All 39 alleles, and virtually all strains, encode a product that reacts with polyclonal antisera specific for purified cysteine protease . No compelling evidence was found for a primitive differentiation of the speB gene into two distinct classes, as has been proposed for M protein, opacity factor phenotype, and vir regulon architecture . The results demonstrate that the cysteine protease is well conserved in natural populations of S . pyogenes, provide additional evidence that this enzyme is involved in host-parasite interactions, and suggest that the protease plays a role in bacterial dissemination, colonization, and invasion, and inhibition of wound healing.

Biochemistry, 1993 Oct 26, 32(42), 11445 - 52
Characterization of the apurinic endonuclease activity of Drosophila Rrp1; Nugent M et al.; Drosophila Rrp1 (Recombination repair protein 1) belongs to a family of DNA repair nucleases that includes Escherichia coli exonuclease III, Streptococcus pneumoniae exonuclease A, bovine BAP, mouse APEX endonuclease, and human APE . Within a 252 amino acid region, colinear homology is shared between all members . Rrp1 is unique in that it includes a 427 amino acid N-terminal region not related to any known sequence . The protein copurifies with an apurinic endonuclease and a double-stranded DNA 3'-exonuclease . In this study, a 5'-end-labeled 37 base pair oligonucleotide substrate containing a single apurinic site was used to characterize the endonuclease activity of Rrp1 . This substrate is utilized efficiently by Rrp1: the specific activity observed is 1 x 10(5) units/mg . The abasic double-stranded DNA oligonucleotide is cleaved only at the abasic site to create a single-strand break . Strand breaks are not detected in the complementary strand, in the single-stranded DNA oligonucleotide, or in the base-paired control substrate . After endonucleolytic cleavage at the abasic site, exonucleolytic processing at the nick is slow and requires a molar excess of Rrp1, while exonuclease III degrades the nicked substrate more efficiently . The Rrp1 cleavage product comigrates with a DNaseI cleavage product, and the newly formed terminus supports DNA synthesis by DNA polymerase . Therefore, Rrp1 cleaves the phosphodiester backbone at one position 5' to the apurinic site and leaves a 3'-hydroxyl terminus . Rrp1 is a class II apurinic endonuclease and is likely to be important in DNA repair in Drosophila.

J Clin Epidemiol, 1993 Oct, 46(10), 1181 - 5
Interpreting a single antistreptolysin O test: a comparison of the "upper limit of normal" and likelihood ratio methods; Gray GC et al.; Single serologic tests may occasionally influence clinicians in making diagnoses . The antistreptolysin O (ASO) test is a frequently used tool for detecting recent Streptococcus pyogenes infection and is helpful in the diagnosis of diseases like rheumatic fever . Using data from a 1989 prospective study of 600 healthy male military recruits, in which 43% experienced S . pyogenes upper respiratory tract infection (2-dilution rise in ASO), this report compared two methods of interpreting a single ASO titer . Using the "upper limit of normal" (80 percentile) method, recruits with an ASO titer of greater than 400 showed evidence of recent S . pyogenes infection . This method had a sensitivity and specificity of only 65.9 and 81.9% respectively . In contrast to the "yes-no" dichotomy of the "upper limit of normal" method, the likelihood ratio method statistics were ASO value specific, more consistent with clinical judgment, and better emphasized the caution clinicians must use in interpreting a single ASO test.

J Dent Res, 1993 Oct, 72(10), 1391 - 7
An in vitro stimulation of the effects of chewing sugar-free and sugar-containing chewing gums on pH changes in dental plaque; Macpherson LM et al.; The objective of these studies was to simulate the effect of chewing sugar-free and sucrose-containing chewing gums on the return of the pH to neutrality after exposure to sucrose of plaque located on the buccal (BLM) and lingual (LLM) surfaces of the lower molar teeth . In study 1, a 0.5-mm-deep artificial plaque containing Streptococcus oralis cells was exposed to 10% sucrose for one min, and a 0.1-mm-thick film of sucrose-free artificial saliva was then flowed over the plaque surface at the unstimulated salivary film velocities previously found at the BLM and LLM sites . At the time of the pH minimum (pH 4-5), one of three conditions was simulated: (a) a no-gum-chewing control, or chewing for 20 min on either (b) a sugar-free gum or (c) a sucrose-containing gum . The recovery of the plaque pH to resting values was rapid during simulation of chewing a sugar-free gum (SFG), much slower with the no-gum control, and even slower with simulation of chewing a sucrose-containing gum (SCG) . The pH recovery was slower with the BLM than the LLM plaque . In study 2, the BLM plaque was exposed to a 2% sucrose solution for 20 min under stimulated salivary conditions, to simulate the consumption of a meal, followed by one of conditions (a), (b), or (c) described above . The pH recovery with simulation of chewing a SCG was faster than with the no-gum control, but much slower than with the SFG simulation.(ABSTRACT TRUNCATED AT 250 WORDS)

J Dent Res, 1993 Oct, 72(10), 1386 - 90
Transport of sugars, including sucrose, by the msm transport system of Streptococcus mutans; Tao L et al.; The range of substrates transported by the sugar-binding protein-dependent msm (multiple sugar metabolism) system of S . mutans was investigated . By determining the ability of unlabeled sugar to compete with radiolabeled melibiose transport, we have demonstrated that the transported sugars included a number of carbohydrates structurally related to raffinose . A model accommodating these results has been devised which accounts for the sugars transported by the msm transport system . Competition with radiolabeled melibiose transport indicated sucrose to be an msm substrate . This was confirmed by examination of uptake of radiolabeled sucrose in scrAB mutants lacking the sucrose-specific phosphotransferase system.

J Bacteriol, 1993 Oct, 175(19), 6364 - 7
Identification of a purC gene from Streptococcus pneumoniae; Hui FM et al.; A gene encoding 5'-phosphoribosyl-5-aminoimidazole-4-N-succinocarboxamide synthetase was identified in Streptococcus pneumoniae as a 708-bp segment of the genome encoding a 27,001-Da protein with strong similarity to known PurC proteins . The S . pneumoniae purC gene, found immediately adjacent to the competence induction genes, comAB, was cloned and sequenced . The predicted protein product of purC displayed substantial (> 40%) identity to the entire sequence of the PurC proteins of Bacillus subtilis and Escherichia coli . Function of the S . pneumoniae gene product was demonstrated by complementation of E . coli purC mutations.

J Bacteriol, 1993 Oct, 175(19), 6354 - 7
Construction of recombination-deficient strains of Streptococcus gordonii by disruption of the recA gene; Vickerman MM et al.; Degenerate oligonucleotide primers were used in a polymerase chain reaction (PCR) to amplify a region of the recA sequence of Streptococcus gordonii Challis . The resulting PCR fragment was cloned into the suicide vector pAM6199 and introduced into strain Challis, giving rise to recombination-deficient strains in which the recA gene was specifically inactivated.

J Bacteriol, 1993 Oct, 175(19), 6220 - 8
Molecular characterization of a STreptococcus mutans mutant altered in environmental stress responses; Yamashita Y et al.; A mutant defective in aciduricity, GS5Tn1, was constructed following mutagenesis of Streptococcus mutans GS5 with the conjugative transposon Tn916 . The mutant grew poorly at acidic pH levels and was sensitive to high osmolarity and elevated temperatures . These properties resulted from a single insertion of Tn916 into the GS5 chromosome, and the DNA fragment harboring the transposon was isolated into the cosmid vector, charomid 9-20 . Spontaneous excision of Tn916 from the cosmid revealed that Tn916 inserted into a 8.6-kb EcoRI fragment . On the basis of the restriction analyses of insert fragments, it was found that Tn916 inserted into a 0.9-kb EcoRI-XbaI fragment . Nucleotide sequence analysis of this fragment indicated the presence of two open reading frames, ORF1 and ORF2 . By using a marker rescue strategy, a 6.0-kb HindIII fragment including the target site for Tn916 insertion and the 5' end of ORF1 was isolated and sequenced . The deduced amino acid sequences of ORF1 and ORF2 showed significant homology with the diacylglycerol kinase and Era proteins, respectively, from Escherichia coli . Nucleotide sequence analysis of the Tn916 insertion junction region in the GS5Tn1 chromosome revealed that the transposon inserted near the 3' terminus of ORF1 . Restoration of ORF1 to its original sequence in mutant GS5Tn1 was carried out following transformation with integration vector pVA891 containing an intact ORF1 . The resultant transformant showed wild-type levels of aciduricity as well as resistance to elevated temperatures and high osmolarity . These results suggest that the S . mutans homolog of diacylglycerol kinase is important for adaptation of the organism to several environmental stress signals.

Infect Immun, 1993 Oct, 61(10), 4392 - 7
Identification of hydrogen peroxide as a Streptococcus pneumoniae toxin for rat alveolar epithelial cells; Duane PG et al.; Streptococcus pneumoniae infections of the lung are associated with significant damage to the alveolar epithelium . Host phagocytes and pneumolysin, a cytolytic toxin of S . pneumoniae, are believed to contribute to this cellular damage, yet experiments in which these elements are absent demonstrate the presence of an additional soluble S . pneumoniae factor that is toxic to alveolar epithelium . We examined the effects of S . pneumoniae-associated alveolar epithelial cell injury by factors other than S . pneumoniae-derived pneumolysin or phagocyte products by exposing cultured rat type II alveolar epithelial cells (RAEC) to S . pneumoniae mutants that lacked pneumolysin activity . We found that mutant pneumolysin-deficient strains of S . pneumoniae produced injury to RAEC similar to that produced by the parent strains . A toxin of type 14 S . pneumoniae was distinguished from pneumolysin by physiochemical (i.e., molecular mass and heat stability) and functional (i.e., hemolytic activity and cytotoxic activity) properties and was identified as hydrogen peroxide . All S . pneumoniae strains tested produced hydrogen peroxide, and in many strains hydrogen peroxide production was comparable to that of activated neutrophils . We conclude that S . pneumoniae produces hydrogen peroxide in concentrations that are cytotoxic to RAEC in vitro and that alveolar epithelial damage due to hydrogen peroxide may be involved in the pathogenesis of host cellular injury in pneumococcal pneumonia.

Infect Immun, 1993 Oct, 61(10), 4375 - 81
Expression and secretion of an Arthrobacter dextranase in the oral bacterium Streptococcus gordonii; Kubo S et al.; We have constructed a plasmid to express and secrete dextranase in the oral bacterium Streptococcus gordonii . The dextranase gene from Arthrobacter sp . strain CB-8 was linked to a promoter and a DNA sequence encoding the signal peptide of Streptococcus downei glucosyltransferase I (gtfI) followed by the Escherichia coli rrnBt1t2 terminator and inserted in the shuttle vector pVA838 . S . gordonii transformed with this plasmid (pMNK-4) expressed and secreted mature Arthrobacter dextranase . The transformant was found to repress the firm adherence of water-insoluble glucan in a coculture experiment with cariogenic bacteria, Streptococcus sobrinus, in the presence of sucrose . Such genetically engineered oral bacteria could provide a therapy to prevent dental caries.

Infect Immun, 1993 Oct, 61(10), 4344 - 9
Saliva-binding region of Streptococcus mutans surface protein antigen; Nakai M et al.; A 190-kDa surface protein antigen (PAc) of Streptococcus mutans binds to human salivary components . For detection of specific binding of the PAc protein to human salivary components, a simple sandwich assay was used . Microtiter plates precoated with recombinant PAc (rPAc), PAc fragments, or S . mutans whole cells were allowed to react with human whole saliva and then were incubated with biotinylated rPAc . The biotinylated rPAc bound to salivary components was detected by use of alkaline phosphatase-conjugated streptavidin and p-nitrophenylphosphate . In this assay, the binding of whole cells of S . mutans and purified rPAc to salivary components was confirmed . For determination of a saliva-binding region of the PAc molecule, 14 truncated PAc fragments were constructed by use of the polymerase chain reaction and an expression vector, pAX4a+ . The binding of these truncated PAc fragments to human salivary components was determined by the sandwich assay . Among the truncated PAc fragments, fragments corresponding to residues 39 to 864 and residues 39 to 1000 of PAc showed a high ability to bind to salivary components . Shorter recombinant fragments corresponding to residues 39 to 217, residues 200 to 481, residues 470 to 749, and residues 688 to 864 did not exhibit any binding ability . The fragment that corresponds to a proline-rich repeating region (residues 828 to 1000) bound directly to the PAc protein . These results suggest that residues 39 864 of the PAc molecule are important in the binding of the surface protein to human salivary components, and the proline-rich repeating region of the PAc protein may contribute to spontaneous self-aggregation of the PAc protein.

Infect Immun, 1993 Oct, 61(10), 4119 - 25
Collagen mediates adhesion of Streptococcus mutans to human dentin; Switalski LM et al.; Some strains of Streptococcus mutans were found to recognize and bind collagen type I . Binding of 125I-labeled collagen type I was specific in that collagen types I and II, but not unrelated proteins, were able to inhibit binding of the labeled ligand to bacteria . Collagen binding to S . mutans was partially reversible and involved a limited number of bacterial binding sites per cell . S . mutans UA 140 cells bound collagen type I with high affinity (Kd = 8 x 10(-8) M) . The number of binding sites per cell was 4 x 10(4) . Collagen-binding strains of S . mutans were found to adhere to collagen-coated surfaces as well as to pulverized root tissue . S . mutans strains that did not bind the soluble ligand were unable to adhere to these substrata . Adherence to collagen-coated surfaces could be inhibited with collagen or clostridial collagenase-derived collagen peptides . Adherence of S . mutans to dentin was enhanced by collagen types I and II but inhibited by collagen peptides . S . mutans UA 140 bound significantly less 125I-collagen type I following treatment with peptidoglycan-degrading enzymes . These enzymes released a collagen-binding protein (collagen receptor) with a relative molecular size of 16 kDa . The results of this study suggest that collagen mediates adhesion of S . mutans to dentin . This interaction may target collagen-binding strains of S . mutans to dentin in the oral cavity and may play a role in the pathogenesis of root surface caries.

Dtsch Med Wochenschr, 1993 Oct 1, 118(39), 1395 - 400
{Toxic shock syndrome caused by Streptococcus pyogenes}; Hohn H et al.; Four days after being bitten by an insect a 35-year-old woman without any serious underlying disease developed an extensive phlegmonous inflammation of the left eyelid which soon spread to the entire left half of her face . Streptococcus pyogenes serotype M1, which produced the erythrogenic toxin A in vitro, was isolated from two blood cultures . The course of the illness was characterized by high fever, diarrhoea, vomiting, circulatory failure, consumption coagulopathy, abnormal renal functions and a generalized exanthem with desquamation of the skin, exhibiting the full-blown picture of a toxic shock syndrome caused by S . pyogenes . She eventually recovered completely under intensive care involving administration of catecholamines, fresh frozen plasma and antithrombin III substitution, as well as antibiotic treatment with clindamycin (600 mg three times daily), ampicillin/sulbactam (4 g three times daily)--after 3 days replaced by imipenem (0.5 g four times daily)--and gentamycin (80 mg three times daily) for two weeks . Extensive necroses later required plastic surgery to the left eyelid, cheek and temporal region.

Neth J Med, 1993 Oct, 43(3-4), 179 - 82
Erysipelas: not always innocent; Ligtenberg G et al.; The case histories of two patients with the "toxic-strep" syndrome are presented . This syndrome consists of a Streptococcus pyogenes group A infection, complicated by multi-organ failure . In our patients renal failure necessitating haemodialysis was present . General characteristics of the syndrome and long-term follow-up are presented.

J Vet Diagn Invest, 1993 Oct, 5(4), 560 - 6
Equine abortion and stillbirth in central Kentucky during 1988 and 1989 foaling seasons; Hong CB et al.; Pathologic and microbiologic examinations were performed on 1,211 aborted equine fetuses, stillborn foals, and placentas from premature foals in central Kentucky during the 1988 and 1989 foaling seasons to determine the causes of reproductive loss in the mare . Placentitis (19.4%) and dystocia-perinatal asphyxia (19.5%) were the 2 most important causes of equine reproductive loss . The other causes (in decreasing order) were contracted foal syndrome and other congenital anomalies (8.5%), twinning (6.1%), improper separation of placenta (4.7%), torsion of umbilical cord (4.5%), placental edema (4.3%), equine herpesvirus abortion (3.3%), bacteremia (3.2%), fetal diarrhea (2.7%), other placental disorders (total of 6.0%), and miscellaneous causes (1.6%) . A definitive diagnosis was not established in 16.9% of the cases submitted . Streptococcus zooepidemicus, Escherichia coli, Leptospira spp., and a nocardioform actinomycete were organisms most frequently associated with bacterial placentitis, and Aspergillus spp . was the fungus most often noted in mycotic placentitis . No viral placentitis was noticed in this series . Dystocia-perinatal asphyxia was mostly associated with large foals, maiden mares, unattended deliveries, and malpresentations . The results of this study indicate that in central Kentucky, the noninfectious causes of equine reproductive loss outnumber the infectious causes by an approximate ratio of 2:1, placental disorders are slightly more prevalent than nonplacental disorders, Leptospira spp . and a nocardioform actinomycete are 2 new important abortifacient bacteria in the mare, the occurrence of contracted foal syndrome is unusually frequent, the incidence of twin abortion has sharply declined, and torsion of the umbilical cord is an important cause of abortion in the mare.

Arch Oral Biol, 1993 Oct, 38(10), 853 - 61
The effect of propranolol on salivary gland function and dental caries development in young and aged rats; O'Connell AC et al.; Medications commonly used in elderly people cause hyposalivation and are associated with an enhanced prevalence of dental caries . Propranolol (a beta-adrenergic antagonist) is a commonly used antihypertensive agent that is prescribed for long-term use . The purpose of this investigation was to compare the effects of this drug on salivary composition and flow rate, and on caries, in young and aged rats . Forty young (28-day) and 36 aged (20-month) female Sprague-Dawley rats were infected with Streptococcus sobrinus 6715 and fed a cariogenic diet for 28 days . Propranolol was given in high (20 mg/kg/day) and low (10 mg/kg/day) doses via osmotic pumps . Unoperated and desalivated animals served as controls . Smooth-surface caries scores in the young animals receiving propranolol at 20 mg/kg/day were statistically higher than in the young intact rats (p < or = 0.05) . Increased smooth-surface and sulcal caries scores were recorded in the aged propranolol-treated animals, but the differences were not statistically significant when compared with those in intact aged animals . Propranolol in aged animals did not affect the amount of alveolar bone loss but increased the risk of development of root caries . Young animals harboured greater populations of Strep . sobrinus and total cultivable flora than did all aged groups except the desalivated group . Salivary flow rates, induced by pilocarpine, were not decreased by the chronic administration of propranolol . Although the total protein concentration in parotid and submandibular saliva from drug-treated animals was reduced, differences were not observed in their SDS-PAGE profile when compared with unoperated animals . The findings demonstrate that chronic use of propranolol reduced the total protein concentration in saliva of all animals, increased caries susceptibility, but did not reduce the stimulated salivary flow rate.

J Gen Microbiol, 1993 Oct, 139 ( Pt 10), 2343 - 51
Identification of two distinct NADH oxidases corresponding to H2O2-forming oxidase and H2O-forming oxidase induced in Streptococcus mutans; Higuchi M et al.; Two distinct NADH oxidases, corresponding to H2O2-forming and H2O-forming enzymes were purified to homogeneity from Streptococcus mutans and their basic properties determined . The H2O2-forming enzyme was a tetramer with a subunit molecular mass of about 56 kDa and required flavin adenine dinucleotide (FAD) for full activity . The enzyme had an isoelectric point of 6.6 and exhibited optimal activity at pH 6.0 . The H2O-forming enzyme was a monomer with a molecular mass of 50 kDa and activity independent of exogenously added flavin . The enzyme had an isoelectric point of 4.8 and exhibited optimal activity between pH 7.0 and 7.5 . Both enzymes oxidized NADH (Km 0.05 and 0.025 mM for the H2O2- and H2O-forming enzyme, respectively) but not NADPH and contained 1 mol of FAD per monomer . Spectra of the oxidized enzymes exhibited maxima at 271, 383 and 449 nm for the H2O2-forming enzyme and 271, 375 and 447 nm for the H2O-forming enzyme . Antibodies raised against the H2O2-forming enzyme or the H2O-forming enzyme reacted with their corresponding antigen, but did not cross-react . The amino-terminal regions of the two enzymes had completely different amino acid sequences.

J Clin Microbiol, 1993 Oct, 31(10), 2724 - 8
DNA fingerprinting of Streptococcus pneumoniae strains by pulsed-field gel electrophoresis; Lefevre JC et al.; Pulsed-field gel electrophoresis of genomic DNA was carried out on Streptococcus pneumoniae strains to determine its value in the epidemiological survey of pneumococcal infections . Twenty-one clinical strains were chosen to cover a broad range of diversity according to geographic location, penicillin susceptibility, serotype, and multilocus enzyme electrophoresis (MLEE) pattern . The restriction endonucleases ApaI and SmaI were used to digest intact chromosomes, and the fragments were resolved by field inversion gel electrophoresis (FIGE) . Each digest produced 10 to 19 fragments for comparison between strains . All the strains, including strains of the same serotype and strains with the same MLEE profile, had different FIGE patterns . In some cases, the restriction patterns differed by only a few fragment bands, and two isolates differed only in the location of a single DNA fragment . The polymorphism obtained with FIGE was greater than those obtained with serotyping and MLEE analysis . The stability of the FIGE profiles was established by testing of two independent clones derived from pneumococcus strain R36A . These results indicated that pulsed-field gel electrophoresis should be an effective tool for the typing of S . pneumoniae strains, capable of subdividing serotypes or MLEE types and of tracing the origin of pneumococcal strains.

J Clin Microbiol, 1993 Oct, 31(10), 2661 - 6
Evaluation of polymerase chain reaction for diagnosis of pneumococcal pneumonia; Rudolph KM et al.; To test the ability of the polymerase chain reaction (PCR) to detect Streptococcus pneumoniae in blood, we generated two sets of nested primers . The first defined 559-bp and 649-bp regions of the pneumolysin gene, and the second defined 445-bp and 553-bp regions of the autolysin gene . These nucleotide segments were detected in DNAs from isolates of all 20 pneumococcal serotypes tested, but they were not detected when used to test DNAs from 41 isolates of nonpneumococcal bacteria and fungi . The sensitivity was evaluated by using purified pneumococcal DNA . We were able to detect 10 fg of S . pneumoniae DNA, or 4.3 genome equivalents . Blood samples were obtained from 16 patients with culture-proven pneumococcal bacteremia and were subjected to PCR analysis . Of eight buffy coat fractions tested, six showed reactivity in the PCR with the pneumolysin primers, and five of the eight produced the expected products when tested with the autolysin primers (sensitivities, 75 and 63%, respectively) . Of the eight whole-blood specimens tested, only three produced the expected products with either set of primers . Additionally, we tested 14 samples from patients with bacteremia that were culture positive for nonpneumococcal bacterial species, and 13 were negative (specificity, 93%) . This combination of sensitivity and specificity may make detection of S . pneumoniae in blood by PCR in comparison with that by blood culture a very promising alternative for a means of definitive diagnosis.

Ann Med, 1993 Oct, 25(5), 451 - 5
Therapy of penicillin- and cephalosporin-resistant pneumococcal infections; Friedland IR; Streptococcus pneumoniae has recently developed resistance to almost every agent that has been used for therapy, including the extended-spectrum cephalosporins . The empiric therapy of penicillin-resistant pneumococcal meningitis should include cefotaximine or ceftriaxone plus vancomycin pending cephalosporin susceptibility results . Intermediate penicillin-resistant pneumococcal infections outside the central nervous system will usually respond to high dose intravenous beta-lactam antibiotic therapy . Highly penicillin-resistant pneumococcal infections may not respond to penicillin therapy, in which case therapy with vancomycin, imipenem or a macrolide (if susceptible) can be considered . Pneumococcal resistance to commonly used oral agents varies geographically and the efficacy of a particular agent can only be assured once the infecting strain is known to be susceptible . It is imperative to determine the susceptibility of every pneumococcal isolate to the agent(s) being used for therapy, particularly in cases of meningitis and to document rapid sterilization of infected body sites or fluids.

Am J Vet Res, 1993 Oct, 54(10), 1608 - 14
Microbiologic changes during antimicrobial treatment and rate of relapse of distal respiratory tract infections in foals; Hoffman AM et al.; Despite the high incidence of distal respiratory tract infection of undetermined cause on farms, to our knowledge, the microbiologic effects of conventional antimicrobial treatment for this condition have not been studied . We evaluated the possible pathogenic role of bacterial isolates from the distal airways of foals with clinical respiratory tract disease, by correlating changes in their numbers (increase or decrease) with clinical, endoscopic, and pulmonary cytologic signs of disease resolution during treatment with antimicrobial drugs . We also determined qualitative changes in in vitro antimicrobial susceptibility of bacterial isolates after 7 days of treatment and relapse rate of foals . Significant (P < 0.05) decrease in the numbers of an isolate in the airways was considered strong evidence of a pathogenic role in this disease syndrome . Foals with endoscopically confirmed distal respiratory tract infection (DRTI; n = 65) were selected at random for treatment (n = 56) or nontreatment (n = 9), and bronchial lavage specimens were cultured and evaluated cytologically before and after 7 days of treatment with trimethoprim-sulfamethoxazole (TMS) and a beta-lactam drug (penicillin, ampicillin, or sulbactam-ampicillin), the standard treatment in all foals . The effect of treatment was to abruptly reduce the clinical (nasal discharge, cough, adventitious lung sounds) and cytologic signs of airway infection . Severity of disease in nontreated foals, however, did not change or did worsen over time . Reduction in the frequency and numbers of Streptococcus zooepidemicus isolated during treatment supported a causal role for this organism in the clinical syndrome observed.(ABSTRACT TRUNCATED AT 250 WORDS)

Mol Gen Genet, 1993 Oct, 241(1-2), 97 - 105
Replication of the promiscuous plasmid pLS1: a region encompassing the minus origin of replication is associated with stable plasmid inheritance; del Solar G et al.; Deletion of a region of the promiscuous plasmid pLS1 encompassing the initiation signals for the synthesis of the plasmid lagging strand led to plasmid instability in Streptococcus pneumoniae and Bacillus subtilis . This defect could not be alleviated by increasing the number of copies (measured as double-stranded plasmid DNA) to levels similar to those of the wild-type plasmid pLS1 . Our results indicate that in the vicinity of, or associated with the single-stranded origin region of pLS1 there is a plasmid component involved in its stable inheritance . Homology was found between the DNA gyrase binding site within the par region of plasmid pSC101 and the pLS1 specific recombination site RSB.

Mol Gen Genet, 1993 Oct, 241(1-2), 129 - 40
Genetic organization of the streptokinase region of the Streptococcus equisimilis H46A chromosome; Mechold U et al.; The complete nucleotide sequences of four genes and one open reading frame (ORF1) adjacent to the streptokinase gene, skc, from Streptococcus equisimilis H46A were determined . These genes are encoded on the opposite DNA strand to skc and are arranged as follows: dexB-abc-lrp-skc-ORF1-rel . The dexB gene, coding for an alpha-glucosidase (M(r) 61,733), and abc, encoding an ABC transporter (M(r) 42,080), are similar to the dexB and msmK genes, respectively, from the multiple sugar metabolism operon of S . mutans . The lrp gene specifies a leucine-rich protein (M(r) 32,302) that has a leucine-zipper motif at its C-terminus . The function of the Lrp protein is not known but appeared to be detrimental when overexpressed in Escherichia coli . Although lrp appears not to be an essential gene, as judged by plasmid insertion mutagenesis, it is conserved in all streptococcal strains carrying a streptokinase gene . The rel gene showed significant homology to the E . coli relA and spoT genes involved in the stringent response to amino acid deprivation . Multiple alignment of the amino acid sequences of Rel (M(r) 83,913), RelA and SpoT revealed 59.4% homology of the primary structures . Northern hybridization analyses of the genes in the skc region showed skc to be transcribed most abundantly . In addition to transcripts for skc, monocistronic mRNAs were detected for all three genes divergently transcribed from skc . Although there was also some read-through transcription from lrp into abc, and from abc into dexB, the transcription pattern suggests a high degree of transcriptional and functional independence not only of skc but also abc and dexB . Prominent structural features in intergenic regions included a static DNA bending locus located upstream and a putative bidirectional transcription terminator downstream of skc.

Rev Med Chil, 1993 Oct, 121(10), 1128 - 34
{Comparative in vitro activity of new oral macrolides against Streptococcus pyogenes strains}; Prado V et al.; Some recently introduced macrolides have several clinical advantages over erythromycin . Azithrommcin, a prototype of these new macrolides could be a good alternative for the treatment of streptococcal pharyngitis, even over penicillin, whose failure rate can be as high as 30% . The aim of this study was to evaluate the in vitro susceptibility of 120 strains of S pyogenes isolated between 1990 and 1992 (40 per year), from diverse infections (specially tonsillitis) . We determined Minimal Inhibitory Concentrations (MIC) of azithromycin, clarithromycin, roxithromycin, erythromycin and penicillin using the agar dilution method and the Minimal Bactericidal Concentration (MBC) by tube dilution for azythromycin and erythromycin . The MIC 90 for the new macrolides ranged from 0.03 to 0.12 microgram/ml, and was 0.03 microgram/ml for erythromycin and penicillin (not different) . All strains were susceptible to all antibiotics and the date of isolation did not influence susceptibility . The MBC for azithromycin was 0.12 microgram/ml (identical to its MIC), which demonstrates the bactericidal effect of this antibiotic . It is concluded that this in vitro data supports the potential role of these new macrolides in the treatment of streptococcal infections.

Int Surg, 1993 Oct-Dec, 78(4), 357 - 9
The electrified drain . A new device for sterilizing the field of drainage; Shafik A; A randomized control study was performed on 24 patients to evaluate the effect of a new drainage system . Two types of drains were used: electrified and the conventional corrugated rubber drains . All of the 24 patients had an incisional hernia repair operation . In 12 patients, the wound was drained with an electrified drain (ED) and in the other 12 by the conventional drain (CD) . The ED consisted of a corrugated rubber drain to which 2 silver-silver chloride electrodes were fixed . The wounds were drained for the first 3 post-operative days during which antibiotics were given . A peroperative and daily swab from the wound was taken during the time of drainage and for 4 days thereafter, and cultured . For evaluation, a pathogen count of less than 10(5) colony-forming units per ml of discharge from wound cultures was considered as successful drainage, while counts above this level were defined as failures . Drainage failure occurred in 4/12 patients (33%) of the CD group . Pathogens encountered were Streptococcus pyogenes, Staphylococcus aureus and albus and P . aeruginosa . Manifestations of wound inflammation occurred in 2 of the 4 patients . The appropriate antibiotic was given to the 4 patients after culture and sensitivity tests were performed . Drainage failure did not occur in any of the ED group . Post-operative laboratory assessment of blood count, liver and kidney functions and serum electrolytes recorded insignificant changes against preoperative values in both groups . The results demonstrate the superiority of the ED over the CD . The electric field produced by the ED seems to be lethal to organisms . The ED is simple, safe and cost-effective.

Res Microbiol, 1993 Oct, 144(8), 609 - 16
Correlation between changes in surface hydrophobicity and interaction of Streptococcus pyogenes with human polymorphonuclear leukocytes after prolonged starvation in sea water; Galdiero E et al.; The aim of this research was to evaluate the persistence of virulence characteristics of Streptococcus pyogenes cells after prolonged starvation in sea water . Studies were carried out on changes in viability, alterations in the chemical composition and surface hydrophobicity and the interaction of S . pyogenes with human polymorphonuclear leukocytes (PMN) after starvation . Results showed that surface hydrophobicity decreased progressively starting after three days of starvation and was correlated with the decrease in total carbohydrate, lipid and protein content . These values correlated with a better interaction of S . pyogenes cells with the PMN, as shown by a chemiluminescence increase that reached a peak after 32 days of starvation . Furthermore, bacterial cells became more easily phagocytized and killed by human PMN.

Zentralbl Veterinarmed B, 1993 Oct, 40(8), 544 - 8
Isolation and distribution of Streptococcus suis capsular types from diseased pigs in Spain; Prieto C et al.; A total of 65 isolates of Streptococcus suis was recovered from various tissues of diseased pigs . Almost 96% of all these isolates could be categorized as one of capsular types 1 to 22 and 1/2 . Capsular type 2 was the most prevalent and represented 53.8% of all isolates, followed by capsular types 1 (9.2%), 1/2 (7.7%) and 8 (4.6%) . Brain-meninges, multiples tissues and lungs were the source of the majority of the isolates . A total of 37% of S . suis isolates, mainly from brain-meninges, were found in pure culture . The antimicrobial susceptibility pattern of S . suis isolates was determined.

Oral Microbiol Immunol, 1993 Oct, 8(5), 283 - 7
Adhesin degradation: a possible function for a Prevotella loescheii protease?
Cavedon K, London J.
Prevotella loescheii PK1295 produces at least 3 proteases that are separable by isoelectric focusing . One of these proteases, an enzyme with an isoelectric point at 8.5 and an M(r) of 36,000, hydrolyzes the fimbria-associated adhesin on P . loescheii responsible for coaggregation with Streptococcus oralis 34, as well as gelatin, casein and fibrin . The action of this protease may contribute to the detachment of P . loescheii from its streptococcal coaggregation partner and provide a mechanism for bacterial relocation in dental plaque.

Oral Microbiol Immunol, 1993 Oct, 8(5), 272 - 6
Involvement of Porphyromonas gingivalis fimbriae in adherence to Streptococcus gordonii; Lamont RJ et al.; Adherence of Porphyromonas gingivalis to early plaque bacteria, such as Streptococcus gordonii, is considered an important colonization mechanism . The molecules that mediate this interspecies binding have not been determined . Fimbriae were prepared from P . gingivalis 33277 by mild agitation, ammonium sulfate precipitation and DEAE-Sepharose chromatography . In a nitrocellulose blot adherence assay, purified fimbriae inhibited S . gordonii G9B-P . gingivalis 33277 binding by up to 54% . In addition, fimbriae bound to S . gordonii cells in a dot-blot assay . Incubation of fimbriae with S . gordonii cells followed by washing, sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE), electroblotting and probing with P . gingivalis antibodies also revealed that the fimbriae bind to S . gordonii . In contrast, S . gordonii did not interact with fimbriae that were first subjected to SDS-PAGE and electroblotting or deposited on a nitrocellulose membrane, suggesting that conformational determinants of the fimbriae may be important in binding . The results indicate that binding between P . gingivalis and S . gordonii is mediated, at least in part, by the porphyromonads' fimbriae.

J Infect Dis, 1993 Oct, 168(4), 922 - 6
Granulocyte colony-stimulating factor protects control rats but not ethanol-fed rats from fatal pneumococcal pneumonia; Lister PD et al.; A model of chronic ethanol ingestion was used to study the effects of granulocyte colony-stimulating factor (G-CSF) on the pathogenesis of pneumococcal pneumonia in intoxicated rats . G-CSF or 5% dextrose in water (D5W) was administered subcutaneously to ethanol-fed and pair-fed control rats on days 6 and 7 of pair feeding . Rats were infected transtracheally with type 3 Streptococcus pneumoniae on day 8 . In pair-fed control rats, G-CSF significantly increased the total number and percentage of polymorphonuclear leukocytes (PMNL) in the peripheral blood (P < .001), augmented PMNL recruitment to infected lungs (P < .01), and significantly increased survival from pneumococcal pneumonia (P = .01) . In contrast, treatment of ethanol-fed rats with G-CSF did not enhance pulmonary PMNL delivery and did not increase survival following experimental pneumococcal pneumonia, despite a significant increase in the total number and percentage of circulating PMNL (P < .001) . These data suggest that despite increasing the numbers of circulating PMNL, G-CSF is unable to provide protection against fatal pneumococcal pneumonia in ethanol-fed rats.

Immunology, 1993 Oct, 80(2), 209 - 16
Mapping major and minor T-cell epitopes in vitro and their immunogenic or tolerogenic effect in vivo in non-human primates; Walker PR et al.; The immunogenicity of synthetic peptides of in vitro mapped T- and B-cell epitopes from a Streptococcus mutans cell-surface antigen were investigated in non-human primates . Peptide (1-15) contains T-cell (7-15) and B-cell (8-13) epitopes, but is only immunogenic if dimerized (1-15)2 or linked to the carrier tetanus toxoid (1-15)TT . Monomers and dimers of T- and B-cell epitopes were prepared and used to immunize macaques . Immunogenicity was assayed in lymphocytes by the uptake of {3H}thymidine and serum antibodies by a solid-phase radioimmunoassay . Macaques immunized with the dimerized (1-15)2 or carrier-linked peptide (1-15)TT exhibited in vitro T-cell proliferative responses to peptides (1-15) and (7-15) . T cells from animals immunized with peptides (1-15), (7-15) or (7-15)2 failed to elicit an immune response . In order to establish if these non-immunogenic peptides might induce tolerance, the same macaques were challenged with the immunogenic peptide (1-15)TT . The results suggest that T-cell responses to peptide (1-15) were reestablished, but instead of responding to peptide (7-15) they were stimulated by a hitherto silent epitope (1-7) . Tolerance to the major T-cell epitope (7-15) and the expression of a minor (silent) T-cell epitope (1-7) was associated with B-cell tolerance, suggesting that T-cell help for antibodies resides in the major T-cell epitope (7-15) . However, short-term T-cell lines revealed T-cell responses to peptides (1-7) and (7-15) in both tolerized and immunized macaques, but the relative frequency of the minor epitope (1-7)-reactive lines was significantly higher in tolerized animals, whilst that for the major epitope (7-15) was higher in immunized animals . These findings suggest that the silent epitope (1-7) is really cryptic, in that it can be detected if the cell lines are first expanded in vitro with the whole peptide (1-15) and then stimulated with the truncated peptides (1-7) or (7-15) . The results are consistent with the concept of a hierarchy of major and minor T-cell epitopes, now demonstrated in non-human primates, in which tolerance to the major T-cell epitope is associated with tolerance to antibody formation and the emergence of a minor T-cell epitope.

FEBS Lett, 1993 Sep 27, 331(1-2), 187 - 92
Cloning, characterization and overexpression of a Streptococcus pyogenes gene encoding a new type of mitogenic factor; Iwasaki M et al.; A new type of mitogenic factor, termed MF, has been found in the culture supernatant of Streptococcus pyogenes and its N-terminal amino acid sequence has been determined . On the basis of this sequence, an S . pyogenes gene encoding MF was cloned and its nucleotide sequence was determined . The MF gene includes a long, open reading frame with 813 nucleotides capable of encoding the MF precursor protein with 271 amino acids . Removal of the putative 43 residues as a signal peptide results in the mature MF protein with 228 amino acids . The molecular mass of the mature MF is calculated as 25,363 which is consistent with the previously determined value of 25,370 for MF secreted from S . pyogenes . Neither nucleotide nor amino acid sequence homology was found between the mature MF and other streptococcal pyrogenic exotoxins, such as SPE A, SPE B and SPE C . The mature MF was recombinantly overexpressed as a fusion protein with glutathione S-transferase in Escherichia coli . The recombinant protein showed mitogenic activity in rabbit peripheral blood lymphocytes and immunoreactivity with the rabbit antiserum raised against the secreted MF from S . pyogenes . These data indicate that a unique gene encoding MF was cloned from S . pyogenes.

FEBS Lett, 1993 Sep 27, 331(1-2), 101 - 4
Penicillin binding protein 2x as a major contributor to intrinsic beta-lactam resistance of Streptococcus pneumoniae; Jamin M et al.; The production and purification to protein homogeneity of a soluble form of PBP2x from a cefotaxime-resistant Streptococcus pneumoniae strain is reported . It was obtained by a site-directed deletion of the membrane anchor in the corresponding gene, a method similar to that successfully utilized for the production of PBP2x from a cefotaxime-sensitive wild type strain . The kinetic parameters characterizing the interactions of both cefotaxime-resistant and -sensitive proteins have been determined and compared . The results are in agreement with the identification of PBP2x as the primary target for cefotaxime in the sensitive strain and as probably one of several targets in the resistant strain.

FEMS Microbiol Lett, 1993 Sep 15, 112(3), 301 - 5
Infectivity of a glucan synthesis-defective mutant of Streptococcus gordonii (Challis) in a rat endocarditis model; Wells VD et al.; Streptococcus gordonii, a member of the human indigenous oral microflora, colonizes smooth tooth surfaces and contributes to dental plaque formation . Although it is not recognized as being a cariogenic pathogen, it may cause endocarditis following invasion of the bloodstream . Using allelic exchange mutagenesis, we have constructed a mutant of S . gordonii (Challis) which is defective in its single functional glucosyltransferase gene and, hence, is unable to synthesize glucan exopolymers from sucrose . When examined in a rat endocarditis model, the sucrose-grown mutant did not differ significantly from S . gordonii wild-type, suggesting that glucan polymers did not contribute to infectivity . This result was in striking contrast to that previously observed with a polymer-defective S . mutans mutant.

Biochim Biophys Acta, 1993 Sep 13, 1178(3), 243 - 8
Glucose stimulates cAMP accumulation in the oral bacterium Actinomyces viscosus; Watson EL et al.; Actinomyces viscosus T14V, a Gram-positive bacterium found in the oral cavity, was found to be insensitive to glucose-mediated catabolite repression . Basal levels of beta-galactosidase (18-26 U) were observed at all phases of growth regardless of the culture conditions . Further, beta-galactosidase could not be induced with lactose, or with a known inducer of the enzyme, isopropyl-beta-D-thiogalactoside, or with dibutyryl cAMP . Glucose, on the other hand, stimulated cAMP accumulation in a concentration-dependent manner . Fructose and sucrose mimicked the effects of glucose on cAMP accumulation, whereas galactose, mannose and maltose had lesser stimulatory effects . Other carbon sources, i.e., lactose, alpha-methylglucoside, ribose, xylose and succinate were without effect . Glucose and alpha-methylglucoside were found to stimulate cAMP accumulation in toluene-permeabilized cells, in the presence of the phosphodiesterase inhibitor, theophylline . Glucose did not stimulate cAMP levels in other Gram-positive bacteria including Streptococcus mutans, S . sanguis and S . salivarius but did cause cAMP accumulation in other strains of A . viscosus . The results suggest that glucose effects on cAMP metabolism are independent of the induction of beta-galactosidase as presently defined for Escherichia coli, and that the effects appear to be selective to the A . viscosus bacteria . The results also suggest that glucose stimulates cAMP accumulation via activation of adenylate cyclase.

Pediatr Dermatol, 1993 Sep, 10(3), 259 - 62
Staphylococcus aureus as a cause of perianal dermatitis; Montemarano AD et al.; Perianal dermatitis has been reported to be caused by group A beta-hemolytic Streptococcus . We present a case caused by Staphylococcus aureus . A clinical clue pointing to this organism was the presence of satellite pustules . Identifying the pathogen in perianal dermatitis is therapeutically important, as oral penicillin VK will not be effective if S . aureus is the true cause . Other streptococcal and staphylococcal cutaneous infections may exhibit overlapping clinical features, including scarlet fever, impetigo, toxic shock syndrome, and cellulitis.

Otolaryngol Head Neck Surg, 1993 Sep, 109(3 Pt 1), 522 - 9
Formation of mucosal polyps in the nasal and maxillary sinus cavities by infection; Norlander T et al.; Unilateral maxillary sinusitis was experimentally induced in New Zealand White rabbits with Streptococcus pneumoniae serotype 3, Bacteroides fragilis NCTC 9343, and Staphylococcus aureus V8 . In another group of rabbits, sinusitis was induced by blocking of the sinus ostium only . Bacteriologic and light microscopic analysis was performed after 5 days to 1 month . Granulation-like polyps developed after deep mucosal inflammatory trauma initiating fibroblast proliferation, angiogenesis, and epithelial migration to cover the polyp . In regions of a more superficial trauma-characterized by epithelial desquamation and fibroblast growth-proliferation and differentiation of basal cells resulted in the formation of microcavities dissecting off edematous polyps . Polyps could be found in all sinusitis groups, irrespective of inducing agent . The cellular events of polyp formation appear to be the result of a continuous inflammatory reaction and are not directly related to the presence of a certain microorganism . Instead, the potential of any microorganism to induce a deep mucosal trauma or epithelial desquamation seems essential for its ability to initiate polyp formation.

Biol Reprod, 1993 Sep, 49(3), 507 - 14
Function of uterine and blood-derived polymorphonuclear neutrophils in mares susceptible and resistant to chronic uterine infection: phagocytosis and chemotaxis; Troedsson MH et al.; In vitro phagocytosis and chemotaxis of uterine and blood-derived polymorphonuclear neutrophils (PMNs) were compared in mares with different resistance to chronic uterine infection (CUI) . Both the primary in vitro function of PMNs and the role of uterine environmental factors on PMN function were investigated . The uteri of mares susceptible to (n = 6) and resistant to CUI (n = 5) were inoculated with 5 x 10(6) Streptococcus zooepidemicus when the mares were in estrus . Uterine secretions in addition to uterine and blood-derived PMNs were sampled at 5 and 24 h later . During a subsequent estrus, bacterial inoculation of the uterus was repeated, and samples were removed from the mares 12 and 36 h later . Neither the phagocytic nor the chemotactic capacity of PMNs changed over time in any of the groups . However, chemoattractive properties of uterine secretions declined over time in both resistant (p < 0.0007) and susceptible mares (p < 0.01) . Significantly higher phagocytosis (p < 0.03) and chemotaxis (p < 0.05) by uterine derived PMNs were found in the susceptible mares compared to resistant mares when a standardized opsonin (pooled plasma) was used . However, uterine secretions from susceptible mares demonstrated a poorer opsonizing capacity (p < 0.00002) but were more chemoattractant (p < 0.004) than secretions from resistant mares . When opsonins and chemoattractants were provided by plasma, no differences were detected in phagocytosis between blood-derived and uterine PMNs . In contrast, chemotaxis of uterine PMNs were superior to blood-derived PMNs in both resistant (p < 0.007) and susceptible mares (p < 0.0001) under these conditions.(ABSTRACT TRUNCATED AT 250 WORDS)

Biol Reprod, 1993 Sep, 49(3), 502 - 6
Immunoglobulin (IgG and IgA) and complement (C3) concentrations in uterine secretion following an intrauterine challenge of Streptococcus zooepidemicus in mares susceptible to versus resistant to chronic uterine infection; Troedsson MH et al.; The validity of measuring concentrations of immunoglobulins in undiluted uterine secretions was established . The concentrations of IgG, IgA, and cleavage factor C3 of the complement system in uterine secretions were compared in mares with different resistance to chronic uterine infection (CUI) . The uteri of mares susceptible (n = 6) and resistant to CUI (n = 5) were inoculated with 5 x 10(6) Streptococcus zooepidemicus when the mares were in estrus . Uterine secretions were sampled, and sampling was immediately followed by a uterine lavage at 5 and 24 h after bacterial inoculation . During a subsequent estrus, bacterial inoculation of the uterus was repeated, and samples were taken from the mares 12 and 36 h later . The fraction of uterine secretion in each uterine washing was determined by dividing the protein concentration of the undiluted uterine secretion by the protein concentration of the corresponding uterine washing . There was a significant correlation between measured concentrations of immunoglobulins in uterine secretions and calculated concentrations in the uterine washings (p < 0.05) . Concentrations of IgG and C3 in uterine secretions declined similarly in both susceptible and resistant mares during the first 24 h after bacterial inoculation (p < 0.04) . In contrast to the susceptible group, which showed a continuous decline at 36 h, resistant mares demonstrated an increased concentration of both IgG and C3 at this time . Concentrations of IgA did not differ between susceptible and resistant mares . It was concluded that the described method of sampling uterine secretions was useful for analyzing IgG and IgA.(ABSTRACT TRUNCATED AT 250 WORDS)

J Bacteriol, 1993 Sep, 175(18), 5925 - 33
Multiple changes in cell wall antigens of isogenic mutants of Streptococcus mutans; Harrington DJ et al.; Isogenic mutants of Streptococcus mutans LT11, deficient in the production of the wall-associated protein antigens A and B, were generated by recombinant DNA technology . The hydrophobicity, adherence, and aggregation of the mutants were compared with those of the parent strain . These studies indicated that hydrophobicity, adherence, and saliva- or sucrose-induced aggregation were unaltered in the A- mutant but that hydrophobicity and adherence to saliva-coated hydroxylapatite were greatly reduced in the B- mutant whilst sucrose-dependent adherence and aggregation were increased . To determine whether these changes correlated with changes in the mutated gene product alone, the levels of a number of cell wall antigens were determined in each of the mutants . The loss of antigen A resulted in significantly reduced levels of wall-associated lipoteichoic acid, and loss of antigen B resulted in reductions in both antigen A and lipoteichoic acid . Data presented here thus suggest that changes in the expression of one wall antigen can have a dramatic effect on the levels of others.

Eur J Biochem, 1993 Sep 1, 216(2), 623 - 9
Isolation of three antibacterial peptides from pig intestine: gastric inhibitory polypeptide (7-42), diazepam-binding inhibitor (32-86) and a novel factor, peptide 3910; Agerberth B et al.; Two antibacterial peptides, cecropin P1 and PR-39 (39-residue proline/arginine-rich peptide), from the upper part of pig small intestine have previously been isolated and characterized . We have now continued our search for antibacterial peptides in different side fractions generated during the isolation of intestinal hormones . Starting from one such fraction and monitoring activity against Bacillus megaterium, we isolated three homogeneous peptides by three consecutive chromatographic steps . Amino acid sequence analysis in combination with mass spectrometry identified two of the peptides as gastric inhibitory polypeptide (7-42) {GIP(7-42)} and diazepam-binding inhibitor (32-86) {DBI(32-86)}, derived from factors already known . However, intact GIP and DBI have hardly any antibacterial activity by themselves . The third peptide constitutes a previously unknown structure, designated as peptide 3910 from its molecular mass . All three peptides showed good activity against B . megaterium . In addition, GIP (7-42) showed some activity against Streptococcus pyogenes and an Escherichia coli mutant with a defect in its outer membrane.

Am J Surg, 1993 Sep, 166(3), 308 - 10
Impaired bacterial killing in early obstructive jaundice; Scott-Conner CE et al.; Sprague-Dawley rats were challenged with intraperitoneal injection of 10(7) Streptococcus pneumoniae 10 days after common duct ligation (BDL) or sham celiotomy (SC) . Quantitative bacterial cultures were performed on liver, spleen, lung, kidney, and heart blood samples obtained 4 hours after injection . All 13 (100%) BDL animals had positive heart blood cultures, but only 6 of 12 (50%) SC animals remained bacteremic (p < 0.05) . Significantly more viable organisms were recovered from lung, liver, spleen, and kidney of BDL animals compared with SC controls . BDL impaired the host's ability to kill this encapsulated gram-positive organism . Viable bacteria remained in all organs studied, which was associated with continuing bacteremia.

J Med Microbiol, 1993 Sep, 39(3), 183 - 90
Effect of co-aggregation on the pathogenicity of oral bacteria; Ochiai K et al.; The pathogenicity of oral bacteria was studied by measuring the development of subcutaneous abscesses in mice after infection with Actinomyces viscosus and Streptococcus mitis either singly or as co-aggregated pairs . Heat-treated cells were also tested . The pathogenicity of the co-aggregates was examined in various viable and heat-treated combinations of the two bacterial species . More abscesses were formed by A . viscosus than S . mitis at all the bacterial concentrations tested . Also, abscess formation by co-aggregates of the two strains produced a higher percentage of abscess formation than those caused by infection with pure suspensions of A . viscosus or S . mitis . Co-aggregated cells were more resistant to phagocytosis and killing by neutrophils in vitro and in vivo . Furthermore, A . viscosus in co-aggregates were resistant to killing after engulfment by neutrophils . These results suggest that oral bacteria that are able to co-aggregate may resist phagocytosis, and this ability may be linked with pathogenicity.

J Med Microbiol, 1993 Sep, 39(3), 165 - 78
The serotypes of Streptococcus pyogenes present in Britain during 1980-1990 and their association with disease; Colman G et al.; A total of 16,909 cultures of Streptococcus pyogenes (Lancefield group A) isolated in Britain during 1980-90 were examined for T- and M-protein antigens . One or other M antigen was detected in 92.6% of the strains . The numbers of isolates of some serotypes, such as M3 and M12, did not show great variation from year-to-year, whereas there were nationwide epidemics, extending over several years, caused by strains of serotypes M1 and M49 . Isolates of serotypes M1 and M3 were associated particularly with invasive disease and fatal infections . Representatives of serotypes M80, M81 and the provisional types PT180, PT1658 and PT5757 were isolated most often from cases of pyoderma . Erythromycin resistance was detected in 30 serotypes but one half of all of the resistant isolates belonged to serotype M4.

Infect Immun, 1993 Sep, 61(9), 3811 - 7
Role of the Streptococcus mutans gtf genes in caries induction in the specific-pathogen-free rat model; Yamashita Y et al.; The role of each of the Streptococcus mutans gtf genes coding for glucan synthesis in cariogenesis was evaluated by using strain UA130 in the specific-pathogen-free (SPF) rat model system . Mutants defective in either or both of the genes required for insoluble glucan synthesis, the gtfB and gtfC genes, exhibited markedly reduced levels of smooth-surface carious lesions relative to that of the parental organism . Likewise, the mutant defective in the gtfD gene coding for the glucosyltransferase-S enzyme synthesizing water-soluble glucans also produced significantly fewer smooth-surface lesions than strain UA130 . None of these mutations markedly altered the rate of sulcal caries induction relative to that of the parental organism . In addition, a mutant of strain UA130 defective in the gtfA gene was reexamined in the SPF rat model . In contrast to previous results from a gnotobiotic rat system, these mutants also induced significantly fewer smooth-surface carious lesions compared with that by strain UA130 . These results suggest that all four genes are important for smooth-surface caries formation . Furthermore, these results are discussed relative to the differences in the diets utilized in the SPF and gnotobiotic rat model systems for assessing the virulence factors of S . mutans.

Infect Immun, 1993 Sep, 61(9), 3719 - 23
Inactivation of the streptococcal erythrogenic toxin B gene (speB) in Streptococcus pyogenes; Chaussee MS et al.; Streptococcal proteinase precursor (SPP) is a zymogen secreted by Streptococcus pyogenes that becomes activated to a cysteine proteinase . SPP has been shown to be immunologically identical to streptococcal erythrogenic toxin B (SPE B), and sequence comparison has shown a high degree of homology between the two proteins . In this study, we have constructed a speB mutant strain of S . pyogenes by insertional inactivation . An internal fragment of the cloned speB gene in plasmid pCR1000 was replaced with an erythromycin resistance determinant, and the recombinant plasmid was introduced into strain NZ131 by electrotransformation . Following the selection of erythromycin-resistant clones, Southern hybridization experiments confirmed the presence of the recombinant plasmid containing the erm gene in the chromosome of the resistant strains . Analysis of extracellular proteins produced by the wild-type and speB mutant strains by Ouchterlony immunodiffusion and isoelectric focusing revealed the presence of SPE B in the wild-type strain but not the speB mutant . Additionally, SPP, which has an isoelectric focusing pattern similar to that of SPE B and reacts with SPE B antiserum, was not detected among the extracellular proteins of the speB mutant strain . Proteinase activity as assayed by two different methods was present in the extracellular proteins produced by the wild-type strain, but the speB mutant strain had no extracellular proteinase activity . The mutant strain had a growth rate similar to that of the wild-type strain and produced normal levels of other extracellular products, suggesting that proteinase was not essential for viability as previously suggested . Our data are consistent with the view that a single gene (speB) produces a single protein that has been identified and/or assayed as either SPE B or SPP.

Infect Immun, 1993 Sep, 61(9), 3597 - 604
Unexpectedly high levels of some presumably protective secretory immunoglobulin A antibodies to dental plaque bacteria in salivas of both caries-resistant and caries-susceptible subjects; Hocini H et al.; The role of salivary antibodies in protection against cariogenic bacteria is actually a matter of debate . Correlation between caries experience and naturally occurring antibodies was extensively investigated . Comparison of salivary antibodies from 21 caries-resistant and 22 caries-susceptible subjects was carried out by using a new quantitative method . Secretory immunoglobulin A (S-IgA) antibodies to Streptococcus sobrinus and Streptococcus sanguis cells were detected in all salivas and at similar levels in both groups . When assayed with two major antigens from S . sobrinus, i.e., protein antigen I/II and cell wall carbohydrates, only specific activities of antibodies to the protein component were increased (P < 0.01), but this occurred unexpectedly in the caries-susceptible group . Western blot (immunoblot) analysis with the culture supernatant and cell wall proteins from S . sobrinus showed the same antibody specificity in both groups . No selective increase of the protease-resistant S-IgA2 subclass was found, and avidities of antibodies to both antigen I/II and cell wall carbohydrates were similar . Our results demonstrate that naturally induced S-IgA antibodies against S . sanguis, S . sobrinus, and the major antigens of the latter are not sufficient to inhibit caries development.

AJR Am J Roentgenol, 1993 Sep, 161(3), 643 - 6
Osteomyelitis in hospitalized children with chickenpox: imaging findings in four cases; Grier D et al.; OBJECTIVE . The most common complications of chickenpox are skin and soft-tissue infections . Pneumonia and CNS involvement occur less often, and skeletal complications are considered rare . The purpose of this study was to evaluate the imaging findings of osteomyelitis in children after chickenpox . MATERIALS AND METHODS . We retrospectively reviewed the records of children admitted to our institution because of chickenpox and analyzed the imaging findings in those who had skeletal involvement . Ninety-seven patients were admitted between January 1991 and January 1993 because of chickenpox or a complication thereof . Four previously healthy patients, three boys and one girl, between 1 and 6 years old had osteomyelitis . Staphylococcus aureus was isolated from bone in one patient, and group A beta-hemolytic streptococcus was isolated from blood cultures in another . No organism was grown in the other two; necrotic bone was recovered from one lesion and the other healed with periosteal formation of new bone typical of osteomyelitis . All patients were treated with IV antibiotics, and their recoveries were uncomplicated . RESULTS . Conventional radiographs showed loss of fat planes in three patients and destruction of bone in two . Bone scintigraphy showed increased uptake of radionuclide in early and late phases in three patients . Uptake in one case was extensive, with a central area of relatively little uptake corresponding to a subperiosteal fluid collection . CT in two and MR imaging in one showed subperiosteal fluid collections surrounding the involved bones in association with bone and marrow changes . CONCLUSION . Osteomyelitis was the fourth most common complication of chickenpox in our series . The appearances on conventional radiographs and scintigrams are indistinguishable from those of typical bacterial osteomyelitis . However, CT and MR imaging showed subperiosteal fluid collections in three of four patients, an appearance only occasionally seen with typical osteomyelitis.

Res Microbiol, 1993 Sep, 144(7), 539 - 45
Acetohydroxy acid synthase and threonine deaminase activities, and the biosynthesis of isoleucine-leucine-valine in Streptococcus bovis; Basso AL et al.; Acetohydroxy acid synthase (AHAS) and threonine deaminase (TD) activities were found in Streptococcus bovis and shown to be involved in the biosynthesis of the branched chain amino acids isoleucine, leucine and valine . Apparent lack of repression of AHAS synthesis by the end-products and reduced sensitivity of S . bovis growth to analogues of the branched chain amino acids suggested that secretion of isoleucine, leucine and valine in the growth medium may be a consequence of the regulatory features of AHAS . A glycyl-leucine-resistant mutant with reduced TD activity secreted a reduced amount of isoleucine and an increased amount of valine, which might be a result of the reduced rate of synthesis of the isoleucine precursor alpha-ketobutyrate and of a consequent preferential carbon flow through the valine branch of the pathway.

Mol Gen Mikrobiol Virusol, 1993 Sep-Oct, (5), 13 - 6
{Regulation of enzymes of the first and last stage of lysine biosynthesis in Streptococcus bovis and Enterococcus faecium}; Kal'cheva EO et al.; Regulation of aspartate kinase and diaminopimelate decarboxylase activities in Streptococcus bovis and Enterococcus faecium cell-free extracts was studied . The levels of synthesis of aspartate kinase and diaminopimelate decarboxylase in both microorganisms are growth-dependent . The synthesis of these enzymes is depressed by lysine, but the activity of aspartate kinase is induced by addition of this amino acid and threonine to the reaction system . Meso-diaminopimelate dehydrogenase activity was not found in the extracts of Streptococcus bovis and Enterococcus faecium . The data excludes the possibility of lysine formation via six enzyme reactions.

Zentralbl Veterinarmed B, 1993 Sep, 40(7), 494 - 500
Prevalence of antibodies to Streptococcus bovis serotype 1 in racing pigeons; de Herdt P et al.; Indirect ELISA techniques for the detection of antibodies to S . bovis serotypes 1, 2 and 3 in pigeon plasma were developed . Whole formaldehyde-inactivated bacteria were used as coating antigens . Bound antibodies were detected with peroxidase-conjugated rabbit anti-pigeon serum and OPD and H2O2 as chromogen and substrate, respectively . ELISA was used to determine the prevalence of antibodies to S . bovis serotype 1 in healthy Belgian racing pigeons . Antibodies were demonstrated in 83 (= 37%) of 225 samples tested . Results indicate that pigeons may build up plasma antibodies in the absence of clinical signs resembling septicaemia.

J Heart Valve Dis, 1993 Sep, 2(5), 558 - 60
Aortic annular abscess complicating prosthetic valve endocarditis with group G streptococcus: detection during life with transesophageal echocardiography; Pollack BD et al.; Infection with group G streptococcus is an unusual but virulent cause of endocarditis . Aortitis and abscess formation due to this organism have been described in one previous report, but only at necropsy . We present here a patient with group G streptococcal endocarditis and aortic annular abscess diagnosed during life by transesophageal echocardiography, leading to successful surgical intervention.

Acta Otolaryngol, 1993 Sep, 113(5), 673 - 8
Anti pneumococcal antibody activity in nasopharyngeal secretions in healthy adults and children; Lindberg K et al.; The local antibody activity to Streptococcus pneumoniae serotype 6B was measured in nasopharyngeal secretions from 20 healthy adults and 43 children, 1-3 years of age, 14 of whom were healthy and 29 were at risk for developing recurrent episodes of acute otitis media (RAOM) according to the criteria described below . In children, anti pneumococcal IgA and IgG antibody activity was of the same magnitude in both groups . Adults showed significantly higher specific IgA activity . Antibody activity of the IgG isotype was also higher in adults, possibly reflecting the higher serum antibody levels . The children at risk of developing RAOM had significantly higher levels of secretory component (SC) in their nasopharyngeal secretions . Our data suggest that local immunity in the nasopharynx is not fully developed in young children, which might contribute to bacterial survival and colonization in the region.

J Antimicrob Chemother, 1993 Sep, 32(3), 473 - 82
Correlation between macrolide lung pharmacokinetics and therapeutic efficacy in a mouse model of pneumococcal pneumonia; Veber B et al.; The correlation between the pharmacokinetics of erythromycin, roxithromycin, clarithromycin, spiramycin and azithromycin and their efficacy was investigated in two pneumococcal pneumonia models . Female Swiss and C57B1/6 mice were infected with Streptococcus pneumoniae strain P4241 by the intratracheal per oral route . This virulent strain produces acute pneumonia with death within 3-4 days (Swiss mice), or subacute pneumonia with death within 10 days (C57B1/6 mice) in untreated mice and the outcome of the disease is closely related to progressive weight loss . Swiss mice received three doses of each macrolide 50 mg/kg bd beginning 18 h post-infection . C57B1/6 mice received three doses of each macrolide 25 mg/kg, bd (except azithromycin was 12.5 mg/kg bd) beginning 48 h post-infection . Cure rates were evaluated on the basis of body weight variations recorded daily after the end of treatment . Pharmacokinetic parameters were determined in infected and non-infected mice after a single dose of each macrolide 50 mg/kg sc . The pharmacokinetics of azithromycin was also determined in leucopenic Swiss mice . We observed a hierarchy of in-vivo efficacy as follows: azithromycin > spiramycin = clarithromycin > roxithromycin = erythromycin which did not correlate with in-vitro MIC or MBC . The same hierarchy was found in terms of the lung T1/2 . Lung T1/2s of macrolides could thus be predictive of their efficacy in respiratory tract infections . A reduced tissue AUC of azithromycin was seen in leucopenic mice suggesting leucocytes may help transport macrolides to sites of infection.

Rhinology, 1993 Sep, 31(3), 101 - 5
The effect of ostial opening on experimental maxillary sinusitis in rabbits; Min YG et al.; Obstruction of the natural ostium is known to be one of the major factors in the pathogenesis of maxillary sinusitis . To explore the therapeutic effect of ostial patency, sinusitis was induced in 32 rabbits by obstruction of the natural ostium and inocculation of Streptococcus pneumoniae . They were divided into two groups: the first ("open") group included 16 rabbits with experimentally induced sinusitis, from which bone chips for obstruction of the natural ostium were removed after a period of 5 days, and the second ("closed") group included 16 rabbits with continuous obstruction of the natural ostium . The induction of sinusitis was found to be successful in all cases, when examined after five days . The amount of nasal and sinus secretion as well as histopathological findings of the sinus mucosa were investigated with light microscopy, scanning and transmission electron microscopy, two and four weeks after induction of sinusitis . The findings were significantly improved in the "open" group.

Pathol Biol (Paris), 1993 Sep, 41(7), 636 - 40
{In vitro antibacterial activity of pristinamycin against penicillin resistant Streptococcus pneumoniae}; Fremaux A et al.; Pristinamycin, a member of streptogramin family, is the association of two groups (components I and pristinamycin II A) which have a high synergistic activity . Given the increasing rates of penicillin resistance in Streptococcus pneumoniae in many countries, and in particular of strains exhibiting multiple resistance to commonly used antibiotics, it was interesting to study the in vitro activity of pristinamycin against penicillin resistant S . pneumoniae (47 strains) and compare it with that of erythromycin . All strains were isolated from otitis media . Minimal inhibitory concentrations (MICs) were determined by an agar dilution technique using Mueller-Hinton medium supplemented with 5% horse blood . An inoculum of 10(4)-10(5) CFU per spot was delivered by a Steers replicator . This study showed that, among the 47 penicillin resistant strains, 29 (61.7%) were resistant to erythromycin but none of them were resistant to pristinamycin . The good in vitro activity of pristinamycin against S . pneumoniae could be of particular interest in cases of infections with multiresistant strains.

Nihon Kyobu Shikkan Gakkai Zasshi, 1993 Sep, 31(9), 1185 - 9
{Mediastinal abscess due to endotracheal intubation}; Iibachi N et al.; A 38-year-old woman was brought to hospital in an unconscious condition due to hypoglycemic coma . At 23 years of age she was diagnosed as having insulin-dependent diabetes mellitus . She had been treated with insulin but the control of her blood sugar was inadequate . Emergency endotracheal intubation was performed and she began to breathe spontaneously . Two days later, sore throat, swelling of the neck and fever appeared . She was therefore transferred to our hospital . CT showed a continuous abscess with multiple air bubble from the pharynx to the mediastinum . Cervical incision was performed and treatment with ampicillin, cefmetazole, and clyndamicin was started . Culture of the pus revealed alpha-streptococcus . The abscess decreased in size and her blood sugar was controlled by insulin and diet . She was discharged after 11 weeks of hospitalization . At that time CT showed only emphysematous change.

J Gen Microbiol, 1993 Sep, 139 ( Pt 9), 2067 - 74
Conserved and variable regions in protein Arp, the IgA receptor of Streptococcus pyogenes; Heden LO et al.; The streptococcal M protein family, a number of cell surface molecules that interact with the human immune system, can be divided into two major classes, A and C, characterized by different types of repeats in the central part of the molecule . Class A and class C molecules are known to have a variable N-terminal region and a more conserved C-terminal region, but little is known about the mechanisms that give rise to this structural variation . In this report, we show that two variants of protein Arp, an IgA receptor in class C of the M protein family, have virtually identical signal sequences and C-terminal halves, but unrelated N-terminal sequences . Comparison of the sequences of the two genes and their flanking regions also demonstrates the presence of well-defined variable and conserved regions . Our results strongly suggest that the N-terminal sequence variation between the two variants of protein Arp was generated through an intergenic recombination event, rather than through intragenic recombination or accumulation of mutations.

Antimicrob Agents Chemother, 1993 Sep, 37(9), 1938 - 44
Genetic diversity of penicillin-binding protein 2B and 2X genes from Streptococcus pneumoniae in South Africa; Smith AM et al.; Streptococcus pneumoniae (the pneumococcus) is believed to have developed resistance to penicillin by the production of altered forms of penicillin-binding proteins (PBPs) that have decreased affinity for penicillin . Sixty-eight clinical isolates of serogroup 6 and 19 pneumococci (MICs, < 0.015 to 8 micrograms/ml) were randomly selected from hospitals across South Africa which are at substantial geographic distance from each other . The polymerase chain reaction was used to isolate the penicillin-binding domain of PBPs 2B and 2X from the chromosomal DNAs of the bacteria; the purified PBP DNA was digested with restriction enzymes, the fragments were end-labelled and separated on polyacrylamide gels, and the DNA fingerprints were visualized following autoradiography . Fingerprint analysis revealed that at least 19 PBP 2B gene variants occur in the serogroup 6 and 19 pneumococci . The PBP 2B gene revealed a uniform profile among penicillin-susceptible isolates, with variation from this profile occurring only in isolates for which MICs were > or = 0.06 micrograms/ml . Analysis of the PBP 2X gene revealed a greater diversity in the population with 26 variant genes, including some diversity among susceptible isolates . Discrete profiles of both genes were found only within narrow bands of the penicillin MIC, so that the gene pattern predicted the MIC . PBP 2X gene variation and the lack of variability among PBP 2B genes in pneumococci inhibited at low MICs confirm that PBP 2X alteration may be responsible for low-level penicillin resistance, while alterations in both PBP 2B and PBP 2X are required for high-level resistance . The extensive diversity of PBP genes in South African serogroup 6 and 19 strains suggests that altered PBP genes have arisen frequently in this population.

Antimicrob Agents Chemother, 1993 Sep, 37(9), 1742 - 5
High rate of erythromycin and clarithromycin resistance among Streptococcus pneumoniae isolates from blood cultures from Providence, R.I; Lonks JR et al.; Four (5%) of 81 recent isolates of Streptococcus pneumoniae from the blood of adult patients but no isolates from pediatric patients (n = 51) were resistant (MIC, > or = 1 microgram/ml) to erythromycin . The MICs of clarithromycin were slightly lower than those of erythromycin, but there was complete cross-resistance . Routine testing and surveillance are needed to determine whether erythromycin resistance among S . pneumoniae isolates is increasing throughout the United States.

J Infect, 1993 Sep, 27(2), 157 - 68
Antimicrobial susceptibility and serotype distribution of Streptococcus pneumoniae from Rwanda, 1984-1990; Bogaerts J et al.; A total of 383 clinical isolates of Streptococcus pneumoniae, obtained from an equal number of patients in Kigali, Rwanda, was tested for resistance to penicillin G with a 1 microgram oxacillin disc . Of these isolates, 99 (25.8%) showed reduced zones of inhibition . By means of an agar dilution method, 21% all isolates were confirmed as relatively resistant (MIC > or = 0.12- < or = 1.0 mg/l) strains of Streptococcus pneumoniae (RRSP) . A high degree of resistance to penicillin G (MIC > or = 2 mg/l) was not observed . Resistance to chloramphenicol (MIC > or = 8 mg/l) was found in 31% RRSP and in 6% penicillin susceptible strains (PSSP) . Doxycycline resistance was common in both RRSP and PSSP strains . All isolates remained fully susceptible to erythromycin . Children more often harboured a strain giving a reduced inhibition zone than did adults (74/230 versus 25/153; P = 0.0005) . A total of 32 serotypes or serogroups were identified, seven of them relating to 64.8% all isolates typed . Of all the isolates 84% belonged to a serotype represented in the 23-valent vaccine or to a cross-reacting serotype . Serotype 25, not included in the vaccine, accounted for 10.7% typed isolates from adults but only for 2.0% typed isolates from children . Results of susceptibility testing and clinical experience suggest that penicillin G, ampicillin and chloramphenicol should not be used alone as empirical treatment for pneumococcal meningitis in patients in Rwanda.

J Hand Surg {Am}, 1993 Sep, 18(5), 868 - 70
Abscesses of the upper extremity from drug abuse by injection; Gonzalez MH et al.; A 4-year retrospective review of 59 consecutive upper extremity abscesses associated with drug abuse by injection is reported . There were 57 patients, with the most common location being the forearm . All abscesses were treated with incision, drainage, and intravenous antibiotics . Seventeen patients required more than one debridement; nine were complicated by fasciitis, osteomyelitis, septic arthritis, or septic tenosynovitis . Thirty-one patients had human immunodeficiency virus testing, and nine results were positive . Bacteriology showed the most common organisms to be streptococcus, Staphylococcus aureus, and Eikenella corrodens . Nineteen percent of the abscesses had anaerobes cultured . Most of the organisms cultured were common oral or skin flora.

J Dairy Sci, 1993 Sep, 76(9), 2783 - 8
Efficacy evaluations on five chlorhexidine teat dip formulations; Drechsler PA et al.; Three developmental postmilking teat dip formulations containing chlorhexidine digluconate were evaluated against Staphylococcus aureus and Streptococcus agalactiae in sequential experimental exposure trials . Two additional commercial chlorhexidine digluconate teat dip products were evaluated in natural exposure trials . Under conditions of experimental challenge, the developmental formulations were efficacious against Staph . aureus but did not significantly reduce incidence of new IMI by Strep . agalactiae . None of the three formulations of a conventional germicide used as teat sanitizers effectively reduced incidence of new Strep . agalactiae IMI under experimental challenge conditions . In the natural exposure trials with negative controls, a .35% chlorhexidine teat sanitizer had efficacy of 88.7% against Staph . aureus and 51.4% against Strep . agalactiae . The .5% chlorhexidine product reduced Staph . aureus and Strep . agalactiae IMI by 86 and 56%, respectively.

Helv Chir Acta, 1993 Sep, 60(1-2), 121 - 5
{Surgical-radiologic interventional treatment in liver abscess with Streptococcus anginosus Milleri}; Naef M et al.; Pyogenic liver abscess is a relatively rare disease, often concerning elderly patients in bad general condition and with underlying diseases . Out of a retrospective study (1984-1991) of 44 patients (f 43%, m 57%) with pyogenic liver abscesses and 12 patients (f 17%, m 83%) with amebic liver abscesses we present 5 patients with multifocal lesions due to Streptococcus anginosus Milleri--a special group concerning therapy and course of disease . The therapy was high-dose i.v . antibiotic therapy in all 5 cases and additional percutaneous drainage with pig-tail catheters--inserted under CT guidance--in 4 cases (1-5 catheters, time of drainage 6-63 days) . The duration of hospitalisation was 15-73 days (median 45), intravenous antibiotic treatment lasted 4-40 days . After discharge oral antibiotics were continued for 14-42 days.

Eur Heart J, 1993 Sep, 14(9), 1292 - 3
A case of infective endocarditis in a farmer caused by Streptococcus equinus; Elliott PM et al.; The following is a case report of a farmer with documented aortic valve disease who developed bacterial endocarditis secondary to Streptococcus equinus . This is a rare pathogen in man and its acquisition in this case may be related to the subject's occupation.

Arch Dis Child, 1993 Sep, 69(3 Spec No), 317 - 8
Pneumococcal infection in the newborn; Primhak RA et al.; Two fatal cases of invasive pneumococcal disease in the newborn are reported, both acquired from the maternal vagina . The rarity of vaginal carriage of pneumococcus suggests that this organism has a higher invasion to colonisation ratio than group B streptococcus and maternal carriage or neonatal colonisation should be more aggressively treated.

Arch Dis Child, 1993 Sep, 69(3), 381 - 2; discussion 382-3
Overwhelming sepsis presenting as sudden unexpected death; Sharief N et al.; Four children, including three infants, who died suddenly and unexpectedly are described . In three of the cases group A beta haemolytic streptococcus was cultured and in the fourth Streptococcus pneumoniae . The organism was grown from multiple sites including blood in two of them . Without microbiological investigation the diagnosis would have been sudden unexpected death syndrome.

Anaesthesist, 1993 Sep, 42(9), 619 - 22
{The bactericidal effect of oxybuprocaine . A possible cause of false negative results in bronchoalveolar lavage}; Anding K et al.; New approaches in the diagnosis of pneumonia, especially in intensive care units, are quantitative cultures of bronchoalveolar (BAL) fluid or the protected specimen brush . The sensitivity of these methods, however, has often been found to be as low as 50-60% . One possible explanation for the low sensitivity of these diagnostic tools is the antimicrobial activity of local anaesthetics used in bronchoscopy . Therefore, we investigated the bactericidal properties of oxybuprocaine, a topical anaesthetic used for bronchoscopy in our clinic, in order to test the reliability of specimens obtained from BAL . METHODS . The bactericidal activity of oxybuprocaine in concentrations of 1%, 0.1%, 0.05% and 0.01% was tested by constructing time-kill curves for Streptococcus pneumoniae, Hemophilus influenzae, Pseudomonas aeruginosa and Escherichia coli . Five stains of each bacterial species were tested . The inoculum size was 10(4) ml, and bacteria were counted after 10, 20, 30, 60 and 120 min . RESULTS . The resulting time-kill curves are demonstrated in Figs . 1-4 . The most sensitive bacteria were S . pneumoniae and H . influenzae, in which significant bactericidal activity could be shown even with a 0.01% solution of oxybuprocaine . E . coli and P . aeruginosa were also inhibited, but only at the highest concentration of 1% . CONCLUSIONS . The use of local anaesthetics before material is taken for culture, e.g . from BAL, may give rise to false-negative results and should therefore be avoided or reduced . For each local anaesthetic used in bronchoscopy, the concentrations that can be used without the risk of false-negative results should be determined.

Mol Microbiol, 1993 Sep, 9(5), 1037 - 50
Genetic identification of exported proteins in Streptococcus pneumoniae; Pearce BJ et al.; A strategy was developed to mutate and genetically identify exported proteins in Streptococcus pneumoniae . Vectors were created and used to screen pneumococcal DNA in Escherichia coli and S . pneumoniae for translational gene fusions to alkaline phosphatase (PhoA) . Twenty five PhoA+ pneumococcal mutants were isolated and the loci from eight of these mutants showed similarity to known exported or membrane-associated proteins . Homologues were found to: (i) protein-dependent peptide permeases, (ii) penicillin-binding proteins, (iii) Clp proteases, (iv) two-component sensor regulators, (v) the phosphoenolpyruvate: carbohydrate phosphotransferases permeases, (vi) membrane-associated dehydrogenases, (vii) P-type (E1E2-type) cation transport ATPases, (viii) ABC transporters responsible for the translocation of the RTX class of bacterial toxins . Unexpectedly one PhoA+ mutant contained a fusion to a member of the DEAD protein family of ATP-dependent RNA helicases suggesting export of these proteins.

J Gen Microbiol, 1993 Sep, 139 ( Pt 9), 2019 - 26
Metabolism of polysaccharides by the Streptococcus mutants dexB gene product; Whiting GC et al.; The Streptococcus mutans dexB gene, a member of the multiple sugar metabolism (msm) operon, encodes an intracellular glucan 1,6-alpha-glucosidase which releases glucose from the non-reducing terminus of alpha-1,6-linked isomaltosaccharides and dextran . Comparison of primary amino acid sequences showed strong homology to Bacillus oligo-1,6-glucosidases and, like these enzymes, DexB was able to release free glucose from the alpha-1,4,6-branch point in panose . This suggested a role for DexB in the metabolism of either starch or intracellular polysaccharide, which contain such branch points . However, purified intracellular polysaccharide from the wild-type S . mutans strain LT11 and a mutant deficient in dexB revealed no substantial differences in the extent of branching as demonstrated by iodine staining spectra and the degree of polymerization . Furthermore, thin layer chromatography of radiolabelled intracellular polysaccharide digested with S . mutans wild-type and mutant cell extracts showed no differences in the products obtained . The involvement of DexB in dietary starch metabolism was investigated using alpha-limit dextrins produced from the action of alpha-amylase on starch . These induced the msm operon, including dexB, and the DexB enzyme was able to act on the alpha-limit dextrins to give further fermentable substrates . The transport system encoded by the msm operon can also transport alpha-limit dextrin . DexB may therefore be important in the metabolism of extracellular starch.

Br Dent J, 1993 Aug 21, 175(4), 133 - 4
A rare complication of dental treatment: Streptococcus oralis meningitis; Colville A et al.; A case of Streptococcus oralis meningitis is reported . This followed extraction of a normal tooth during routine orthodontic treatment . No focus of infection could be demonstrated, either local to or distant from the extraction site . Full recovery followed hospital admission and intravenous benzyl penicillin.

Ann Intern Med, 1993 Aug 15, 119(4), 278 - 83
Complete remissions in hairy cell leukemia with 2-chlorodeoxyadenosine after failure with 2'-deoxycoformycin; Saven A et al.; OBJECTIVE: To determine whether clinical cross-resistance and intolerance exists between the nucleosides 2'-deoxycoformycin (DCF) and 2-chlorodeoxyadenosine (2-CdA) in the treatment of patients with hairy cell leukemia despite similar structures and mechanisms of action . DESIGN: Phase II clinical study . SETTING: Referral cancer center . PARTICIPANTS: Five patients with hairy cell leukemia who had been previously treated with DCF . INTERVENTION: Single course of 2-CdA at 0.1 mg/kg body weight per day for 7 days by continuous intravenous infusion . RESULTS: Of five patients, three were resistant to and two were intolerant of (having had life-threatening toxic reactions) DCF therapy . Four patients obtained a complete response with a median follow-up period of more than 11 months . The other patient in whom splenectomy, interferon, and DCF treatments were unsuccessful had a partial response lasting 2 months and subsequently died of Streptococcus pneumoniae bacteremia . Three of the four patients with complete responses remain in unmaintained remission, whereas the fourth has progressive splenic enlargement with stable hematologic parameters . The median leukocyte count increased from 2.0 x 10(9)/L to 3.8 x 10(9)/L, the median absolute neutrophil count increased from 0.56 x 10(9)/L to 2.73 x 10(9)/L, the median hemoglobin level increased from 112 g/L to 140 g/L, and the median platelet count increased from 55 x 10(9)/L to 123 x 10(9)/L . Two patients had culture-negative neutropenic fever associated with treatment . CONCLUSIONS: 2-Chlorodeoxyadenosine induced complete responses in patients with hairy cell leukemia resistant to DCF, suggesting a lack of cross-resistance . Also, 2-CdA is not prohibitively toxic in patients intolerant of DCF.

Proc Natl Acad Sci U S A, 1993 Aug 15, 90(16), 7676 - 80
Cleavage of interleukin 1 beta (IL-1 beta) precursor to produce active IL-1 beta by a conserved extracellular cysteine protease from Streptococcus pyogenes; Kapur V et al.; Streptococcal pyrogenic exotoxin B (SPE B), a conserved extracellular cysteine protease expressed by the human pathogenic bacterium Streptococcus pyogenes, was purified and shown to cleave inactive human interleukin 1 beta precursor (pIL-1 beta) to produce biologically active IL-1 beta . SPE B cleaves pIL-1 beta one residue amino-terminal to the site where a recently characterized endogenous human cysteine protease acts . IL-1 beta resulting from cleavage of pIL-1 beta by SPE B induced nitric oxide synthase activity in vascular smooth muscle cells and killed of the human melanoma A375 line . Two additional naturally occurring SPE B variants cleaved pIL-1 beta in a similar fashion . By demonstrating that SPE B catalyzes the formation of biologically active IL-1 beta from inactive pIL-1 beta, our data add a further dimension to an emerging theme in microbial pathogenesis that bacterial and viral virulence factors act directly on host cytokine pathways . The data also contribute to an enlarging literature demonstrating that microbial extracellular cysteine proteases are important in host-parasite interactions.

FEBS Lett, 1993 Aug 9, 328(1-2), 169 - 73
Purification of the beta product encoded by the Streptococcus pyogenes plasmid pSM19035 . A putative DNA recombinase required to resolve plasmid oligomers; Rojo F et al.; Genetic evidence suggests that the gene beta product of Streptococcus pyogenes plasmid pSM19035 is required for converting plasmid multimers into monomers . The beta protein was purified from cells overexpressing the cloned gene . N-terminal protein sequence analysis demonstrated that the purified protein had the predicted sequence, except that the N-terminal initiator methionine was not present . Native beta protein consists of a dimer of two identical subunits with a molecular mass of 23.8 kDa (25 kDa in SDS-PAGE) . The beta protein (isoelectric point of 9.7) binds specifically to a DNA fragment (312 bp in length) which contains the promoter region of the orf alpha-gene beta operon and two regions (sites I and II) that show dyad axes of symmetry . It is proposed that protein beta binds to sites I and II to mediate resolution of plasmid oligomers.

J Mol Biol, 1993 Aug 5, 232(3), 1007 - 9
Crystallization of a genetically engineered water-soluble primary penicillin target enzyme . The high molecular mass PBP2x of Streptococcus pneumoniae; Charlier P et al.; A genetically engineered water-soluble derivative of PBP2x of Streptococcus pneumoniae has been produced, purified and crystallized in a form suitable for X-ray diffraction analysis . The best crystals have been grown at 15 degrees C, from solutions containing 8% polyethylene glycol 10,000 at pH values ranging from 3.9 to 6.0 . These crystals diffract to a resolution of 3.5 A and have a space group P6(1)22 (or enantiomorph) with unit cell dimensions of a = b = 162.2 A, c = 171.8 A, alpha = beta = 90 degrees, gamma = 120 degrees . The molecular mass and cell dimensions suggest that there is one molecule of enzyme per asymmetric unit . The breakdown of a chromogenic cephalosporin derivative diffused into a crystal reveals clearly that the enzyme is active in the crystalline state.

Kansenshogaku Zasshi, 1993 Aug, 67(8), 718 - 23
{Isolation of penicillin-resistant Streptococcus pneumoniae in Saga Medical School Hospital}; Tanabe I et al.; A recent nationwide increase in beta-lactams-resistant Streptococcus pneumoniae has attracted a great deal of attention . We studied the drug sensitivity of S . pneumoniae isolated from various clinical specimens in Saga Medical School Hospital between April 1988 and December 1991 . To determine the drug sensitivity of the strains, we used a micro-dilution method and determined the MIC . Drug resistance was evaluated using MIC of ampicillin (ABPC) as a reference MIC, and the results were roughly classified into the following three groups: sensitive (< or = 0.1 microgram/ml), moderately resistant (0.2-3.13 micrograms/ml) and highly resistant (> or = 6.25 micrograms/ml) . The isolation frequency was calculated on the basis of one strain from one patient . No strain of S . pneumoniae with high resistance against ABPC was found in 1988 (94 strains of S . pneumoniae were isolated) and 1990 (115 strains isolated), but one such strain (0.8%) was found among 129 strains isolated in 1989, and 2 such strains (2.4%) among 84 strains isolated in 1991 . Moderately resistant strains were isolated at the frequencies of 12.8%, 15.5%, 22.6%, and 21.4% respectively, in 1988, 1989, 1990, and 1991 . A sum of the frequencies of "moderately resistant" and "highly resistant" (2.4%) strains was 23.8% in 1991 . The frequency of resistant strains is increasing and the intensity of resistance is also being elevated.

Immunology, 1993 Aug, 79(4), 648 - 52
Activation of the classical pathway of complement by binding of bovine lactoferrin to unencapsulated Streptococcus agalactiae; Rainard P; The ability of lactoferrin (Lf) bound to Streptococcus agalactiae to interfere with the deposition of complement components on the bacterial surface was investigated by enzyme-linked immunosorbent assay (ELISA) . By using a strain of S . agalactiae which activates the alternative pathway of complement in the absence of antibodies, it was found that pretreatment of bacteria with Lf shortened the lag phase preceding the deposition of C3 on bacteria . The kinetics of C3 deposition was comparable to that obtained by adding antibodies against S . agalactiae to agammaglobulinaemic precolostral calf serum (PCS) heated at 56 degrees for 3 min to inactivate the alternative pathway . Accelerated C3 deposition did not occur in the absence of Ca2+ ions . Deposition of C4 on bacteria occurred only when either antibodies or Lf were added to PCS . These results demonstrate that the interaction of lactoferrin with bacteria activated the classical pathway of complement in the absence of antibodies . The binding of purified C1q to bacteria was promoted in a dose-dependent manner by Lf, suggesting that recruitment of classical pathway of complement resulted from the interaction of C1q with Lf adsorbed to the bacterial surface . Phagocytosis of bacteria opsonized with heated PCS (at 56 degrees for 3 min) and Lf was comparable to that occurring in the presence of heated PCS and antibodies . In conclusion, Lf was able to substitute for antibodies in order to activate the classical pathway of complement and to opsonize unencapsulated S . agalactiae efficiently.

FEMS Microbiol Lett, 1993 Aug 1, 111(2-3), 263 - 8
The glutamine cyclotransferase reaction of Streptococcus bovis: a novel mechanism of deriving energy from non-oxidative and non-reductive deamination; Cook GM et al.; Streptococcus bovis deaminated glutamine by a mechanism that did not involve glutaminase . Since pyroglutamate and ammonia were the only end-products, it appeared that glutamine deamination was catalyzed by a cyclotransferase reaction . Stationary S . bovis cells had essentially no intracellular ATP or membrane potential (delta psi), however, when they were provided with glutamine, intracellular ATP and delta psi increased to 0.52 mM and 158 mV, respectively . When glutamine-energized cells were treated with N,N-dicyclohexylcarbodiimide (DCCD, 150 microM), there was an even greater increase in intracellular ATP (> 5-fold) and the delta psi was dissipated . Because toluene-treated cells produced ATP from ADP and Pi, it did not appear that the cell membrane was directly involved in glutamine-dependent ATP generation . The rate of ammonia production was directly proportional to the glutamine concentration, but the stoichiometry of ATP to ammonia was always 1 to 1 . Based on these results, it appeared that glutamine was deaminated by glutamine cyclotransferase which was coupled to ATP formation . The membrane bound ATPase then used the ATP to create a delta psi.

Bone Marrow Transplant, 1993 Aug, 12(2), 165 - 6
Pneumococcal arthritis after allogeneic bone marrow transplantation; Schwella N et al.; We report a case of pneumococcal arthritis occurring in a 15-year-old boy following allogeneic BMT . The post-transplant course was complicated by GVHD requiring prolonged immunosuppressive therapy . He experienced recurrent infections, including pneumococcal pneumonia . Thirty-five months after BMT and 12 months after the pneumococcal pneumonia, pneumococcal arthritis of the left knee occurred . This is the first reported case of arthritis caused by Streptococcus pneumoniae after allogeneic BMT . Penicillin prophylaxis may be used to prevent recurrence of pneumococcal infections in patients with chronic GVHD.

Curr Opin Obstet Gynecol, 1993 Aug, 5(4), 508 - 12
Group B streptococcal infections during pregnancy; Yancey MK et al.; Group B streptococcus, acquired intrapartum from the female genital tract, is the leading cause of neonatal sepsis . Intrapartum maternal antibiotic prophylaxis administered to colonized parturients is efficacious in reducing neonatal colonization and morbidity . However, the optimal method of identifying mother-infant pairs at risk remains controversial . Universal antenatal screening has been effective in identifying colonized women for subsequent intrapartum therapy in research protocols . However, the cost-effectiveness and efficacy of this management scheme, in a general population, has not been determined . The predictive value of antenatal cultures for identifying intrapartum group B streptococcus colonization varies inversely with the interval between culture and delivery with generally low predictive values for cultures performed more than 10 weeks before delivery . Rapid intrapartum screening with various methods has been investigated in a number of studies, while several methods are sensitive in identifying heavily colonized women, they remain insensitive in detecting light colonization.

Clin Infect Dis, 1993 Aug, 17 Suppl 1, S202 - 7
Potential improvements in therapeutic options for mycoplasmal respiratory infections; Bebear C et al.; Macrolides and tetracyclines are the most active antibiotics against mycoplasmas in vitro . In particular, erythromycin has been widely used for the treatment of infections caused by Mycoplasma pneumoniae . However, improvements in therapy are needed to accommodate specific characteristics of the microorganism or unusual manifestations of the illness it causes . Because no rapid microbiological technique is available for the diagnosis of M . pneumoniae infections, empirical treatment must be effective against other relevant pathogens as well . Macrolides and fluoroquinolones have recently undergone substantial development . The newer macrolides have more favorable pharmacokinetic properties and are better tolerated than older agents of this class, while the newer fluoroquinolones exhibit a broadened spectrum of in vitro activity that in some instances includes M . pneumoniae and Streptococcus pneumoniae . Although the existing data on in vivo efficacy are only preliminary, the newer macrolides and fluoroquinolones are promising agents for the treatment of M . pneumoniae infection and, more generally, for that of community-acquired pneumonia.

J Vet Med Sci, 1993 Aug, 55(4), 623 - 6
The epidemiological studies of Streptococcus suis infections in Japan from 1987 to 1991; Kataoka Y et al.; The epidemiological studies of S . suis infections in Japan were carried out between 1987 to 1991 . A total of 380 S . suis strains isolated from pigs, cattle and a horse were serotyped by using antisera against S . suis types 1 to 22 . A total of 318 (83.7%) of S . suis isolates were serologically typable . Serotype 2 was the most prevalent with 28.2%, followed by type 7 (10.8%), 1/2 (8.4%), 3 (7.4%) and 4 (5.5%) . Of twenty S . suis strains isolated from cattle, eight were type 9, one was type 10, five were type 18, one was type 20 and five were untypable . One out of all the strains was also isolated from a racing horse with pneumonia . The majority of the isolates were originated from meningitis (38.2%), followed by from pneumonia (33.4%) and endocarditis (9.2%) . Of all of the S . suis isolates, 333 isolates (87.6%) were identified correctly by API STREP 20 system.

Enferm Infecc Microbiol Clin, 1993 Aug-Sep, 11(7), 378 - 81
{Infected atrial myxoma simulating infective endocarditis}; Llinares P et al.; BACKGROUND: We present a case of infected atrial myxoma simulating bacterial endocarditis . MATERIAL AND METHODS: A 75 year old male, without any antecedents of interest, with fever an evolution a month, and a cardiac murmur . Blood cultures were practiced by BACTEC N.R . 730 system . The diagnosis was performed by the bidimensional and transesophageal echo, and confirmed with the resection from surgery . The method of bibliographical review used, has been the data base of comprehensive Medline, cvc since 1987 up June 1992 and the Oncodise's Concerlit archive from the year 1985 up to june 1992 the date base of the IME (Indice Medico Espanol) was also review up to April 1992 . RESULTS: The blood cultures were positive, 7/7 Streptococcus viridans and 3/7 a Staphylococcus epidermidis resistant to meticiline, we them with the same antibiogram . Echocardiography and angiography show a lef atrial mass, surgical resection of the mass, confirmed the hystological diagnostic of the myxoma and signs of infection . CONCLUSIONS: This is the first case in our country, with shows the rarity of it . We analyze the differential diagnosis with the non infected myxoma and the bacterial endocarditis . We think that there should be an early surgical treatment, together with antibiotic therapy, due to the high incidence of embolism in theses patients.

Acta Paediatr, 1993 Aug, 82(8), 687 - 9
Neonatal bacterial septicemia in a tropical area . Four-year experience in Guadeloupe (French West Indies); Robillard PY et al.; During a four-year study (1987-1990) at the Neonatal Department, University Hospital Pointe-a-Pitre (French West Indies), blood culture was systematically performed on all admitted newborns . The incidence of septicemia was 48 of 1000 admissions and 8.9 of 1000 inborn live births . Among the 107 neonatal positive blood cultures, group B streptococcus accounted for 37% of blood culture isolates and was the most frequent cause of septicemia . The overall mortality rate was 8.4% . The incidence of neonatal bacterial septicemia was among the high rates reported in the literature . The incidence of neonatal bacterial septicemia is discussed as a public health problem in perinatology in Guadeloupe in spite of good medical care . A review of the literature on bacterial septicemia in tropical or developing countries compared to the Guadeloupean experience allows speculation that this problem might be underestimated in third world countries.

Gan To Kagaku Ryoho, 1993 Aug, 20(11), 1453 - 6
{Differences in antitumor effect of various BRMs by intratumoral administration: induction of immunosuppressive acidic protein}; Ebina T et al.; The antitumor effects of biological response modifiers (BRM) in a new experimental mouse model, the "double grafted tumor system", were analysed . BALB/c mice received simultaneous inoculations of Meth-A fibrosarcoma cells on right flank (10(6) cells) and left flank (2 x 10(5) cells) on day 0, and BRMs were injected intratumorally into right tumor on day 3, 4 and 5 . The growth of the left-flank tumor was the real target for the evaluation of a given drug after 21 days . PSK (a protein-bound polysaccharide preparation), IL-1 and Cepharanthin, cured not only the right, but also the left, non-treated tumor in a double grafted tumor system . OK-432 (a Streptococcus preparation) and BCG cured the right tumor and inhibited the growth of the left tumor . Lentinan (a polysaccharide preparation) inhibited neither the right nor the left tumor . Immunosuppressive acidic protein (IAP) in serum was increased transiently soon after intradermal injection of PSK, OK-432 and TNF in BALB/c mice . But Lentinan did not induce IAP . IAP in serum was gradually increased after intradermal inoculation of Meth-A tumor in BALB/c mice . At 21 days after tumor inoculation, IAP in serum reached a maximum level (300 micrograms/ml) . The serum IAP level of Meth-A-bearing mice as well as that of normal mice increased after the intratumoral injection of PSK . At 21 days after tumor inoculation, IAP in PSK-treated mice returned to normal level . The biochemical differences between PSK-induced IAP (early, inflammatory IAP) and Meth-A-induced IAP (late, tumor-induced IAP) was investigated by crossed immunoaffino electrophoresis (CIAE) . Inflammatory IAP was rich in biantennary sugar chain, and tumor-induced IAP was rich in tri-tetraantennary sugar chain.

J Clin Microbiol, 1993 Aug, 31(8), 2192 - 4
Use of polyvalent coagglutination reagents for serotyping of Streptococcus suis; Gottschalk M et al.; Polyvalent coagglutination reagents (PRs) have been evaluated for the serotyping of Streptococcus suis . Monovalent antisera produced against 28 S . suis reference strains have been grouped to obtain five different pools . A total of 249 field isolates previously identified and belonging to different serotypes were tested with PRs prepared by two different procedures: (i) monovalent coagglutination reagents were individually prepared and mixed in equal proportions, and (ii) antisera were mixed in equal proportions before the addition of the Staphylococcus aureus suspension . Only antisera tested by a tube agglutination test with 2-mercaptoethanol and presenting titers of 1:32 or higher were used . Results obtained with PRs prepared by both procedures were similar, and there was a very good correlation between the capsular type of the isolate and the reaction obtained with PRs . Thus, from a practical viewpoint, it is suggested that PRs be prepared by the first procedure . To isolates, were tested in parallel with both the PRs and the monovalent coagglutination reagents over a 1-year period . Ninety-nine percent of the typeable and all of the untypeable isolates were correctly identified . Serotyping with PRs is suggested to be a very useful and reliable screening procedure, particularly when a large number of S . suis isolates have to be serotyped . In addition, the choice of antisera to be included in a given pool is facultative and should be oriented to the needs of a region or a country.

J Clin Microbiol, 1993 Aug, 31(8), 2097 - 100
Typing of pneumococci by using 12 pooled antisera; Sorensen UB; A new simplified chessboard system for typing of Streptococcus pneumoniae is described . It is intended for typing or grouping of 90 to 95% of the pneumococcal strains most commonly isolated from blood or cerebrospinal fluid and is based on 12 pooled diagnostic antisera, each reacting with 7 to 11 single types, together covering the 23 different vaccine-related types as well as 25 other cross-reacting types . Worldwide surveillance of the type distribution is important in order to ensure an optimal formulation of pneumococcal polysaccharide vaccines and, in the future, of polysaccharide-protein conjugate vaccines . The simplified typing system described in this paper makes it easier to carry out surveillance in other than specialized reference laboratories . Finally, it takes advantage of the fact that some types cause disease more often in children--as opposed to adults--than do others.

Scand J Dent Res, 1993 Aug, 101(4), 229 - 31
Cytotoxic and antibacterial effects of orthodontic appliances; Grimsdottir MR et al.; The cytotoxic and antibacterial effects of orthodontic appliances were assessed . Metallic devices used in orthodontics, such as molar bands, brackets, and archwires were tested by the agar overlay cytotoxicity test with mouse fibroblast cells . The same devices were tested for antibacterial effect with Streptococcus mutans and S . sanguis . The multicomponent devices, which are bonded with silver- and copper-based brazing alloys, were more cytotoxic than the single-component devices, probably because copper is more cytotoxic than nickel . The devices had a definite, but low, antibacterial effect, as compared with the 0.05% chlorhexidine positive control . A cytotoxic effect of the devices per se might contribute to a localized gingivitis . It is uncertain whether orthodontic devices have any significant inhibitory effect on dental plaque viability.

Oral Surg Oral Med Oral Pathol, 1993 Aug, 76(2), 161 - 8
Changes in the oral microflora during cytotoxic chemotherapy in children being treated for acute leukemia; O'Sullivan EA et al.; Thirty-four children with diagnosed cases of acute leukemias and being treated with cytotoxic chemotherapy at St James' Hospital, Leeds, were followed for between 6 months and 1 year to determine the changes in their oral microflora . They were examined before treatment commenced and then at monthly intervals . Swabs were taken from the oral cavity to test for the presence or absence of bacteria and Candida . Saliva samples were also used to assess the levels of Streptococcus mutans in the mouth . Sensitivity tests were carried out to assess the effect of the cytotoxic agents on the oral flora . All children received prophylactic nystatin and chlorhexidine gluconate mouthrinses four times daily for the whole period of the study . There was significant difference (p < 0.0001) for counts of S . mutans at different treatment stages . Sensitivity tests showed that S . mutans was sensitive to the cytotoxic drug daunorubicin, and this drug was probably responsible for the fall in S . mutans counts . A significant difference was also found in the types of bacteria isolated between the study and reference groups, but there was no change in the composition of the flora in the study group during treatment . These bacteria were also found to mirror those cultured from routine blood samples in children with acute leukemia.

J Dent Res, 1993 Aug, 72(8), 1180 - 3
In vitro demineralization by strains of Actinomyces viscosus and Streptococcus sobrinus of sound and demineralized root surfaces; Firestone AR et al.; Root sections were inoculated with one of two strains of Actinomyces viscosus or a strain of Streptococcus sobrinus and then incubated for 9 days in Trypticase soy broth (TSB) containing 0.25% glucose or TSB supplemented with 0.25% sucrose (TSB+S) . Lesion progression was measured from microradiographs . One section from each group was examined with a transmission electron microscope . Lesion progression was associated with a fall in the pH of the medium . However, lesion progression was not correlated with the mean 48-hour pH of the medium . In both TSB and TSB + S, lesion progression with A . viscosus was significantly greater than in the S . sobrinus group . However, the mean 48-hour pH value in TSB + S was lower than that in the S . sobrinus group . Plaque formation in TSB was, subjectively, least in the S . sobrinus group . Examination of transmission electron micrographs revealed bacteria penetrating the surfaces of the sections and extending into the lesion in the A . viscosus groups but not in the S . sobrinus group . This in vitro bacterial plaque model of root caries may be suitable for investigations of the bacterial etiology of root-surface caries and the virulence factors associated with pathogenicity.

Vet Clin North Am Equine Pract, 1993 Aug, 9(2), 365 - 74
Strangles; Timoney JF; The etiology, epizootiology, pathogenesis, and clinical presentation of strangles are described . Streptococcus equi, the causative organism, is highly host-adapted to Equidae and shows no antigenic variation . Protective immunity apparently is mediated by a combination of serum opsonic and nasopharyngeal mucosal humoral responses . Vaccines based on M protein or inactivated bacterial suspensions may reduce the clinical attack rate by 50%, a level of protection much lower than that produced during recovery from strangles.

Bol Med Hosp Infant Mex, 1993 Aug, 50(8), 564 - 9
{Pharyngo-tonsillitis and necrosing submaxillary adenitis caused by Streptococcus pyogenes associated with toxic shock syndrome in children from Mexico City}; Maulen de Vazquez I et al.; We report on six previously healthy children between nine months and nine years old, who suffered streptococcal faringoamigdalitis and cervical adenitis with scarlet fever and toxic shock syndrome; four of them died in a fulminant course and two survived . These patients behave similarly to others reported from United States of America, England and Australia, and in similar way these clinical entity could be due to bacterial pyrogenic exotoxins according to the clinical fulminant course.

Eur J Biochem, 1993 Aug 1, 215(3), 851 - 7
Teichoic acid and lipoteichoic acid of Streptococcus pneumoniae possess identical chain structures . A reinvestigation of teichoid acid (C polysaccharide); Fischer W et al.; Teichoic acid (C polysaccharide) was extracted and purified from Streptococcus pneumoniae R6 with standard procedures except that lipoteichoic acid was extracted first . The dephosphorylated repeating unit was isolated after hydrolysis with 48% (by mass) HF, the bis(phosphocholine)-containing repeating unit was isolated by alkali hydrolysis, anion-exchange chromatography and phosphomonoester cleavage . On the basis of compositional analysis, fast-atom-bombardment mass spectrometry and NMR spectroscopy the following structure is proposed: {formula: see text} where AATGal is 2-acetamido-4-amino-2,4,6-trideoxy-D-galactose . The repeating units are linked to each other by phosphodiester bonds between O5 of the ribitol and O6 of the glucopyranosyl residue of adjacent units . This chain structure is identical with that previously established for pneumococcal lipoteichoic acid {Behr, T., Fischer, W., Peter-Katalinic, J . & Egge, H . (1992) Eur . J . Biochem . 207, 1063-1075} . This represents a unique situation because in other Gram-positive bacteria teichoic and lipoteichoic acids are structurally unrelated.

Ann Otol Rhinol Laryngol, 1993 Aug, 102(8 Pt 1), 639 - 45
Mucosal fine structure in experimental sinusitis; Westrin KM et al.; Rabbit maxillary sinuses were inoculated with Streptococcus pneumoniae and Bacteroides fragilis, and the histologic response in the sinus mucosa was observed over a 12-week period . An increased height of the cylindric cells and hyperplasia of the basal cells were frequent findings irrespective of the pathogen inoculated . The disease was found to influence the character of the secretory product from epithelial secretory cells and to degranulate the subepithelial glands . Ciliary loss was a transitional finding . A reduction in the number of mitochondria, the occurrence of deformed short microvilli, and cytoplasmic blebbing were seen in the cells devoid of normal cilia . It is inferred from this study that pneumococcal sinusitis in rabbits is a self-limiting process, and the mucosal sequelae of the acute infection are persisting goblet cells, slight focal fibrosis, and edema . Inoculation with B fragilis produces a chronic inflammatory process, with infiltration of mononuclear cells, luminal dilatation of the glands exhibiting zymogen granule depletion, and an increased thickness of the whole mucosal layer.

Kokyu To Junkan, 1993 Aug, 41(8), 797 - 800
{A case of infective endocarditis in which a new vegetation appeared on a different site during chemotherapy}; Inomata T et al.; 42-year-old man, who had been febrile for about a month, was admitted to our hospital . Laboratory testing showed leukocytosis and high titer of CRP . Streptococcus sanguis II was detected in his blood culture . According to the echocardiogram, he had a vegetation on the anterior mitral leaflet, so he was diagnosed as having infective endocarditis . Antibiotic susceptibility test using the disc method showed (3+) response to penicillin G . After intravenous administration of 20 million units of penicillin G for 3 weeks, a new vegetation appeared on the posterior mitral leaflet although the one on the anterior mitral leaflet had disappeared . Imipenem/cilastatin was administered until the acute phase reactants became negative . But the vegetation did not disappear, so he had vegetectomy . This is the first case report of infective endocarditis in which a new vegetation appeared on a different site despite the disappearance of the first lesion during chemotherapy.

Epidemiol Infect, 1993 Aug, 111(1), 27 - 39
Acquisition and invasiveness of different serotypes of Streptococcus pneumoniae in young children; Smith T et al.; Rates of acquisition and mean duration of nasal carriage of different serotypes of Streptococcus pneumoniae have been estimated by fitting a stochastic model to longitudinal carriage data in children from Papua New Guinea . Immunogenicity and two indices of relative invasiveness were determined for each serotype . Immunogenic serotypes were less frequently acquired and were carried for shorter periods, but no relationship between immunogenicity and invasiveness was apparent using either index of invasiveness . Frequent invasion was associated with a high acquisition rate and high frequency and prolonged duration of carriage . Carriage studies can provide a broad indication of which serotypes cause invasive disease but not the proportion of disease due to individual serotypes; some serotypes which cause invasive disease (e.g . serotype 46) are not found even in extensive carriage studies . The antibiotic resistance of carriage organisms, however, does approximate the resistance patterns of invasive organisms and thus may be used to monitor changing patterns of antimicrobial susceptibility in the community.

Arch Surg, 1993 Aug, 128(8), 842 - 6; discussion 846-8
Splenic abscess in the intensive care unit; Ho HS et al.; BACKGROUND AND METHODS: From 1980 through 1990, nine patients developed de novo splenic abscess during their stay in our intensive care unit (ICU), representing the first series of such reported cases . RESULTS: All nine patients were septic prior to the diagnosis of splenic abscess . The signs and symptoms of splenic abscess commonly described in the literature were of little help in detecting this pathology in ICU patients . Mean +/- SD platelet count, however, increased significantly, from 274 x 10(9)/L +/- 50 x 10(9)/L at admission to 647 x 10(9)/L +/- 94 x 10(9)/L at diagnosis . At diagnosis, left pleural effusion was present in all patients . Only three patients had detectable left upper quadrant tenderness . Abdominal computed tomographic scans, when used, were diagnostic in all cases . All patients were treated by splenectomy; eight had a solitary abscess . Six abscesses were caused by enteric organisms, two by Staphylococcus aureus, and one by Streptococcus epidermidis . Eight patients (89%) had had the offending organism previously isolated from their blood or from another infected site . Mortality was 45% . CONCLUSIONS: Splenic abscess, although a rare clinical entity, does occur de novo in ICU patients and is associated with significant mortality . Unexplained thrombocytosis in a septic ICU patient with persistent left pleural effusion is suggestive of splenic abscess . Previous culture and sensitivity results are useful in guiding perioperative antibiotic choices.

Crit Care Med, 1993 Aug, 21(8), 1207 - 12
Observations on the role of tumor necrosis factor-alpha in a murine model of shock due to Streptococcus pyogenes; Wayte J et al.; OBJECTIVE: To examine the effect of a monoclonal antibody to tumor necrosis factor-alpha (TNF-alpha) in a murine model of shock due to Streptococcus pyogenes . DESIGN: Prospective, multiexperimental, randomized, controlled trial . SETTING: University hospital research laboratory . INTERVENTIONS: An LD90 murine model of Gram-positive shock using S . pyogenes, associated with the presence of significant concentrations of TNF-alpha in the circulation . Prophylactic administration of antibody with concomitant saline controls . A 500-micrograms TN3-19.12 (hamster monoclonal antibody to recombinant murine TNF), or saline, by intravenous injection was administered . MEASUREMENTS AND MAIN RESULTS: Administration of 0.3 mL of 6 x 10(8) colony-forming units/mL of S . pyogenes H250 to mice resulted in 90% to 100% mortality rates in 72 hrs . Serum TNF-alpha concentrations peaked at 2 hrs after bacterial challenge and were 67.7 +/- 18.6 ng/mL . Treatment with anti-TNF-alpha monoclonal antibody abolished the serum TNF-alpha concentrations but did not affect the mortality rate . Serum endotoxin concentrations were < 50 pg/mL before challenge and at 0.5, 1, 2, 5, and 24 hrs after challenge . CONCLUSIONS: Pretreatment with an anti-TNF monoclonal antibody was not protective in this model of S . pyogenes sepsis, despite the presence of significant amounts of TNF in the circulation . These data suggest that TNF-alpha may not play such a crucial role in the pathogenesis of shock due to S . pyogenes.

Infect Immun, 1993 Aug, 61(8), 3369 - 74
Association of phenotypic and genotypic characteristics of invasive Streptococcus pyogenes isolates with clinical components of streptococcal toxic shock syndrome; Talkington DF et al.; Sixty-two invasive Streptococcus pyogenes strains, including 32 strains isolated from patients with streptococcal toxic shock syndrome (STSS), were analyzed for the following phenotypic and genotypic characteristics: M-protein type, serum opacity factor production, protease production, the presence of streptococcal pyrogenic exotoxin (Spe) genes A, B, and C, and in vitro production of SpeA and SpeB . These characteristics were analyzed for possible associations with each other as well as with clinical components of STSS . M-type 1, the most commonly isolated M-type, was significantly associated with protease production . Protease activity was significantly associated with the clinical sign of soft tissue necrosis . M-type 1 and 3 strains from STSS patients were significantly associated with the clinical signs of shock and organ involvement as well as with SpeA production in vitro . Finally, the production of SpeA was significantly associated with the clinical component of shock and organ involvement as well as with rash . These data suggest that STSS does not make up a single syndrome but, rather, that the multiple STSS clinical criteria probably reflect different phenotypic characteristics of individual S . pyogenes isolates.

Infect Immun, 1993 Aug, 61(8), 3318 - 26
Repeats in an extracellular protein of weakly pathogenic strains of Streptococcus suis type 2 are absent in pathogenic strains; Smith HE et al.; Streptococcus suis type 2 strains that are pathogenic for pigs produce a 110-kDa extracellular protein factor (EF) . Nonpathogenic and weakly pathogenic strains do not produce EF or produce a protein (EF*) that is immunologically related to EF . To study the pathogenesis of S . suis type 2 in pigs and to develop tools and methods for the control of S . suis type 2 infections, we cloned and characterized the genes encoding EF and various EF* proteins . Analysis of the deduced amino acid sequences showed that the first 833 amino acids at the N terminus of the EF and EF* proteins were nearly identical . The proteins differed, however, at their C termini . Unlike the 110-kDa EF protein, the EF* proteins contained several repeated units of 76 amino acids . The number and arrangement of the repeats in the EF* proteins varied . The data suggest that the gene encoding EF could have evolved from an epf* gene by a specific deletion event . The lack of repeated amino acid units in the EF protein may be related to virulence.

Infect Immun, 1993 Aug, 61(8), 3199 - 208
Inactivation of the gene encoding surface protein SspA in Streptococcus gordonii DL1 affects cell interactions with human salivary agglutinin and oral actinomyces; Jenkinson HF et al.; Cell surface protein SSP-5 in the oral bacterium Streptococcus gordonii M5 binds human salivary agglutinin in a Ca(2+)-dependent reaction (D.R . Demuth, E.E . Golub, and D . Malamud, J . Biol . Chem . 265:7120-7126, 1990) . The region of the gene encoding an N-terminal segment of a related polypeptide (SspA) in S . gordonii DL1 (Challis) was isolated following polymerase chain reaction amplification of genomic DNA . The sspA gene in S . gordonii DL1 was insertionally inactivated by homologous recombination of the erythromycin resistance (Emr) determinant ermAM onto the streptococcal chromosome . The SspA polypeptide (apparent molecular mass, 210 kDa) was detected on Western blots (immunoblots) of spheroplast extracts and extracellular culture medium proteins from wild-type strain DL1 but was absent from Emr mutants . One SspA- mutant (designated OB220) was not altered in rate or extent of aggregation by whole saliva or parotid saliva but showed reduced aggregation in the presence of purified salivary agglutinin . Mutant bacteria were unaffected in their ability to adhere to hydroxylapatite beads coated with whole or parotid saliva and were unaltered in cell surface hydrophobicity . However, the SspA- strain OB220 was deficient in binding salivary agglutinin and in binding to six strains of Actinomyces naeslundii . Therefore, expression of SspA polypeptide in S . gordonii is associated with both agglutinin-dependent and agglutinin-independent aggregation and adherence reactions of streptococcal cells.

Mol Cell Probes, 1993 Aug, 7(4), 255 - 9
Detection of streptococcal pyrogenic exotoxin genes by a nested polymerase chain reaction; Black CM et al.; Severe invasive disease associated with group A Streptococcus (GAS) has recently increased in frequency . Isolates of GAS from normally sterile sites were examined for the streptococcal pyrogenic exotoxin genes spe A, spe B and spe C to determine if they play a role in this disease . Four primers for each gene were used in a nested polymerase chain reaction (PCR) configuration . The first PCR generated fragments of 818, 1106, and 801 bp, respectively, for the extotoxin genes . The second PCR generated fragments of 500, 912 and 654 bp for the spe A, spe B and spe C genes using the fragments from the first PCR as template . Of 62 strains tested, 35 (56%) contained the spe A gene, and 17 (27%) contained the spe C gene . All GAS strains studied, regardless of disease association, contained the spe B gene . These data corroborate accumulating evidence that the genes encoding pyrogenic exotoxin types B and C are not associated with severe invasive streptococcal illness including streptococcal toxic shock-like syndrome . This PCR-based gene detection system has clinical and epidemiologic applications because of its ease of performance, non-isotope labelling, high specificity and sensitivity, and lack of requirement for purified DNA.

Zentralbl Bakteriol, 1993 Aug, 279(3), 394 - 403
Distribution of capsular types 1 to 28 and further characteristics of Streptococcus suis isolates from various European countries; Estoepangestie S et al.; Most of the 150 Streptococcus suis isolates from pigs and ruminants used in this study grew under aerobic conditions and were alpha-hemolytic on sheep blood agar . Part of the cultures required an increased CO2 concentration . These cultures, representing the CO2- dependent ecovar of S . suis, were mainly beta-hemolytic on sheep and horse blood agar and gave a synergistic hemolytic reaction with staphylococcal beta-lysin . Similar to S . suis reference cultures, the routine isolates showed typical biochemical properties of this species . Few cultures, mostly those from ruminants, could be classified as the sorbitol and mannitol-positive ecovar . Formamide extracts of 81% of the cultures reacted with group D-specific antisera . Serotyping of the S . suis isolates revealed mainly capsular types 2, 1/2, 1, 5, 11, 13, 23, 3 and 15 . The determination of antibiotic susceptibility revealed a high number of cultures to be resistant to clindamycin, erythromycin, kanamycin, neomycin, streptomycin and tetracycline . Cultural, biochemical and serological properties together with antibiotic resistance patterns could be used to characterize individual isolates of S . suis . This could be of importance in epidemiological studies.

Antimicrob Agents Chemother, 1993 Aug, 37(8), 1630 - 6
Evaluation of antimicrobial regimens for treatment of experimental penicillin- and cephalosporin-resistant pneumococcal meningitis; Friedland IR et al.; The most appropriate therapy for meningitis caused by Streptococcus pneumoniae strains resistant to the extended-spectrum cephalosporins is unknown . We evaluated ceftriaxone, vancomycin, and rifampin alone and in different combinations and meropenem, cefpirome, and clinafloxacin alone in the rabbit meningitis model . Meningitis was induced in rabbits by intracisternal inoculation of one of two pneumococcal strains isolated from infants with meningitis (ceftriaxone MICs, 4 and 1 microgram/ml, respectively) . Two doses, 5 h apart, of each antibiotic were given intravenously (except that ceftriaxone was given as one dose) . Cerebrospinal fluid bacterial concentrations were measured at 0, 5, 10, and 24 h after therapy was started . Clinafloxacin was the most active single agent against both strains . Against the more resistant strain, ceftriaxone or meropenem alone was ineffective . The combination of vancomycin and ceftriaxone was synergistic, suggesting that this combination might be effective for initial empiric therapy of pneumococcal meningitis until results of susceptibility studies are available.

Antimicrob Agents Chemother, 1993 Aug, 37(8), 1599 - 603
Effect of increased dosages of amoxicillin in treatment of experimental middle ear otitis due to penicillin-resistant Streptococcus pneumoniae; Barry B et al.; A gerbil model of acute middle ear otitis was used to evaluate the efficacy of increased dosages of amoxicillin in eradicating infection induced by penicillin-resistant Streptococcus pneumoniae . Three different strains were used: (i) a serotype 23 penicillin-susceptible strain; (ii) a serotype 23 penicillin-resistant strain (MIC of penicillin, 2 micrograms/ml); and (iii) a serotype 19 highly penicillin-resistant strain (MIC of penicillin, 4 to 8 micrograms/ml) . Animals were inoculated bilaterally with 10(7) CFU per ear by transbulla challenge and treated 2 to 4 h postinfection by amoxicillin administrated subcutaneously . The course of the disease was monitored bacteriologically on days 2, 4, and 8 postinfection . The three strains had a similar pathogenicity in untreated animals in terms of the duration of the disease, bacterial counts in middle ear (ME) fluid, and systemic complications . Infection due to the penicillin-susceptible strain was cured after two injections of 2.5 mg/kg of body weight . No bacteria were recovered at day 2 after two injections at 10 and 25 mg/kg with the penicillin-resistant and highly penicillin-resistant strains, respectively . Under these experimental conditions, increased does of amoxicillin consistent with MICs were able to clear ME infection . Pharmacokinetic parameters of amoxicillin in serum and ME fluid were within the clinical range at the doses used in the study.

Biochemistry, 1993 Jul 20, 32(28), 7278 - 85
A new kinetic mechanism for the concomitant hydrolysis and transfer reactions catalyzed by bacterial DD-peptidases; Jamin M et al.; In the presence of an adequate nucleophilic acceptor substrate (A) and ester and thiolester donor substrates (S), the Streptomyces R61 soluble DD-peptidase catalyzes both hydrolysis and acyl group transfer reactions . Simple bisubstrate models do not explain the variation of the transfer to hydrolysis ratios with the donor and acceptor concentrations . A new kinetic mechanism for the concomitant hydrolysis and transfer reactions is proposed which involves an acceptor and a second, nonproductive donor substrate binding site . In this model, the acceptor essentially binds to the acyl-enzyme, and the second donor molecule only binds to the ternary ES*A complex . Hydrolysis can then proceed from the quaternary ES*AS complex . The values of all of the parameters involved in the reaction of a thiolester substrate with D-alanine as the acceptor substrate were determined at 15 and 37 degrees C . The results obtained with a protein modified by site-directed mutagenesis, and with which the transpeptidation reaction appeared to be specifically impeded, are discussed on the basis of the new kinetic mechanism . The data obtained with the soluble form of the high molecular weight penicillin binding protein 2X from Streptococcus pneumoniae are also in agreement with this model.

Carbohydr Res, 1993 Jul 19, 245(2), 245 - 57
Convergent synthesis of an elusive hexasaccharide corresponding to the cell-wall polysaccharide of the beta-hemolytic Streptococcus group A; Marino-Albernas JR et al.; A convergent synthesis of a hexasaccharide corresponding to the cell-wall polysaccharide of the beta-hemolytic Streptococcus Group A is described . The strategy relies on the preparation of a key linear trisaccharide unit beta-D-GlcpNAc-(1-->3)-alpha-L-Rhap-(1-->2)-alpha-L-Rhap which has previously resisted our efforts . The trisaccharide functions both as a glycosyl acceptor and donor to give an elusive hexasaccharide . This fully functionalized unit can serve, in turn, as a glycosyl acceptor or donor for the synthesis of higher-order structures . Deprotection gives a hitherto unknown hexasaccharide for use as a hapten in immunochemical studies . The characterization of all compounds by high-resolution 1H and 13C NMR spectroscopy is also described.

J Am Vet Med Assoc, 1993 Jul 15, 203(2), 295 - 9
Effect of management practices on the Streptococcus suis carrier rate in nursery swine; Dee SA et al.; Management practices on swine farms were analyzed to determine factor(s) associated with high prevalence of pigs that were carriers of Streptococcus suis . Samples were obtained for bacteriologic culture via direct swabbing of palatine tonsils of healthy nursery pigs on 35 farms throughout the United States . Overall, 36.7% of the pigs were determined to be carriers . Isolates of S suis were serotyped, and antimicrobial susceptibility tests were performed by use of Kirby-Bauer techniques . Streptococcus suis types 1 and 2 were most commonly isolated . All isolates were susceptible to enrofloxacin, 97% of the isolates were susceptible to ceftiofur, and 94% were susceptible to ampicillin . However, only 80% of the isolates were susceptible to penicillin, and only 18% were susceptible to tetracycline . Environmental, managerial, nutritional, and health factors were measured on each farm . Excessive temperature fluctuation, high relative humidity, crowding, and an age spread of > 2 weeks between pigs in the same room were the 4 most commonly encountered problems on farms with higher-than-average percentages of carrier pigs . Continuous flow facilities were found on 50% of these farms, and various disease problems, vitamin E/selenium deficiency, inadequate vaccination programs (attributable to the presence of atypical serotypes), and penicillin-resistant strains were found on 6 to 28% of these farms . Overall, 83% (15/18) of farms with higher-than-average percentages of carrier pigs also had a history of clinical S suis disease.

Am J Ophthalmol, 1993 Jul 15, 116(1), 56 - 62
Pneumococcal endophthalmitis associated with nasolacrimal obstruction; Lopez PF et al.; Pneumococcal endophthalmitis can be a devastating postoperative infection after cataract extraction or penetrating keratoplasty . Streptococcus pneumoniae was isolated as the causative agent in three of the 124 patients (2%) who were treated for endophthalmitis at our institution between 1984 and 1990 . Two of the three patients lost light perception in the affected eye . All three patients had previously unrecognized or untreated chronic nasolacrimal obstruction of varying causes . We studied the role of pneumococcal lacrimal conjunctivitis in the pathogenesis of the postoperative pneumococcal endophthalmitis in these patients.

J Infect Dis, 1993 Jul, 168(1), 158 - 63
Evidence for the introduction of a multiresistant clone of serotype 6B Streptococcus pneumoniae from Spain to Iceland in the late 1980s; Soares S et al.; Almost all of the multiresistant pneumococci that appeared suddenly in clinical specimens in Iceland between 1989 and 1992 belonged to serogroup 6 . Fifty-seven of these isolates were analyzed for serotype, penicillin-binding protein pattern, multilocus enzyme genotype, and fragmentation pattern obtained by pulsed-field electrophoretic separation of restriction enzyme digests of chromosomal DNA . All isolates were of serotype 6B and had similar or identical patterns in each molecular test . The Icelandic isolates were indistinguishable from a subgroup of multiresistant serotype 6B pneumococci that has been present with high incidence in Spain during the past two decades . The data suggest the import to Iceland of a single multiresistant clone of pneumococcus, most likely from Spain.

Infect Immun, 1993 Jul, 61(7), 2899 - 905
Antigenicity and immunogenicity of a synthetic peptide derived from a glucan-binding domain of mutans streptococcal glucosyltransferase; Smith DJ et al.; The immunogenicity and antigenicity of a multiply antigenic peptide construct containing four copies of the synthetic peptide TGAQTIKGQKLYFKANGQQVKG were measured in rodents and humans, respectively . The composition of this peptide construct (termed GLU) was derived from a major repeating sequence in the C-terminal region of mutans streptococcal glucosyltransferases that synthesize water-insoluble glucan (GTF-I) . The GLU peptide elicited high levels of serum immunoglobulin G antibody to GLU after subcutaneous injection into Sprague-Dawley rats . These antisera also reacted with intact GTF isozymes from Streptococcus sobrinus and Streptococcus mutans (by enzyme-linked immunosorbent assay {ELISA} and Western blot {immunoblot} analyses) and with an 87-kDa glucan-binding protein from S . sobrinus (by Western blot) . The synthesis of filter-retained glucan by GTF-Sd of S . sobrinus could be inhibited (30%) by preincubation with anti-GLU rat serum . Splenic and lymph node lymphocytes from rats injected once with S . sobrinus GTF isozymes demonstrated significant proliferation after 5 days of culture with GLU . The GLU peptide reacted with 4 of 29 human parotid saliva samples and 5 of 29 human serum samples (by ELISA) . These results suggest that the GLU peptide contains B- and T-cell epitopes that are similar to those of intact mutans streptococcal GTFs and possibly certain other glucan-binding proteins as well . Furthermore, since antibody to this epitope(s) appears to inhibit GTF function, sequences within this peptide construct may have value for inclusion in a synthetic dental caries vaccine.

J Clin Gastroenterol, 1993 Jul, 17(1), 25 - 8
Streptococcus bovis does not selectively colonize colorectal cancer and polyps; Norfleet RG et al.; The objective was to determine if Streptococcus bovis selectively colonizes colorectal cancer and polyps . Stools were submitted before colonoscopy; fluid and selected tissue biopsies obtained during colonoscopy were cultured for S . bovis . The setting was a large multispecialty clinic . Outpatients undergoing colonoscopy for suspected colorectal cancer and polyps were the participants . Forty studies on 35 patients were performed . One of 35 stools (2.9%) obtained before colonoscopy yielded S . bovis . S . bovis was cultured from three of 40 fluid aspirations (7.5%), one of 33 adenomas biopsied (3%), none of six adenocarcinomas, none of 14 nonneoplastic polyps, one of 40 (2.5%) biopsies from normal mucosa adjacent to an adenoma, and none of 40 mucosal biopsies remote from any lesion . These data do not support selective colonization of colorectal neoplasms by S . bovis.

Graefes Arch Clin Exp Ophthalmol, 1993 Jul, 231(7), 402 - 4
Proton magnetic resonance spectroscopy of vitreal changes in experimental streptococcal endophthalmitis; Cheng HM et al.; We used magnetic resonance spectroscopy to examine endophthalmitis in rabbits inoculated with a virulent strain of Streptococcus pneumoniae . On different days after infection, the animals were sacrificed and the vitreous isolated and examined with water-suppressed proton magnetic resonance spectroscopy . A broad resonance corresponding to the methyl envelope of lipoprotein lipids appeared 2 days after infection and persisted until the eyes developed phthisis (around 10 days postinfection) . This resonance was absent in the control eye and the bacterial culture; it could be used as the marker of breakdown of blood-vitreous barrier and onset of endophthalmitis-induced changes.

Int J Food Microbiol, 1993 Jul, 19(2), 123 - 34
Characterization of bacteriocins from Enterococcus faecium with activity against Listeria monocytogenes; Arihara K et al.; Laboratory cultures and environmental isolates of bacteria were screened for antagonism towards Listeria monocytogenes using an agar spot test . Seven of the 163 strains that were tested, one Streptococcus bovis, one Enterococcus casseliflavus, two E . avium and three E . faecium, consistently displayed antilisterial activity . Cell-free, pH-neutralized supernatants prepared from the three E . faecium strains (JBL1061, JBL1083 and JBL1351) exhibited strong antilisterial activity against L . monocytogenes, and were subjected to more detailed analyses . The antagonistic factors produced by these three strains were sensitive to chloroform and several proteolytic enzymes, resistant to heat (121 degrees C, 20 min), and stable over a wide pH range (3.0-10.0) . Moreover, they were listericidal without causing cell lysis . These data suggest that a bacteriocin(s) is involved in the inhibition of L . monocytogenes by E . faecium JBL1061, JBL1083 and JBL1351.

J Med Microbiol, 1993 Jul, 39(1), 53 - 7
Adherence of glucan-positive and glucan-negative strains of Streptococcus bovis to human epithelial cells; Von Hunolstein C et al.; Adherence to buccal epithelial cells (BEC) and the role played in the binding by lipoteichoic acid (LTA) and other superficial components have been studied in reference and clinical strains of Streptococcus bovis either glucan-positive biotype I or glucan-negative biotype II . To avoid the synthesis of glucan by biotype I strains, adherence was studied in bacteria grown in Todd-Hewitt broth, a sucrose deficient medium . Both biotypes were shown to bind to BEC and clinical isolates, irrespective of biotype attached to the same degree but in greater numbers than reference strains . Inhibition studies suggest that at least two mechanisms,--LTA and protein-mediated--are responsible for the adherence of both glucan-positive and negative strains of S . bovis . Moreover, in glucan-positive strains capsular polysaccharides may be also involved.

Electrophoresis, 1993 Jul, 14(7), 613 - 8
Dissociation and electrophoretic separation of dextranase and dextranase inhibitor from a tightly bound enzyme-inhibitor complex of Streptococcus sobrinus; Wellington JE et al.; Endodextranase was separated from dextranase inhibitor in culture filtrates of Streptococcus sobrinus by sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE) in gel slabs containing blue dextran . Sample preparation included dissociation of the enzyme from its inhibitor by boiling for 1 min in SDS . During subsequent incubation of the gel, dextranase was located as clear bands on a blue background, and dextranase inhibitor appeared as blue zones on a clear background following incubation in dextranase solution . The enzyme and the inhibitor existed in multiple forms, and the range of molecular masses for dextranase (223-132 kDa) permitted an excellent separation from dextranase inhibitor (49-25 kDa) . Although dextranase-negative mutants, and wild type strains grown at low dilution rate in the chemostat, were devoid of free dextranase activity, the enzyme was easily located by analytical SDS-PAGE . Likewise, analysis of filtrates from wild type strains, which contained no free inhibitor activity when growth occurred at high dilution rate, revealed dextranase inhibitor activity on the gels . The total production (free + combined) of dextranase and inhibitor by S . sobrinus was determined by dissociation of enzyme-inhibitor complexes in concentrated cell-free filtrates, their separation by preparative SDS-PAGE and electroelution from the gels, followed by renaturation of protein activity . From a comparison of activity tests of free dextranase and free inhibitor in untreated filtrates with the results of similar tests on renatured electroeluates, the proportion of each constituent bound into a complex under each growth condition could be deduced.

J Vet Diagn Invest, 1993 Jul, 5(3), 363 - 7
Streptococcus suis infection in swine: a retrospective study of 256 cases . Part I . Epidemiologic factors and antibiotic susceptibility patterns; Reams RY et al.; A retrospective study of 256 cases of naturally acquired Streptococcus suis infections in swine submitted to the Indiana Animal Disease Diagnostic Laboratory from 1985 to 1989 was performed to determine the epidemiologic factors and antibiotic susceptibility patterns associated with S . suis serotypes 1-8 and 1/2 . A standardized computer form was used to record the history, signalment, and clinical signs obtained from the records of selected cases and the microscopic lesions identified after review of the histopathology slides for each case . A computer statistics package (SAS) was used to evaluate the data . Although the number of recovered S . suis isolates increased in the fall and winter months, most serotypes were readily isolated throughout the year; only serotypes 1, 4, 7, and 1/2 increased in frequency of isolation in the fall, winter, and spring months . The majority (61.1%) of infected pigs in this study were < 12 weeks of age . More than 75% of pigs infected with serotypes 1, 6, 7, and 1/2 were < 12 weeks of age . There was extensive overlap in the age distributions for pigs with each serotype, and statistically significant differences for most serotypes were not observed . Fifty percent of pigs infected with S . suis serotypes 1 and 1/2 were 3-10 weeks of age, 50% of pigs infected with serotype 2 were 6-14 weeks of age, and 50% of pigs infected with serotypes 3, 4, 5, 7, and 8 were 2-16 weeks of age . Isolates of S . suis were not uniformly susceptible to penicillin, and a large percentage of isolates were resistant to many antibiotics in common usage.(ABSTRACT TRUNCATED AT 250 WORDS)

Arch Oral Biol, 1993 Jul, 38(7), 627 - 9
Fermentation of carbohydrates in different flours by Streptococcus mutans; Matee MI et al.; The ability of Streptococcus mutans to ferment carbohydrates and to produce acid was investigated in different flours in vitro . The amounts of acid produced suggest a possible ecological role of the tested flours in the occurrence of Strep . mutans in dental plaque.

Antimicrob Agents Chemother, 1993 Jul, 37(7), 1518 - 24
Passage of cefotaxime and ceftriaxone into cerebrospinal fluid of patients with uninflamed meninges; Nau R et al.; Cefotaxime and ceftriaxone have proven to be effective in pyogenic infections of the central nervous system . Since in some bacterial central nervous system infections the blood-cerebrospinal fluid (CSF) barrier is either minimally impaired or recovers in the course of the illness, we studied the penetration of both antibiotics in the absence of inflamed meninges . Patients who had undergone external ventriculostomies for noninflammatory occlusive hydrocephalus received either cefotaxime (2 g/30 min) or ceftriaxone (2 g/30 min) to treat extracerebral infections . Serum and CSF were drawn repeatedly after the first dose . With ceftriaxone, they were also drawn after the last dose . The concentrations of cefotaxime, its metabolite desacetylcefotaxime, and ceftriaxone were determined by high-performance liquid chromatography with UV detection . Maximum concentrations of cefotaxime in CSF were reached 0.5 to 8 h (median = 3 h; n = 6) after the end of the infusion and ranged from 0.14 to 1.81 mg/liter (median = 0.44 mg/liter; n = 6) . Maximum levels of ceftriaxone in CSF ranging from 0.18 to 1.04 mg/liter (median = 0.43 mg/liter; n = 5) were seen 1 to 16 h (median = 12 h; n = 5) after the infusion . The elimination half-life of cefotaxime in CSF was 5.0 to 26.9 h (median = 9.3 h; n = 5), and that of ceftriaxone was 15.7 to 18.4 h (median = 16.8 h; n = 3) . It is concluded that after a single dose of 2 g, maximal concentrations of cefotaxime and ceftriaxone in CSF do not differ substantially . The long elimination half-lives guarantee uniform concentrations in CSF . These concentrations reliably inhibit highly susceptible bacteria but cannot be relied on to inhibit staphylococci and penicillin G-resistant Streptococcus pneumoniae.

Kansenshogaku Zasshi, 1993 Jul, 67(7), 680 - 5
{A case of brain abscess due to Streptococcus sanguis in association with multiple pulmonary arteriovenous fistulas}; Nakamura A et al.; A case is reported here of brain abscess due to Streptococcus sanguis in association with multiple pulmonary arteriovenous fistulas . A 19-year-old male who had been diagnosed in 1988 as pulmonary arteriovenous fistulas was admitted to our hospital for repeated epistaxis, headache, and vomiting . A brain abscess which was diagnosed using various roentogenologic examinations, worsened despite conservative therapy . Additional surgical drainage was performed; S . sanguis was isolated from the drainage fluid . After drainage, clinical symptoms gradually improved with no subsequent neurological deficits . We have formulated the following hypothesis regarding the mechanism of abscess formation in this case: S . sanguis invaded from a ruptured nasomucosal vein, forming a septic emboli in the blood flow, which passed through a pulmonary arteriovenous shunt and led to the formation of a brain abscess which established a metastatic presence in the cerebral tissue.

Diagn Microbiol Infect Dis, 1993 Jul, 17(1), 19 - 22
Clinical assessment of anaerobic isolates from blood cultures; Sharp SE et al.; Patients at two tertiary-care medical centers were evaluated to determine the clinical significance of anaerobic isolates from their blood specimens and to identify whether aerobic and/or anaerobic conditions were necessary for the detection of Streptococcus pneumoniae isolates . Significant anaerobes were isolated from only 0.1% and 0.4% of all blood cultures collected . The majority of patients with significant anaerobes had clinical conditions in which anaerobes are known to cause infections . Of the S . pneumoniae organisms, 83% were isolated only from the aerobic bottles of a blood culture set . These data lend support to the recommendations for the selective ordering of anaerobic blood cultures without compromising the isolation of S . pneumoniae.

Appl Environ Microbiol, 1993 Jul, 59(7), 2014 - 21
Isolation and characterization of the lantibiotic salivaricin A and its structural gene salA from Streptococcus salivarius 20P3; Ross KF et al.; A bacteriocin-like inhibitory substance, salivaricin A, was purified from cultures of Streptococcus salivarius 20P3 and was shown by ion spray mass spectrometry to have a molecular mass of 2,315 +/- 1.1 Da . Amino acid composition analysis demonstrated the presence of lanthionine, indicating that salivaricin A may be a member of the lantibiotic class of antibiotic substances . The sequence of eight amino acids at the N terminus of the molecule was determined by Edman degradation, and mixed oligonucleotide probes based on part of this sequence (GSGWIA) were used to detect the salivaricin A structural gene . A 6.2-kb EcoRI fragment of chromosomal DNA from strain 20P3 that hybridized with the probes was cloned, and the hybridizing region was further localized to a 379-bp DraI-AluI fragment . Analysis of the nucleotide sequence of this fragment indicated that salivaricin A is synthesized as a 51-amino-acid prepeptide that is posttranslationally modified and cleaved to give a biologically active 22-residue peptide containing one lanthionine and two beta-methyllanthionine residues . The secondary structure of presalivaricin A was predicted to be similar to that of type A lantibiotics, with a hydrophilic alpha-helical leader sequence and a propeptide region with potential for beta-turn formation and a lack of alpha-helicity . The sequence around the cleavage site of presalivaricin A differed from that of other type A lantibiotics but was similar to that of several bacteriocin-like inhibitory substances produced by lactic acid bacteria.

Eur J Pediatr, 1993 Jul, 152(7), 577 - 80
Acute osteomyelitis and septic arthritis in the neonate, risk factors and outcome; Frederiksen B et al.; Twenty-two neonates with acute osteomyelitis (AO) or septic arthritis (SA) were included in a study based on a review of medical reports and a long-term clinical and radiological follow up . Clinical symptoms, bacteriology, risk factors, and outcome are discussed . The diagnoses were difficult, the clinical symptoms vague, fever rare and white cell count normal . Detection by plain radiological films was more efficient than by radionuclide bone scan . Staphylococcus aureus was the predominant causative organism and a shift towards group B Streptococcus in recent years was not identified . Risk factors for AO and SA were prematurity (13/22), respiratory distress syndrome (15/22) and perhaps most important: umbilical artery catheterisation (15/22) . Severe sequelae were found in only 1 patient, while 3 patients had slight asymptomatic changes . The relatively favourable long-term outcome is unexplained, but may be related to early and appropriate, long lasting antibiotic treatment.

Neurosurg Clin N Am, 1993 Jul, 4(3), 543 - 51
Infectious lesions of the brain stem; Hall WA; Infectious lesions of the brain stem are rare and include primarily abscess and encephalitis . The most common etiologic agents for abscess formation are Streptococcus sp., Staphylococcus sp., and M . tuberculosis . Encephalitis is associated most often with L . monocytogenes and herpes simplex virus infection . Classical brain stem syndromes are uncommon with brain stem infections, and CSF obstruction can be seen with neurocysticercosis . The diagnosis of these lesions has been greatly aided by CT and MR imaging . Microsurgery and stereotaxis are both appropriate techniques for the treatment of brain stem abscess that establish a diagnosis, identify the causative agent, and relieve mass effect on important neural structures . Symptoms of hydrocephalus should be treated with temporary or permanent CSF diversion . Viral involvement of the brain stem is usually self-limited, and improved antimicrobial therapy has contributed to a decrease in the morbidity and mortality of bacterial and parasitic infections . Although once believed to be uniformly fatal, infections of the brain stem have now been successfully treated for more than a decade.

Clin Infect Dis, 1993 Jul, 17(1), 79 - 81
Intrapartum transmission of group A streptococcus; Panaro NR et al.; Intrapartum transmission of group A streptococcus has not been well documented . As the incidence of severe infections due to this organism has recently increased, it is important to assess if such transmission occurs . We observed two cases of severe neonatal infections due to group A streptococcus, one of which was fatal, that appeared to have been transmitted from the mother during birth . Perinatal prophylaxis, which has been recommended for infections due to group B streptococcus, should be evaluated for infections due to group A streptococcus.

Clin Infect Dis, 1993 Jul, 17(1), 66 - 73
Antibody to capsular polysaccharides of Streptococcus pneumoniae: prevalence, persistence, and response to revaccination; Musher DM et al.; The prevalence of immunity to Streptococcus pneumoniae in the adult population of the United States is unknown . In the study described herein, military recruits had anticapsular IgG antibody to only 15% of common pneumococcal serotypes, whereas working men and elderly men had IgG antibody to 33% and 34% of the common serotypes, respectively (P < .001) . Among eight elderly subjects, the prevalence of IgG antibody to capsular polysaccharides increased from 30% to 78% after pneumococcal vaccination; 6 years thereafter, the rate of positive reactions had declined to 58% and IgG levels had declined substantially . With revaccination, IgG levels returned to within (+/-) 40% of the original postvaccination levels . IgM and IgG antibody appeared or began to increase in titer 6 days after vaccination; the rate and degree of response were the same after the first and second exposures . Since most individuals rapidly develop IgG antibody after colonization by S . pneumoniae and since IgG confers immunity, these data suggest that pneumonia is infrequent among healthy adults not because preexisting immunity is widespread but because--with colonization--an immune response develops rapidly, preceding specific events that might lead to infection . Our findings support recommended vaccination procedures and suggest that wider application in subsets of healthy younger adults should be considered.

Oral Surg Oral Med Oral Pathol, 1993 Jul, 76(1), 97 - 103
In vitro study of the penetration of three bacterial strains into root dentine; Perez F et al.; The purpose of this study was to assess in vitro migration of the following three bacterial species into dentinal tubules: Streptococcus sanguis, Actinomyces naeslundii and Prevotella intermedia . Twenty-seven bovine incisors were randomly divided into three groups . Only the root dentin was used for the experiment . Within each group, the nine incisors were sectioned into 36 dentin blocks that were incubated with one of the tested bacterial suspensions . Twelve samples were taken after 10, 20, and 28 days . Half the samples were observed with scanning electron microscopy and the others with light microscopy after standard histologic procedures, and the depth of bacterial penetration was measured . Analysis of the examinations showed that whatever the technique used, only one strain on this experimental model migrated into dentinal tubules . S . sanguis was observed at a depth of 792 microns, but no migration was observed for either A.naeslundii or P.intermedia . The differences in migration of the bacteria tested appear to be related to their morphologic factors and cellular arrangement.

Oral Surg Oral Med Oral Pathol, 1993 Jul, 76(1), 112 - 9
Microbiologic contamination during dental radiographic film processing; Stanczyk DA et al.; This study investigated microbiologic contamination of an automatic dental radiograph processor and daylight loader during a week of simulated clinical use . Pure cultures of Candida albicans, Streptococcus pneumoniae, Staphylococcus aureus, or Klebsiella pneumoniae were used to contaminate 320 vinyl intraoral radiograph packets . Each end of the films was deliberately contaminated during opening . These films and 24 uncontaminated control films were processed . Daylight loader ports, inlet and outlet rollers, fixer and developer samples, and 12 processed films were cultured daily . To simulate a weekend, the processor sites were cultured during 72 hours of inactivity after the contaminated runs . The results showed that contamination of the processor and daylight loader occurred and remained even after 48 hours of inactivity . Films remained contaminated after processing . In addition, cross-contamination of films occurred in the processor.

Mil Med, 1993 Jul, 158(7), 433 - 7
A longitudinal study of infections and injuries of Ranger students; Martinez-Lopez LE et al.; Causes of medical attrition and their implications for medical support for the U.S . Army Ranger course are considered, based on data collected from 190 students in a summer class . In the second half of the course, an increase in documented infection rates, notably cellulitis of the lower extremities and Streptococcus carriage prevalence, coincided with indications of compromised immune function . The authors suggest that aggressive treatment in the field, including liberal use of antibiotics, and periodic examination of each student by medical personnel are critical factors which will minimize medical attrition and ensure safe participation of soldiers in this and other stressful and sustained field exercises.

J Clin Microbiol, 1993 Jul, 31(7), 1896 - 8
Recovery of Borrelia burgdorferi by filtration; Jobe DA et al.; Bacterial contamination frequently interferes with successful recovery of the Lyme spirochete from cultures of tissue from Borrelia burgdorferi-infected humans, rodents, or ticks . We used 0.20- and 0.45-microns-pore-size syringe-tip filters to recover spirochetes from cultures contaminated with other bacteria . Low concentrations (1 to 10/ml) of B . burgdorferi organisms could be recovered from cultures seeded with 1 x 10(8) to 4 x 10(8) Staphylococcus aureus, Streptococcus faecium, Escherichia coli, or Bacillus subtilis organisms per ml . We also used this technique to recover B . burgdorferi from contaminated environmental and clinical cultures of B . burgdorferi . We conclude the filtration is an efficient method for recovering Lyme spirochetes from contaminated samples and increasing the number of successful isolations of B . burgdorferi.

Pediatr Infect Dis J, 1993 Jul, 12(7), 565 - 70
Outbreak of early onset group B streptococcal sepsis; Adams WG et al.; During January and August, 1990, 23 cases of early onset Group B Streptococcus (GBS) disease occurred in a Kansas City, MO, hospital with an attack rate of 14/1000 live births, compared with an annual rate of 1.2 cases/1000 live births for 1988 through 1989 . Case infants were compared with controls matched by birth weight, race, maternal age and day of delivery and to a second group of infants of mothers colonized with GBS to identify risk factors and consider intervention strategies during the outbreak . The presence of multiple serotypes among the invasive strains suggested that the outbreak was not caused by a common source . Case mothers were more likely than control mothers to have chorioamnionitis, intrapartum fever or rupture of membranes > 12 hours, and premature case infants were more likely to have a history of rupture of membranes before onset of labor . Multiparous mothers of case infants were more likely to have a history of spontaneous abortion (odds ratio, 6.7; 95% confidence interval, 1.0 to 45.9) . No single factor could explain the increase in GBS disease . If intrapartum antibiotic prophylaxis had been used for selected GBS carriers based on presence of either rupture of membranes > 12 hours, intrapartum maternal fever or preterm labor, 7.4% of all deliveries would have received antibiotics and 73% of cases could potentially have been prevented . We conclude that identification of colonized mothers with perinatal risk factors and use of intrapartum antibiotics could be expected to prevent substantial disease during an outbreak of early onset GBS disease.

J Dairy Sci, 1993 Jul, 76(7), 2033 - 8
Evaluation of 57 teat sanitizers using excised cow teats; Murdough PA et al.; Fifty-seven teat dip formulations were tested for germicidal activity with an excised teat assay . Streptococcus agalactiae (ATCC 27956), Staphylococcus aureus (ATCC 29740), and Escherichia coli+ (a wild strain isolated from an Ohio cow 2956RR during the dry period) were used . Log reductions ranged from 5.6480 to 1.8330 for Strep . agalactiae compared with undipped controls . Staphylococcus aureus were reduced from 4.8972 to 1.0102 . Escherichia coli were reduced from 5.8677 to 1.1450 . The percentages of the products tested that had log reductions < 3 against Strep . agalactiae, Staph . aureus, and E . coli were 24, 30, and 61 . Four teat dip formulations contained 4% sodium hypochlorite; all were effective against Strep . agalactiae, Staph . aureus, and E . coli . The three formulations containing glutaraldehyde were effective against the three mastitis pathogens . Formulations containing 1 and .5% iodine were not consistently effective against Strep . agalactiae, Staph . aureus, or E . coli . Teat sanitizers containing .5% chlorhexidine also showed inconsistency . Variations in formulation for products containing iodine or chlorhexidine affected germicidal activity.

Cornea, 1993 Jul, 12(4), 324 - 9
Betadine decontamination of donor globes; Mindrup EA et al.; Between May 1983 and December 1989, 2,921 donor eyes received by the Minnesota Lions Eye Bank underwent a decontamination protocol using 10% Betadine (1% povidone-iodine) solution . Positive pretreatment limbal cultures were obtained on 52.1% of donor eyes . Posttreatment limbal cultures demonstrated a 76.1% reduction in microbial growth, including an 85.7% reduction in Candida species . Streptococcus species were reduced by 76.7% and coagulase-negative Staphylococcus were reduced by 76.1% . In addition, of 250 donor rims obtained at the time of surgery, two had coagulase-negative . Staphylococcus present that were also present after the decontamination procedure . In no cases did endophthalmitis occur during this study . This study demonstrates that this protocol using 10% Betadine solution is extremely effective in decontaminating donor globes of aerobic bacteria and fungi . However, gentamicin-resistant organisms survived this protocol, emphasizing the need to develop storage media containing a broader-spectrum antibiotic agent then gentamicin.

Arch Ophthalmol, 1993 Jul, 111(7), 947 - 51
Severe corneoscleral infection . A complication of beta irradiation scleral necrosis following pterygium excision; Moriarty AP et al.; OBJECTIVE: To assess the precipitating factors, clinical course, and treatment of 11 cases of severe intraocular infections of radionecrosis after pterygium excision in an attempt to minimize the devastating ocular sequelae . DESIGN AND SETTING: From the database of cases of radionecrosis at Royal Perth (Australia) Hospital and Lions Eye Institute, Perth, we identified 11 cases of severe intraocular infection complicating radionecrosis . We reviewed the case notes and the available radiotherapy records (n = 8) . PATIENTS: Eleven patients admitted during an 8-year period . RESULTS: Mean (+/- SD) dose of radiotherapy was 22.7 +/- 1.0 Gy and mean latency period, 14.45 +/- 2.5 years . Among the six proven bacterial cases, Pseudomonas was identified in four, Staphylococcus aureus in one, and Streptococcus pneumoniae was involved in one bilateral case . Among the four fungal cases, Petriellidium boydii was indicated in two, and Fusarium and Scedosporium inflatum in one each . The condition may remain undiagnosed for some time and mimic a posterior scleritis, serous retinal detachment, or pseudotumor . INTERVENTIONS: Early debridement and culture; close microbiological assistance; and systemic antimicrobials for a prolonged period . Perforation or incipient perforation necessitated penetrating keratoplasties in seven patients and repeated keratoplasties in three . MAIN OUTCOME MEASURES: The use of radiotherapy following pterygium excision should be limited and only low doses used . Ulcer beds and calcific plaques at sites of radionecrosis should not be directly covered without first performing adequate sterilization . Removal of plaques may precipitate sepsis; ulcer beds and plaques harbor infective agents . CONCLUSION: Severe radionecrosis may expose a patient to a lifelong risk of intraocular sepsis and profound visual morbidity . Conjunctival autografting is a safer method to reduce recurrence rate after pterygium excision.

Chemotherapy, 1993 Jul-Aug, 39(4), 265 - 71
Post-antibiotic effects of ofloxacin on Escherichia coli, Klebsiella pneumoniae, Staphylococcus aureus, and Streptococcus pyogenes; Howard BM et al.; A viable counting technique was used to determine the post-antibiotic effect (PAE) of ofloxacin against four bacterial species, treated with either once of four times the minimum inhibitory concentration for 1 or 3 h . Similar to the results obtained previously with ciprofloxacin, ofloxacin gave PAE values with Escherichia coli, Staphylococcus aureus, and Streptococcus pyogenes . Cell division of Klebsiella pneumoniae was inhibited on removal of ofloxacin, but no clear PAE was demonstrated with this species because once replication recommenced, the mean generation times of drug-treated cultures were much shorter than those of untreated controls . Therefore, although the results obtained with ciprofloxacin and ofloxacin imply a consistency of PAE for 4-quinolones within a species, the response to DNA damage induced by 4-quinolones is multifaceted and species dependent . 4-quinolones inhibit both DNA replication and cell division, whilst at the same time stimulating DNA repair pathways . Thus, in some cases PAEs result from an increased post-treatment lag phase which may be followed by nearly normal multiplication, whereas in other cases a long lag may be followed by abnormally rapid cell division, with the generation times of treated cultures being shorter than those of corresponding drug-free controls . The PAE of a drug-induced lag may thus be masked by rapid cell division once growth resumes.

Am Rev Respir Dis, 1993 Jul, 148(1), 152 - 7
Capsular type-specific polysaccharide partially inhibits group B Streptococcus-induced pulmonary hypertension; Li JX et al.; Capsular type-specific polysaccharide is thought to be an important pathogenetic factor in Group B streptococcus (GBS) sepsis . To determine the effects of capsular type-specific polysaccharide on GBS-induced hemodynamic responses, anesthetized infant piglets were infused for 3 h with three related GBS Type lb strains that express different amounts of capsular type-specific polysaccharide . A larger capsule strain and a smaller capsule strain were isolated from an infected infant and its mother, respectively . A capsule-deficient mutant was then made from the larger capsule strain by transposon insertion mutagenesis . The smaller capsule strain and capsule-deficient mutant caused similar elevations in mean pulmonary artery pressure and pulmonary vascular resistance index and reductions in cardiac index . The larger capsule strain caused moderate pulmonary hypertension, but this response was smaller than for the other two GBS strains . Further comparisons in responses between the large capsule strain and its capsule-deficient mutant were then performed using unanesthetized piglets . The mutant caused significantly greater pulmonary hypertension and arterial plasma thromboxane B2 levels than the large capsule strain . The pulmonary hypertension induced by both strains was reversed by dazmegrel, a thromboxane A2 synthase inhibitor . These results suggest that (1) capsular type-specific polysaccharide is not an essential component in the generation of acute hemodynamic responses; (2) expression of large amounts of capsular type-specific polysaccharide on the organism surface partially inhibits GBS-induced pulmonary hypertension; and (3) the inhibition of the pulmonary responses is due to reduced thromboxane A2 release.(ABSTRACT TRUNCATED AT 250 WORDS)

J Heart Valve Dis, 1993 Jul, 2(4), 481 - 4
Aorto-left atrial fistula in prosthetic aortic endocarditis; Kelion AD et al.; Aortic valve endocarditis commonly leads to the formation of a root abscess, but fistulae are uncommon . The echocardiographic findings in a patient with Streptococcus viridans endocarditis of a prosthetic aortic valve associated with a fistula between the aorta and the left atrium are presented . The diagnosis was made by transthoracic echocardiography, although the transesophageal study gave higher resolution views and allowed a more confident exclusion of mitral valve involvement.

Avian Dis, 1993 Jul-Sep, 37(3), 839 - 44
Focal dermatitis and cellulitis in broiler chickens: bacteriological and pathological findings; Messier S et al.; Involvement of aerobic bacteria, especially Escherichia coli, in lesions of cellulitis in broiler chickens was investigated . Samples of subcutaneous caseous material for bacteriological examination were collected aseptically at the slaughterhouse from 109 broilers with lesions . Skin tissue was taken from five of these birds for histopathological examination . In 96 of the 109 (88.1%) broilers sampled, E . coli was isolated from the lesion, and in 60 of these birds it was the only bacterial species found . In 33 broilers, Streptococcus dysgalactiae was found along with E . coli . Although serotype O78 was isolated the most frequently, numerous other serotypes were found; no correlation could be established between the size of the lesions and the serotype isolated . The microscopic lesions were characterized by thickening of the dermis with a granulomatous inflammatory reaction . This study confirms the frequent association of E . coli with cellulitis lesions in broiler chickens and reports the frequent isolation of S . dysgalactiae from the lesion.

J La State Med Soc, 1993 Jul, 145(7), 297 - 300
Craniocervical necrotizing fasciitis; Morrow JS et al.; Craniocervical necrotizing fasciitis is a serious, life-threatening infection affecting fascial planes within the head and neck . Frequently the result of odontogenic origin, these polymicrobial infections, often involving group A beta hemolytic streptococcus acting in synergy with an anaerobe, can spread rapidly, causing significant morbidity and mortality, and must be diagnosed as early as possible . Treatment consists primarily of appropriate intravenous antibiotics and aggressive surgical debridement.

Quintessence Int, 1993 Jul, 24(7), 511 - 5
Antibacterial activity of dentinal bonding agents; Emilson CG et al.; The susceptibility of five bacterial species to seven dentinal bonding agents was examined in vitro . Agar diffusion tests using filterpaper disks containing 10 microL each of conditioner, primer, or resin were performed on blood agar and mitis salivarius bacitracin agar . Chlorhexidine (0.2%) was used as a positive control . After incubation, zones of inhibited bacterial growth were measured . Of all the compounds tested, Gluma cleanser and Gluma etchant showed the strongest growth inhibition for all bacterial strains . No antibacterial effect was noted for Prisma Universal Bond 2 and Superlux Universal Bond 2 systems . The primers of Gluma, Denthesive, and Scotchbond 2 displayed antibacterial activity that, in some cases, was comparable to that of 0.2% chlorhexidine . Zones of inhibition were seen for the resin materials of Scotchbond 2 and Tripton with Streptococcus mutans, Streptococcus sanguis and Actinomyces viscosus . No inhibition was seen after these resins were cured, whereas the antibacterial effect of XR-Bond on S sanguis and A viscosus was not affected by light curing.

Yale J Biol Med, 1993 Jul-Aug, 66(4), 315 - 24
The pneumococcus and some men who came to Yale: the Dorothy M . Horstmann Lecture; Austrian R; Yale has been fortunate indeed to have had Dorothy Horstmann as a member of its faculty for all but one of the last 50 years . It has had also the wisdom to take cognizance of her value as an individual and of her contributions to biomedical science and human welfare on two occasions in recent years . Her studies of poliomyelitis, hepatitis, and rubella, executed with perceptiveness, rigor and modesty, have benefited countless numbers; and for her many achievements all are in her debt . I am beholden to her colleagues for this opportunity to pay tribute to a wise and gracious friend . In casting about for a subject befitting this occasion, the thought occurred that it might be of interest to examine the contributions of some former and present members of Yale's faculty to the subject of a group of infections still endemic in all human societies, namely those caused by Streptococcus pneumoniae or the pneumococcus . The list is doubtless not exhaustive but includes such notables as Winternitz, Blake, Paul, Trask, Eaton, and Beeson of former days, as well as reflecting ongoing investigations today by Eugene Shapiro and his colleagues . In reviewing some of this earlier work, it will be my endeavor to place it in the context of contemporary understanding . In the interest of some semblance of order, the material will be examined in topical rather than in chronological order, dealing with bacteriologic and immunologic, pathogenetic, therapeutic, and prophylactic considerations in that sequence.

Zhonghua Kou Qiang Yi Xue Za Zhi, 1993 Jul, 28(4), 197 - 9, 254
{Study on feasibility of Chinese green tea polyphenols (CTP) for preventing dental caries}; You SQ; This study demonstrated that streptococcus mutans could be inhibited completely after contacted with 0.1% CTP for 5 minutes . There were no drug resistance after repeat cultures in 0.025% CTP . Plaque Index and Gingival Index decreased significantly (P < 0.001) after 0.2% CTP were used to rinse and brush the teeth . Results proved that CTP is an effective agent to prevent dental caries.

Antibiot Khimioter, 1993 Jul, 38(7), 3 - 6
{Macrotetrolide antibiotics from a recombinant strain of Streptococcus chrysomallus}; Orlova TI; A mixture of antibiotic substances was isolated from the culture fluid of a recombinant strain of Streptomyces chrysomallus . The substances were identified as macrotetrolides (nonactin, monactin, dinactin and trinactin) by the mass spectrometry, ionoform properties and thin layer chromatography in the antibiotic samples and ethylacetate extracts of the fermentation broth filtrate . The parent strain of Streptomyces chrysomallus also synthesized a mixture of macrotetrolides . However, it contained no nonactin and the total level of the macrotetrolide biosynthesis was 5 to 7 time lower than that in the recombinant strain (determined by a chemical method).

J Clin Pathol, 1993 Jul, 46(7), 617 - 20
Rapidly fatal necrotising fasciitis caused by Streptococcus pyogenes; Donaldson PM et al.; AIMS--To describe the morbid anatomical and bacteriological features in a series of five cases of rapidly fatal Streptococcus pyogenes necrotising fasciitis . METHODS--Post mortem and bacteriological examinations were made of five patients dying within 48 hours from rapidly fatal necrotising fasciitis . RESULTS--All five cases died rapidly from a toxic Streptococcus toxin syndrome as a result of developing necrotising fasciitis following trivial injury . CONCLUSIONS--Necrotising fasciitis caused by Streptococcus pyogenes infection can be rapidly fatal . This is probably the result of a toxic shock syndrome . Rapid, early diagnosis and swift and probably empirical treatment is required to avoid a fatal outcome.

Mem Inst Oswaldo Cruz, 1993 Jul-Sep, 88(3), 431 - 4
The effect of subminimal inhibitory concentrations of penicillin on growth rate and haemolysin activity of group G Streptococcus; Vieira VV et al.; The influence of the subminimal inhibitory concentrations (1/3 and 1/4 of the MIC) of penicillin on growth rate and on haemolysin production of a strain of group G Streptococcus was studied . It was shown that 1/3 of the MIC almost completely inhibited the bacterial growth, but it was not able to inhibit haemolysin activity in the culture supernate . The generation time of bacteria grown in 1/4 of the MIC was approximately twice longer than that of the control culture . In all cultures, the haemolysin, after being produced (or liberated), reached a peak and decreased to low levels, which could suggest that group G Streptococcus produces some end products of metabolism that are able to inhibit haemolysin activity.

Lik Sprava, 1993 Jul, (8), 59 - 62
{The clinico-immunological characteristics of bronchial asthma patients undergoing autologous ultraviolet blood irradiation}; Tkachenko IuIa et al.; Ultraviolet irradiation of blood studied in 201 patients with various forms of bronchial asthma proved to be the most effective in "aspirin" and infectious-allergic forms of the disease . Analysis of immunological changes showed that ultraviolet irradiation of blood brings to the norm content of IgG in serum, influence beneficially quantity and functional activity of T-lymphocytes, reduces auto-immunization and sensibilization to Streptococcus.

Res Microbiol, 1993 Jul-Aug, 144(6), 457 - 65
Ribotyping of Streptococcus agalactiae strains isolated from vaginas of asymptomatic women; Huet H et al.; One hundred and eleven strains of Streptococcus agalactiae isolated from vaginas of asymptomatic women were characterized by determination of restriction length polymorphism profiles of rDNA regions (rDNA RFLP patterns) and serotyping . Thirty-five different PstI rDNA RFLP patterns were identified . Half of the strains fell into only seven of these 35 groups . No correlation between serotypes and rDNA RFLP patterns was found . These results indicate that (i) the genetic diversity of the S . agalactiae species is relatively limited and (ii) determination of rDNA RFLP patterns can be used as a typing system only in conjunction with serotyping.

Obstet Gynecol, 1993 Jul, 82(1), 84 - 7
Evaluation of two rapid tests for detection of maternal endocervical group B streptococcus: enzyme-linked immunosorbent assay and gram stain; Hagay ZJ et al.; OBJECTIVE: To establish the reliability of two rapid tests for detection of group B streptococcus, the new enzyme-linked immunosorbent assay (ELISA) and the Gram stain . In addition, we wished to determine whether the combination of these tests would increase test sensitivity . METHODS: During a 2-year period, cervical secretions from 660 patients who presented with either premature rupture of membranes or preterm labor at a gestational age of 37 weeks or less were tested by three methods: the Equate ELISA test, a Gram stain smear, and a culture for group B streptococcus . Results of the rapid tests were compared with the corresponding culture results . RESULTS: Cultures were positive for group B streptococcus in 50 patients, a prevalence of 7.5% . The sensitivity for the Equate ELISA test was 24% and for the Gram stain, 20% . Specificity was 95 and 89%, respectively . When results of these tests were combined, the sensitivity increased to 26% . Both rapid tests yielded a high rate of false positives . In more than 50% of false-positive cases, bacteria other than group B streptococcus were isolated . CONCLUSION: Neither the Gram stain nor the Equate ELISA test is sensitive enough to be used as a screening test for the identification of group B streptococcus . Furthermore, the combination of both rapid tests yielded only a slight increase in sensitivity . The high false-positive rate of the ELISA test seems to be related to a cross-reactivity of the anti-group B streptococcal antibody with other cervical bacteria.

Orv Hetil, 1993 Jun 27, 134(26), 1407 - 9
{Polyresistant Streptococcus pneumoniae causing cumulative diseases in infants and young children}; Marosvari I et al.; Eight cases are reported here . Isolated Penicillin resistant Streptococcus pneumoniae strains were also resistant to Oxacillin, Erythromycin, Ampicillin, Cotrimoxazole . In five cases resistance to second generation cephalosporines (Cefaclor, Cefuroxime) also could be demonstrated . All of these multiply resistant strains retained their susceptibility to the third generation cephalosporines (Cefotaxime, Ceftriaxone) . Claforan treatment resulted recovery in all of the patients.

Tidsskr Nor Laegeforen, 1993 Jun 20, 113(16), 2010 - 1
{Pneumococcal vaccine recommended for HIV-infected individuals}; Hoel T et al.; The Epidemic Section at the Oslo City Department of Health and Environment, is responsible for monitoring communicable diseases in Oslo . We have registered an increase in the number of severe cases of pneumococcal disease with bacteremia, sepsis and meningitis . Fifty-two cases of invasive pneumococcal disease occurred in Oslo in 1992 . There are no available data on the HIV-status of these patients . Streptococcus pneumoniae is frequently found as part of the normal flora of the upper respiratory tract, and is an important pathogen for patients infected with HIV . We discuss indications for use of pneumococcal vaccine, and recommend earlier and more extensive use of this vaccine in HIV-infected persons in Norway.

FEMS Microbiol Lett, 1993 Jun 15, 110(2), 175 - 8
Effect of anti-TNF-alpha treatment in an antibiotic treated murine model of shock due to Streptococcus pyogenes; Martin RA et al.; Experimentally, Gram-negative septic shock can be prevented by the prophylactic use of an anti-TNF-alpha monoclonal antibody . The clinical similarity between Gram-negative and Gram-positive septic shock suggested that anti-TNF-alpha therapy might have a wide application . Increased levels of TNF-alpha were seen in a murine model of septic shock due to Streptococcus pyogenes but administration of an anti-TNF-alpha monoclonal antibody had no beneficial effect on the outcome.

Med Klin (Munich), 1993 Jun 15, 88(6), 357 - 61
{Current data on the antibiotic sensitivity of Streptococcus pneumoniae (Pneumococcus) . The significance of penicillin resistant isolates}; Reinert RR et al.; Antibiotic-resistant pneumococci, including strains resistant to penicillin, are being isolated with increasing frequency also in Europe . Therefore, we studied the antibiotic sensitivity to penicillin, erythromycin, chloramphenicol, tetracycline, ofloxacin, and ciprofloxacin in 131 strains of Streptococcus pneumoniae; most of them were isolated from patients with systemic infections . A reduced susceptibility to penicillin was found in 7.6% (n = 10) of the Streptococcus pneumoniae strains . For the first time in Germany, in the present investigation two pneumococcal strains highly resistant to penicillin were isolated (minimal inhibitory concentration {MIC} values > or = 2 mg/l) . These strains exhibited high MIC values against various cephalosporins as well . 10.7% of all pneumococci were resistant to tetracycline, resistance to erythromycin was found in 3.8% of the isolates . The emergence of pneumococci in Germany with reduced susceptibility to penicillin underscores the importance to include alternative drugs in sensitivity testing of pneumococci involved in systemic infections . Depending on the localization of the infection, parenteral third generation cephalosporins, glycopeptides and quinolone derivatives are primarily adequate in the treatment of infections caused by penicillin-resistant pneumococci.

Eur J Biochem, 1993 Jun 15, 214(3), 819 - 27
Two different genes coding for fibronectin-binding proteins from Streptococcus dysgalactiae . The complete nucleotide sequences and characterization of the binding domains; Lindgren PE et al.; The binding of Streptococcus dysgalactiae to fibronectin involves fibronectin-binding protein(s) present on the bacterial surface . Previously, we reported the cloning of two different genes coding for cell-wall-associated fibronectin-binding proteins from S . dysgalactiae strain S2 {Lindgren, P.-E., Speziale, P., McGavin, M . J., Monstein, H.-J., Hook, M., Visai, L., Kostiainen, T., Bozzini, S . & Lindberg, M . (1992) J . Biol . Chem . 267, 1924-1931} . The two genes, fnbA and fnbB, have now been sequenced and the primary amino acid sequences of the two fibronectin-binding proteins, FnBA and FnBB, have been deduced . The two proteins have predicted molecular masses of 117 kDa and 122 kDa, respectively, and are organized in a similar way . The fibronectin-binding activities are localized in repeated motifs, 32-37 amino acids long, in the COOH-terminal regions of the proteins . The two fibronectin-binding proteins have heterologous amino acid sequences, except for the COOH-terminal ends which include the fibronectin-binding repeats . The fibronectin-binding regions of the genes have been fused to IgG-binding domains of protein A, utilizing the IgG-binding capacity of the resulting fusion proteins, to facilitate isolation of the fibronectin-binding domains.

Eur J Biochem, 1993 Jun 15, 214(3), 757 - 61
Isomalto-oligosaccharide-containing lipoteichoic acid of Streptococcus sanguis . Microheterogeneity and distribution of chain substituents; Kochanowski B et al.; The lipoteichoic acid of Streptococcus sanguis DSM 20567 contains a poly(glycerophosphate) chain, with 49% of the glycerophosphate residues being substituted with D-alanine ester, 35% with alpha-D-glucopyranosyl and alpha-isomalto-oligosaccharide residues . Analysis of molecular species by affinity chromatography on concanavalin A showed all chains to be substituted and alanine ester and glycosyl residues to be present on the same rather than on separate chains . Molecular species varied in the length of the poly(glycerophosphate) chain, the extent of glycosylation, and had a constant alanine-ester content . An alkali-hydrolysis procedure revealed a distribution pattern between random and regular for the glycosyl substituents and suggested a similar distribution for the alanyl residues which occupy the free positions between the glycosyl substituents.

Eur J Biochem, 1993 Jun 15, 214(3), 747 - 55
Isomalto-oligosaccharide-containing lipoteichoic acid of Streptococcus sanguis . Basic structure; Kochanowski B et al.; The lipoteichoic acid of Streptococcus sanguis DSM 20567 and of DSM 20068 was isolated by phenol/water extraction and hydrophobic-interaction chromatography . The preparations from both strains have an identical structure: a 1,3-linked poly(glycerophosphate) chain phosphodiester-linked to Glc-(alpha 1-2)Glc(alpha 1-3)acyl2Gro as the lipid anchor . The chain is substituted with D-alanine ester and glycosyl residues which comprise mono-, di-, tri- and tetra-alpha-D-glucopyranosyl residues with (1-6) interglycosidic linkages . The glycosylglycerols were released with 48% (by mass) hydrofluoric acid, separated and characterized by a combination of chemical procedures and modern techniques of 1H-NMR and 13C-NMR spectroscopy . The alpha-isomalto-oligosaccharides add a novel motif to lipoteichoic-acid chain substituents . 1H-NMR and 13C-NMR spectroscopy also provided a detailed picture of the basic glycosylated poly(1,3-glycerophosphate) diglucosylglycerol . It proved a single unbranched chain structure, provided evidence for the chain length, the extent of glycosylation, the structure of the lipid anchor and the site of attachment of the poly(glycerophosphate) chain on the lipid anchor . Owing to its unique glycosyl substituents the lipoteichoic acid may serve as a taxonomic marker for the redefined species S . sanguis (formerly S . sanguis type I).

Biochem J, 1993 Jun 15, 292 ( Pt 3), 735 - 41
Penicillin-binding protein 2x of Streptococcus pneumoniae: enzymic activities and interactions with beta-lactams; Jamin M et al.; The high-molecular-mass penicillin-binding protein (PBP) 2x, one of the primary targets of beta-lactam antibiotics in Streptococcus pneumoniae, has been produced as a soluble form and purified in large amounts . It has been shown to catalyse hydrolysis and transfer reactions with different ester and thiolester substrates and its catalytic behaviour was often similar to that of the soluble DD-peptidase from Streptomyces R61 . This provided an easy method to monitor the activity of the PBP . For the first time, a reliable kinetic study of the interaction between a lethal target and beta-lactam antibiotics has been performed . Characteristic kinetic parameters were obtained with different beta-lactam compounds . These results not only validated the mechanism established with non-essential extracellular enzymes, but will also constitute the basis for comparative studies of the low-affinity variants from penicillin-resistant strains.

J Pediatr, 1993 Jun, 122(6), 929 - 37
Comparison of group B streptococcal hyperimmune globulin and standard intravenously administered immune globulin in neonates; Weisman LE et al.; Standard intravenously administered immune globulin (IVIG) contains varying amounts of group B streptococcus (GBS) antibody . A GBS hyperimmune IVIG was produced by immunizing plasma donors . The GBS type-specific opsonic activity was > or = 90% in the hyperimmune IVIG at a 1280 dilution-1 versus at a 10 dilution-1 in standard IVIG . Suckling rat survival after GBS type-specific infection was 100% when the rats were treated with hyperimmune IVIG versus < or = 20% with standard IVIG . To evaluate the effect of this product on GBS antibody levels and clinical toxic effects, we randomly administered either GBS hyperimmune IVIG, 500, 250, or 100 mg/kg, or standard IVIG, 500 mg/kg, to 20 neonates with suspected sepsis . No adverse effects were observed . Total and subclass serum IgG levels reflected only the dose; serum GBS type-specific IgG and opsonic activity reflected both the product and dose of IVIG administered . Standard IVIG did not significantly increase serum GBS type-specific IgG, whereas hyperimmune IVIG, 500 mg/kg, produced a fourfold rise for > 6 weeks; more variable increases were observed after 250 and 100 mg/kg doses were given . Serum GBS type-specific opsonic activity correlated with serum GBS type-specific IgG levels (R2 = 0.74; p < 0.0001) . Further studies of this or similar products will be necessary to determine whether GBS type-specific antibody improves the outcome of GBS-infected neonates.

J Infect Dis, 1993 Jun, 167(6), 1401 - 5
Penicillin-binding protein expression at different growth stages determines penicillin efficacy in vitro and in vivo: an explanation for the inoculum effect; Stevens DL et al.; Mechanisms to explain the "inoculum effect" have not been elucidated in gram-positive infections . A mouse model of group A streptococcal myositis was used to compare the efficacies of two beta-lactams, penicillin and ceftriaxone, and a protein synthesis inhibitor, clindamycin, at three different inoculum sizes . beta-lactams were more susceptible to inoculum effects than was clindamycin both in vivo and in vitro (P < .05) . The large inocula were hypothesized to reach stationary phase of growth sooner than smaller inocula both in vitro and in vivo . The penicillin-binding protein (PBP) patterns from membrane proteins isolated from mid-log-phase and stationary-phase cultures of Streptococcus pyogenes were compared . Binding of radiolabeled penicillin by all PBPs was decreased in stationary cells; however, PBPs 1 and 4 were undetectable at 36 h . Thus, the loss of certain PBPs during stationary-phase growth in vitro may be responsible for the inoculum effect observed in vivo and may account for the failure of penicillin in both experimental and human cases of severe streptococcal infection.

CMAJ, 1993 Jun 1, 148(11), 1909 - 16
Group A Streptococcus: a re-emergent pathogen . Infectious Diseases and Immunization Committee, Canadian Paediatric Society; Protein rib: a novel group B streptococcal cell surface protein that confers protective immunity and is expressed by most strains causing invasive infections; Department of Medical Microbiology, University of Lund, SwedenThe group B Streptococcus, an important cause of invasive infections in the neonate, is classified into four major serotypes (Ia, Ib, II, and III) based on the structure of the polysaccharide capsule . Since the capsule is a known virulence factor, it has been extensively studied, in particular in type III strains, which cause the majority of invasive infections . Two cell surface proteins, alpha and beta, have also been studied in detail since they confer protective immunity, but these proteins are usually not expressed by type III strains . We describe here a cell surface protein, designated protein Rib (resistance to proteases, immunity, group B), that confers protective immunity and is expressed by most strains of type III . Protein Rib was first identified as a distinct 95-kD protein in extracts of a type III strain, and was purified to homogeneity from that strain . Rabbit antiserum to protein Rib was used to demonstrate that it is expressed on the cell surface of 31 out of 33 type III strains, but only on 1 out of 25 strains representing the other three serotypes . Mouse protection tests showed that antiserum to protein Rib protects against lethal infection with three different strains expressing this antigen, including a strain representing a recently identified high virulence type III clone . Protein Rib is immunologically unrelated to the alpha and beta proteins, but shares several features with the alpha protein . Most importantly, the NH2-terminal amino acid sequences of the Rib and alpha proteins are identical at 6 out of 12 positions . In addition, both protein Rib and the alpha protein are relatively resistant to trypsin (and Rib is also resistant to pepsin) and both proteins vary greatly in size between different clinical isolates . Finally, both protein Rib and the alpha protein exhibit a regular ladderlike pattern in immunoblotting experiments, which may reflect a repetitive structure . Taken together, these data suggest that the Rib and alpha proteins are members of a family of proteins with related structure and function . Since protein Rib confers protective immunity, it may be valuable for the development of a protein vaccine against the group B Streptococcus, an encapsulated bacterium.

J Dent Res, 1993 Jun, 72(6), 1015 - 20
Adhesion of actinomyces isolates to experimental pellicles; Steinberg D et al.; The ability of oral bacteria to adhere to surfaces is associated with their pathogenicity . Actinomyces can adhere to pellicle and cells through extracellular fimbriae . Research on adhesion of actinomyces has been conducted with use of hydroxyapatite (HA) coated with mammalian-derived salivary constituents, whereas the bacterial-derived components of the acquired pellicle have been largely ignored . The influence of the cell-free bacterial enzyme, glucosyltransferase (GTF), on adhesion of human and rodent isolates of Actinomyces viscosus was examined . Cell-free GTF was adsorbed onto parotid saliva-coated hydroxyapatite (sHA) . Next, A . viscosus was exposed to the pellicle following the synthesis of glucan formed in situ by GTF . Glucans formed on the pellicle served as binding sites for adhesion of a rodent strain of A . viscosus . Conversely, the presence of in situ glucans on sHA reduced the adhesion of human isolates of A . viscosus compared with their adhesion to sHA . Adhesion of the rodent strains may be facilitated through a dextran-binding protein, since the rodent strains aggregated in the presence of dextrans and mutan . The human isolates were not aggregated by dextran or mutan . Pellicle harboring A . viscosus rodent strains interfered with the subsequent adhesion of Streptococcus mutans to the bacterial-coated pellicle . In contrast, the adhesion of S . mutans to pellicle was not decreased when the pellicle was pre-exposed to a human isolate of A . viscosus . The experimental data suggest that human and the rodent isolates of A . viscosus have distinct glucan adhesion properties.(ABSTRACT TRUNCATED AT 250 WORDS)

J Antimicrob Chemother, 1993 Jun, 31 Suppl E, 137 - 46
Comparison of azithromycin versus clarithromycin in the treatment of patients with upper respiratory tract infections; Muller O; The efficacy and safety of azithromycin and clarithromycin were compared in an open multicentre study involving 380 adult patients with acute otitis media, acute sinusitis, or acute streptococcal pharyngitis or tonsillitis . Patients were assigned randomly to receive azithromycin as a single dose of 500 mg daily for three days, or clarithromycin 250 mg bid for ten days . Overall clinical efficacy was found to be similar in each treatment group at day 10-14, with a satisfactory outcome (cured or improved) in 95% of azithromycin and 96% of clarithromycin patients . Bacteriological efficacy was also similar, with eradication of the pathogen in 94% and 95% of isolates, respectively, in the azithromycin and clarithromycin groups . In otitis media, a satisfactory clinical response was seen in 97% of patients in each treatment group . Azithromycin therapy resulted in a clinical response rate of 93% in sinusitis patients, with bacteriological eradication in 93% of patients . Two patients (who were cured clinically) had persistent pathogens . Similarly, clarithromycin achieved clinical response and bacteriological eradication in 95% and 92% of sinusitis patients, respectively . Pathogens persisted in two patients with clinical cure, and in one case of clinical failure . In pharyngitis or tonsillitis, Streptococcus pyogenes was eradicated successfully in 95% of patients in both groups, and the clinical success rates were 96% and 97% for azithromycin and clarithromycin, respectively . No case of clinical failure was associated with persistence of S . pyogenes infection . At the follow-up assessment of this diagnosis group, reinfection had occurred in three (8%) azithromycin patients and one (3%) clarithromycin patient, and all but one patient remained asymptomatic . Both drugs were well-tolerated, with 8.4% of patients on azithromycin and 7.4% on clarithromycin reporting adverse events, mainly gastrointestinal . It was concluded that a three-day course of azithromycin was as effective and well-tolerated as a ten-day course of clarithromycin in adults with acute upper respiratory tract infections.

J Antimicrob Chemother, 1993 Jun, 31 Suppl E, 129 - 35
Once-daily azithromycin in the treatment of adult skin and skin-structure infections; Amaya-Tapia G et al.; The aim of this prospective, blinded, randomized study was to demonstrate the efficacy and safety of oral azithromycin and dicloxacillin in the treatment of adults with acute skin and skin-structure infections . Sixty-two patients were included in the intent-to-treat group and 60 were evaluable for analysis . Azithromycin was given as a 500 mg once-daily dose for three days and dicloxacillin as 250 mg qid for seven days . Isolated pathogens included primarily Staphylococcus aureus, Streptococcus spp., and coagulase-negative staphylococci . Clinical resolution was 83.3% in the azithromycin group and 83.9% in the dicloxacillin group, with bacteriological eradication of 90.0% in the azithromycin group and 87.1% in the dicloxacillin group . Persistence of infection was recorded in one patient in the dicloxacillin group and superinfection in one patient in the azithromycin group . Azithromycin appears to be a safe and effective antibiotic for the treatment of adult patients with acute skin and skin-structure infections.

J Antimicrob Chemother, 1993 Jun, 31 Suppl E, 103 - 9
A comparative study of the efficacy, safety and tolerance of azithromycin, dicloxacillin and flucloxacillin in the treatment of children with acute skin and skin-structure infections; Rodriguez-Solares A et al.; An open, randomized, multicentre study was undertaken to compare a three-day regimen of azithromycin with a seven-day course of dicloxacillin or flucloxacillin in the treatment of 118 children (aged 2-12 years) with clinically diagnosed acute skin and skin-structure infections . Sixty patients received a single daily dose of azithromycin of 10 mg/kg for three days, whilst 58 received a cloxacillin ester: either dicloxacillin (n = 49) at a daily dose of 12.5-25 mg/kg (depending on severity of infection); or flucloxacillin (n = 9) at 250-2000 mg/day (depending on age) . Both cloxacillin esters were administered in four divided doses for seven days . Clinical, safety and, where possible, bacteriological assessments were made before therapy and after 3 to 5 and 7 to 10 days of treatment . A successful clinical response (cure and improvement) was recorded in 57 of 59 (97%) of evaluable azithromycin patients, and in 57 of 58 (98%) of cloxacillin ester patients . Eradication of the key pathogens was 31 of 34 (91%) and 34 of 35 (97%) for Staphylococcus aureus, and 5 of 5 and 4 of 4 for Streptococcus pyogenes in the azithromycin and cloxacillin ester groups, respectively . Both medications were well tolerated, with mild to moderate side-effects (abdominal pain and vomiting) occurring in two patients in each group, and laboratory abnormalities (elevated eosinophil count) in one patient in each group . There were no withdrawals from therapy . The results of this study suggest that azithromycin is as effective and as well tolerated as a cloxacillin ester antibiotic in the treatment of children with acute skin and skin-structure infections.

Semin Arthritis Rheum, 1993 Jun, 22(6 Suppl 1), 4 - 8
Effects of high-molecular-weight hyaluronates on the functions of guinea pig polymorphonuclear leukocytes; Tamoto K et al.; The effect of hyaluronate (HA) with a molecular weight of 1,900,000 (HA190) purified from products of Streptococcus equi on various functions of guinea pig peritoneal polymorphonuclear leukocytes (PMNs) was examined . HA190 effectively inhibited both the chemotactic activity of PMNs for a chemotactic peptide, formyl-Met-Leu-Phe, and the phagocytic activity of the cells for serum-opsonized zymosan (SOZ) in a dose-dependent manner . When the inhibitory activity of the HAs of different molecular weights, including HA190, HA of molecular weight 800,000 (HA80), and HA of molecular weight 300,000 (HA30), was assessed, the HA190 showed the strongest inhibitory activity and HA30 the lowest activity . In contrast, significant inhibition of the superoxide generation by PMNs upon stimulation with SOZ was not observed even in the presence of HA190 and HA80 at the highest concentration used (2.5 mg/mL) . This finding indicated that the HAs studied did not prevent the interaction of PMNs with stimuli . From these data it is concluded that the binding of high-molecular-weight HAs to the HA receptors on PMNs may produce intracellular signals that are responsible for suppression of phagocytosis and chemotaxis but not for superoxide generation.

J Gen Microbiol, 1993 Jun, 139 ( Pt 6), 1291 - 300
Alterations in the cellular envelope of spontaneous IIIManL-defective mutants of Streptococcus salivarius; Brochu D et al.; In Streptococcus salivarius, the phosphoenolpyruvate: mannose phosphotransferase system (PTSMan) transports and concomitantly phosphorylates mannose, glucose, fructose and 2-deoxyglucose . PTSMan consists of a membrane Enzyme II and two forms of Enzyme III (IIIMan) having molecular masses of 38.9 kDa (IIIManH) and 35.2 kDa (IIIManL) respectively . We have previously reported the isolation of spontaneous mutants lacking IIIManL, and showed that they exhibited abnormal growth when cultured in mixtures of sugars containing glucose . The mutants also synthesize several cytoplasmic glucose-repressible proteins during growth on glucose and some of them constitutively express a fructose PTS which is induced by fructose in the parental strain . We have now investigated the properties and composition of the cellular envelope of three S . salivarius IIIManL-defective mutants (strains A37, B31 and G29) after growth on glucose . The mutants have altered sensitivity to various toxic compounds that interfere with cell-envelope functions . The mutants also exhibited altered membrane-protein profiles when analysed by two-dimensional PAGE and modified total lipid and phosphorus contents and lipid/protein ratio . In one mutant (strain G29), the proportion of the phospholipids separated by TLC was different from the parental strain . Electron microscopy indicated that one mutant (strain A37) possessed more fimbriae than the parental strain . The results suggested that these IIIManL-defective mutants were affected in a global regulatory gene controlling several cellular or physiological functions, many of these being related to the cellular envelope.

Z Kardiol, 1993 Jun, 82(6), 388 - 91
{Reversible contact lesion in mitral valve endocarditis--follow-up study with transesophageal echocardiography}; Menzel T et al.; This is a case report of a 59-year-old patient with an endocarditis of the mitral valve caused by streptococcus viridans . Precordial echocardiography showed a highly mobile vegetation of the anterior mitral leaflet prolapsing during systole into the left atrium . During diastole contact with the ventricular septum caudally to the left ventricular outflow tract was noted . By using transesophageal echocardiography (TEE), this zone appeared as a localized increased echogenity of the parietal endocardium and underlying myocardium . Antibiotic therapy led to a cure of the endocarditis (clinically and according to clinical chemistry) . The TEE follow-up 2 months later showed persisting mitral valve vegetation, whereas neither the endocardial lesion nor the abnormal myocardial echo pattern were seen any longer . The likely inflammatory etiology of the described lesion is discussed and seems obvious.

Enferm Infecc Microbiol Clin, 1993 Jun-Jul, 11(6), 304 - 8
{Microbiological characteristics and spectrum of infections of 108 Streptococcus anginosus isolated}; Molina F et al.; BACKGROUND: The aim of the present study was to assess the key microbiologic characteristics aid in the identification of Streptococcus anginosus in the laboratory and know the spectrum of clinical infections it produces . METHODS: From March 1991 to April 1992 all the isolated strains of clinical significant samples were collected . For identification the API 20 STREP (BioMerieux) system was used . The histories of the patients with infection by S . anginosus were retrospectively reviewed to collect clinical and microbiologic data of interest . RESULTS: The 108 strains of St . anginosus isolated were diminute colonies on sheep blood agar with CO2 enrichment . They had a characteristic smell, were beta-hemolitic or non hemolitic and of the Lancefield group A, C, F, G or not groupable . All had invariable biochemical features in the API 20 STREP: produced acetone and alkaline phosphatase, hydrolized arginine, did not hydrolize hypurate nor did they ferment ribose . Streptococcus anginosus produced purulent infections of different localization: abdominal, head-neck, pleuro-pulmonary, muscle-skeletal, skin and soft tissues and miscellaneous . Most of these infections were polymicrobial (81.5%) . CONCLUSIONS: St . anginosus was easily identified in the laboratory by its morphologic characteristics and biochemical reaction in the API 20 STREP . It produced a wide variety of supurative infections, some being severe: cerebral, pulmonary, hepatic, empyema abscess . The identification of this microorganism at a species level should contribute to better recognition as a pathogen of occassionally severe supurative infections.

Enferm Infecc Microbiol Clin, 1993 Jun-Jul, 11(6), 295 - 8
{Colonization by Streptococcus group B in full term pregnancy and newborns in a community in Venezuela}; Riera L et al.; BACKGROUND: The aim of this study was to define the incidence of cervico-vaginal colonization by group B Streptococcus (SGB) in full term pregnancy as well as vertical and horizontal transmission in newborns attended in two public hospitals in Valencia, Venezuela . METHODS: An study cervico-vaginal exudates from 171 full term pregnant women was performed together with general obstetric survey . Oropharyngeal and nasal exudate studies in 118 newborns of the mothers studied were carried out during the first 12 hours after birth as was a neonatologic survey . RESULTS: The global percentage of maternal colonization by SGB were 32.7% while in the NB it was 45.8% . Among the NB colonized by SGB 73.2% were considered to have acquired the bacteria from the mother (vertical) with no significant differences in the data found in the two hospitals . The rate of horizontal colonization of the newborns was 42.3% in one hospital and only 8% in the second . CONCLUSIONS: There were no significant statistical differences between the rate of cervico-vaginal colonization in women attended in two public hospitals in Venezuela . No differences were observed in the rate of vertical colonization of newborns but to the contrary, that of the horizontal (nosocomial) colonization was of 42.3% and 8% in the Charity and University Hospitals, respectively.

Arch Oral Biol, 1993 Jun, 38(6), 507 - 16
Urease activity in Streptococcus salivarius at low pH; Sissons CH et al.; Arginine metabolism to alkali by the arginine deiminase system in oral bacteria increases their acid tolerance . The potential of urease activity in Streptococcus salivarius to fulfil a similar role was examined . In cell extracts between pH 5.0 and 8.0, urease activity was over 80% the maximal rate . The urease rate was zero at pH 4.3, and at pH 3.6 the enzyme was rapidly inactivated (t 1/2 of 0.6 min) . The pH range of intact cells was broader . In Strep . salivarius cells acidified to pH 2.6 for 5 min, urease was completely retained and the ureolytic pH rise was rapid . There was no urease activity after acidification to pH 2 . In cells acidified to maintain the pH between 3.3 and 4, viability was maintained for a short period (extrapolation indicated 20 min) and then decreased . This acidification induced alkali generation or acid removal that decreased in parallel to loss of viability . A small fraction (10%) of the urease was rapidly inactivated, after which both the remaining urease and pH response decreased at a similar rate to cell viability (t 1/2 of 15-20 min), but for at least 1 h following acidification, a rapid ureolysis induced rise in pH to above 7 . In cells held at pH 3.6 and treated to compromise their membranes by freeze-thawing or transient acidification to pH 2.3, 70-80% of the urease was lost rapidly and the remainder inactivated at a rate similar to that in intact cells . Therefore, although at pH below 4, S . salivarius urease is outside its pH activity range and the free enzyme is rapidly inactivated, intact cells the urease is protected and ureolytic generation of ammonia is capable of substantially raising the pH for at least 1 h while the cell population is being progressively killed by acid.

Appl Environ Microbiol, 1993 Jun, 59(6), 1969 - 71
Cloning of the gene encoding Streptococcin A-FF22, a novel lantibiotic produced by Streptococcus pyogenes, and determination of its nucleotide sequence; Hynes WL et al.; Streptococcin A-FF22 (SA-FF22) is a lantibiotic produced by Streptococcus pyogenes FF22 . The nucleotide sequence of the SA-FF22 structural gene (scnA) was determined and shown to encode a 51-amino-acid prepeptide . The proteolytic processing site of the SA-FF22 prepeptide differs from that which characterizes other type A lantibiotics.

Appl Environ Microbiol, 1993 Jun, 59(6), 1747 - 51
Effect of amino acids on the heat production and growth efficiency of Streptococcus bovis: balance of anabolic and catabolic rates; Russell JB; Streptococcus bovis JB1 grew nearly twice as fast (0.9 versus 1.6 h-1) and had a 40% greater growth yield (18 versus 12.5 mg of protein per mmol of glucose) when an ammonia-based medium was supplemented with amino acids, but the glucose consumption rate (88 mumol mg of protein-1 h-1) and specific rate of heat production (2.1 mW/mg of protein) were unaffected . Amino acid availability had little effect on the catabolic rate, but the specific heat decreased 40% (8.8 to 5.2 J/mg of protein) . These growth rate-dependent changes in metabolic efficiency were fivefold greater than the maintenance energy . Chloramphenicol (100 mg/l), an inhibitor of protein synthesis, caused a gradual decrease in anabolic (growth) rate, but there was little change in the rate of glucose consumption and the specific heat increased . When growth was inhibited by iodoacetate, the catabolic and anabolic rates both declined and there was not increase in specific heat . On the basis of these results, the benefit of amino acid supplementation was largely explained by the balance of anabolic and catabolic rates . When amino acids were available, the anabolic and catabolic rates were more closely matched and less energy was spilled as heat.

Clin Infect Dis, 1993 Jun, 16 Suppl 4, S263 - 5
Empyema due to Bacteroides gracilis: case report and in vitro susceptibilities to eight antimicrobial agents; Lee D et al.; We describe a patient with empyema due to Bacteroides gracilis and a viridans streptococcus . Therapy with both cefoxitin and imipenem failed, and the patient remained symptomatic even after thoracotomy was performed . Clinical response occurred after initiation of clindamycin therapy . The susceptibilities of the patient's isolate, other clinical strains, and the reference strain were determined by an agar dilution method . The isolates were generally susceptible to all the agents tested; however, some strains were resistant to clindamycin (MIC, 8 micrograms/mL), penicillin G (MIC90, 16 micrograms/mL), and metronidazole (MIC90, 64 micrograms/mL) . The B . gracilis isolate from our patient was susceptible to all agents tested, including cefoxitin and imipenem.

Ophthal Plast Reconstr Surg, 1993 Jun, 9(2), 125 - 31
Clinical bacteriology of dacryocystitis in adults; Coden DJ et al.; To better define the spectrum and relative incidence of pathogens causing dacryocystitis in adults, samples of purulent lacrimal sac contents were obtained from 236 patients undergoing dacryocystorhinostomy for a clinical diagnosis of dacryocystitis . Positive culture results were obtained in 52.5% . Cultures were pure, consisting of a single organism in 71%, and were mixed in 29% . Gram-positive organisms were most common, accounting for 64.5% of the isolates . Staphylococcus epidermidis, comprising 27.3% of the isolates and Staphylococcus aureus, comprising 22.1% of the isolates, were the most frequently encountered organisms . Gram-negative organisms were present in 27.3% of the isolates with Pseudomonas aeruginosa the most common, accounting for 8.7% overall . Anaerobic organisms were found in 7.0% of the isolates with Propionibacterium acnes the most frequent, recovered in 4.7% overall . Unexpected findings included the paucity of Streptococcus pneumoniae organisms recovered and the high incidence of involvement by gram-negative and anaerobic organisms.

J Dent, 1993 Jun, 21(3), 179 - 84
New findings on the microbial flora associated with adult periodontitis; Rawlinson A et al.; The predominant microbial flora associated with adult periodontitis was investigated in 21 patients aged 20-40 years . Microorganisms from samples of subgingival plaque were cultured on selective and non-selective media under aerobic and anaerobic conditions . Ten species or groups out of a total of 31 were found to comprise the predominant cultivable flora: diphtheroids, Porphyromonas asaccharolytica, coagulase-negative staphylococci, 'Streptococcus milleri'-group, Bacteroides ureolyticus, Capnocytophaga ochracea, the Prevotella veroralis/buccalis complex, P . intermedia, P . oralis and unidentified Prevotella spp . Two species previously reported at periodontitis sites, namely P . gingivalis and Fusobacterium nucleatum, were not isolated, whereas Prevotella species accounted for the majority of isolates in this investigation . The large proportion of non-pigmented Prevotella species, P . asaccharolytica and B . ureolyticus that were found have not generally been reported previously . The role of these microorganisms and also coagulase-negative staphylococci, diphtheroids and the 'Streptococcus milleri'-group requires further investigation in adult periodontitis.

J Clin Microbiol, 1993 Jun, 31(6), 1619 - 21
Screening for cephalosporin-resistant Streptococcus pneumoniae with the Kirby-Bauer disk susceptibility test; Friedland IR et al.; Kirby-Bauer disk susceptibility tests with five standard cephalosporin disks were performed on 23 penicillin-resistant Streptococcus pneumoniae isolates for which ceftriaxone MICs were 0.125 to 4 micrograms/ml . Cefuroxime disk inhibition zone diameters distinguished clearly isolates for which ceftriaxone MICs were > or = 2 micrograms/ml from more susceptible strains, whereas cephalothin, ceftizoxime, cefotaxime, and ceftriaxone disks distinguished these isolates less clearly than the cefuroxime disk did.

Zhonghua Yi Xue Za Zhi (Taipei), 1993 Jun, 51(6), 436 - 9
{Clinical efficacy of cefmetazole in intraabdominal infection}; Hu BS et al.; A number of different organisms can be isolated from intraabdominal infection . The most common are aerobic Gram-negative bacilli . Anaerobes are not unusual . From June 1989 to January 1990, Cefmetazole was administered to 23 patients with intraabdominal infection at Veterans General Hospital-Taipei . There were six patients with spontaneous bacterial peritonitis, five biliary tract infection, five liver abscesses, five with pelvic inflammatory disease, one acute ruptured appendicitis and another intraabdominal abscess . In addition, ten patients had sepsis . Clinical response was satisfactory in 21 (91.3%) of 23 patients, and the microbiological eradication rate was 90% (36/40) . One patient with Streptococcus and Bacteroides oralis liver abscess relapsed after organism eradication . Therapy failed in a case with Pseudomonas aeruginosa and Bacteroides fragilis infection . This study showed Cefmetazole to be an effective and safe antibiotic for treatment of intraabdominal infection.

Arq Bras Cardiol, 1993 Jun, 60(6), 377 - 81
{Pulse therapy (high doses of venous methylprednisolone) in children with rheumatic carditis . Prospective study of 40 episodes}; Herdy GV et al.; PURPOSE--To use corticosteroids in a shorter period to treat rheumatic carditis, keeping the patient in the hospital; and verify the time interval of normalization of rheumatic activity tests with this method . METHODS--In 36 patients (40 episodes) intravenous methyl-prednisolone (1g/day) was administered . The number of series ranged from two to four, according to severity of the disease . The ages ranged from 6 to 17 years old, all of them fulfilled the criteria of Jones for diagnosis of rheumatic fever . They were submitted to treatment to eradicate the streptococcus, worms, PPD and dental focus extraction, before use of corticosteroids . RESULTS--In all patients the signals and symptoms of heart failure improved . In six cases occurred complications during pulse therapy that were easily controlled with clinical measures . Two series of methylprednisolone were used in 10 children, three in nine and four in 21 episodes . Eight patients were sent to valve replacement . The interval of time that laboratory tests of rheumatic activity became negative was 41.2 +/- 13.3 days . CONCLUSION--Using this IV corticotherapy it was possible decrease the amount of days of this medication, keeping the patient in the hospital . In this way we eliminate the problem of interruption of the treatment . There was not significative difference between oral and IV corticotherapy in order to the laboratory tests become negative.

Res Microbiol, 1993 Jun, 144(5), 389 - 94
Genetic studies of cefotaxime resistance in Streptococcus pneumoniae: relationship to transformation deficiency; Seroude L et al.; A laboratory pneumococcal strain resistant to cefotaxime was studied by DNA-induced transformation in order to characterize its genetic structure . At least three independent genes were required to confer the highest level of resistance to this beta-lactam antibiotic . The accumulation of mutations in these three genes accounted for three levels of resistance . Mutation of the gene encoding penicillin-binding protein 2x was very likely responsible for the first step of resistance, which was a prerequisite for sequential increase in resistance . Additionally, strains highly resistant to cefotaxime were defective for natural transformation . Revertants of these strains were frequently observed . Such strains had recovered full transformability, suggesting a correlation between the inability to be transformed and a high level of resistance to cefotaxime . The possibility of electrotransforming these highly resistant strains suggests that natural transformation is probably blocked at the DNA-uptake level.

Oral Microbiol Immunol, 1993 Jun, 8(3), 167 - 71
Branched-chain amino acid transport in Streptococcus mutans Ingbritt; Dashper SG et al.; Leucine transport in glucose-energized cells of Streptococcus mutans exhibited Michaelis-Menten-type kinetics at low extracellular concentrations, with a K1 of 15.3 microM and a Vmax of 6.1 nmol/mg dry weight/min . At high extracellular leucine concentrations, the transmembrane diffusion of leucine was not saturable, indicating that passive diffusion becomes a significant mechanism of leucine transmembrane movement under these conditions . The proton motive force (PMF) was measured in glucose-energized cells of S . mutans and was found to have a maximum value of 126 mV at an extracellular pH (pH0) of 5.0; this decreased to 45 mV at pH0 8.0 . The intracellular accumulation of leucine was significantly correlated with the magnitude of the PMF . The addition of excess isoleucine or valine caused a marked decrease in the leucine transport rate . Maximal rates of leucine transport occurred at pH0 6.0, and the rate of leucine transport was independent of the growth medium . The results suggest that there is a PMF-driven, branched-chain amino acid carrier in S . mutans with a proton: substrate stoichiometry of 1.

Oral Microbiol Immunol, 1993 Jun, 8(3), 154 - 60
Serum immunoglobulin G antibodies to Porphyromonas gingivalis, Prevotella intermedia, Fusobacterium nucleatum and Streptococcus sanguis during experimental gingivitis in young adults; Danielsen B et al.; Twenty-eight young, healthy adults completed an experimental gingivitis study in which blood and clinical recordings were obtained at baseline; after a 4-week period of thorough oral hygiene; after a subsequent 3-week period of plaque accumulation; and after another 2 weeks of thorough oral hygiene . Serum immunoglobulin G antibodies against whole cells of Porphyromonas gingivalis, Prevotella intermedia, Fusobacterium nucleatum and Streptococcus sanguis were determined using enzyme-linked immunosorbent assay . Mean serum immunoglobulin G antibody levels to P . intermedia, F . nucleatum and S . sanguis remained essentially constant during the experiment, whereas the immunoglobulin G antibodies to P . gingivalis declined during the initial period of oral hygiene and the subsequent period of plaque accumulation to an average of 84.5% of the baseline value . This reduction could be attributed to the people who developed marked gingival inflammation during the period of plaque accumulation, indicating that the systemic host response may be associated with local tissue responses to variations in oral hygiene . These people were, however, also characterized by higher initial serum immunoglobulin G responses to P . gingivalis than people who developed less pronounced gingival inflammation during the experiment . The variability and individuality noted in the host response to potential pathogens have important implications for attempts to use such measures for establishing a diagnosis or prognosis for the individual patient.

J Endod, 1993 Jun, 19(6), 297 - 301
Migration of a Streptococcus sanguis strain through the root dentinal tubules; Perez F et al.; The persistent presence of bacteria in the root canal system often leads to the failure of treatment . The aim of this study was to study the in vitro penetration of root dentinal tubules by bacteria . Bovine dentin was inoculated with a strain of Streptococcus sanguis, NCTC 7863; samples were taken at 10, 20, and 28 days, and bacterial penetration of the tubules was demonstrated using two techniques, scanning electron microscopy and light microscopy after Brown and Brenn staining . The results showed that S . sanguis can penetrate deep inside the tubules (792 microns) . The maturity of the dentin blocks seems to be a major factor in tubule penetration.

Zentralbl Bakteriol, 1993 Jun, 279(2), 283 - 93
Erythrogenic toxin type A (ETA): epidemiological analysis of gene distribution and protein formation in clinical Streptococcus pyogenes strains causing scarlet fever and the streptococcal toxic shock-like syndrome (TSLS); Reichardt W et al.; Erythrogenic toxin type A (ETA) is assumed to play a causative role in both scarlet fever and the streptococcal toxic shock-like syndrome (TSLS) . For a molecular epidemiological analysis of the gene of erythrogenic toxin type A (speA) we used altogether 497 clinical isolates of Streptococcus pyogenes belonging to three groups: a) isolates from patients with scarlet fever, b) isolates from cases with TSLS, c) isolates from patients with other streptococcal infections (like otitis media, tonsillitis, impetigo) (general group) . We found that less than 50% of the scarlet fever-associated strains possessed the speA gene as compared to 25% of the general group . Only 5 to 30% of these strains secreted the toxin under experimental conditions in very low quantities . Among strains isolated from TSLS, 67% appeared to contain the speA gene . The amount of ETA secreted into the medium was also extremely low . Southern hybridization patterns proved to be the same with an speA-specific probe in all three groups of streptococcal isolates (HaeIII, HindIII) . Increased occurrence of the speA gene among scarlet fever and TSLS-associated strains does not seem to be sufficient to support the hypothesis that ETA may have a causative role in both diseases since a considerable number of strains in these groups did not possess the speA gene.

Vet Microbiol, 1993 Jun, 35(3-4), 275 - 84
Monitoring of resistant organisms in man and identification of their origin; Wiedemann B; Information on the epidemiology of bacterial resistance is fragmentary despite an enormous number of publications since the introduction of antibiotics to human medicine, and remains a field of speculation mixed and influenced by fear of the total collapse of antimicrobial chemotherapy by development of resistance (for review see Wiedemann et al., 1986) . Bacteria have evolved mechanisms to withstand the attack of antibiotics and, in parallel, mechanisms for the spread of these characters to other bacteria by means of exchange of genetic information . However the development of resistance cannot be generalized . Staphylococcus aureus gained penicillin resistance within a few years after the introduction of this drug, while Streptococcus pyogenes remains 100% susceptible to penicillin, despite of the long use of penicillins in huge quantities . Thus any statement about the development and epidemiology of resistance has to be addressed specifically to a drug, a bacterial species, and a location . Until now there is no identifiable general trend, which would allow us to deduce a general picture or a future development from a limited database . In this paper long term multicentre studies are presented to demonstrate the area of concern for the treatment of human infections . In this context it is of specific interest to try and trace the origin of bacteria which cause infections in humans.

AIDS Res Hum Retroviruses, 1993 Jun, 9(6), 553 - 63
Programmed cell death in AIDS-related HIV and SIV infections; Gougeon ML et al.; One of the difficulties in understanding the complex pathology of human immunodeficiency virus (HIV) infection is to explain the progressive depletion of the CD4 helper T cell population and consequently the destruction of the immune system . Although cytopathic effects of HIV are observed in vitro, they cannot in vivo account for CD4 T cell depletion because relatively few cells are productively infected . Thus immunological mechanisms must be envisaged . We have found that peripheral blood lymphocytes (PBLs) from asymptomatic HIV-infected individuals are primed for a suicide process known as apoptosis or programmed cell death (PCD) . DNA fragmentation characteristic of apoptosis was enhanced by stimulation of lymphocytes with ionomycin, a known inducer of apoptosis in suitably primed cells . Identification of the T cell subpopulations programmed for apoptosis indicated that both CD4+ and CD8+ cells died when cultured without stimulation or when polyclonally stimulated with ionomycin . Activation-induced cell death was also observed after stimulation with self-MHC class II-dependent superantigens, namely bacterial toxins from Staphylococcus (SEB), Streptococcus (ETA), and Myocoplasma (MAM) and under these conditions the CD4+ T cells were preferentially affected . To explore whether new macromolecular synthesis were required for apoptosis, various known inhibitors of apoptosis such as cycloheximide, cyclosporin A, Zn2+, or EGTA were tested . Activation-induced apoptosis was found sensitive to these inhibitors, indicating an active mechanism, but apoptosis observed in nonstimulated cultures was not, suggesting that these cells already contained the complete machinery for death . Prevention of apoptosis could be obtained in the presence of a mixture of cytokines and the minimal signal necessary for this prevention was IL-1 alpha and IL-2 . Finally, a correlation between PCD and AIDS-pathogenesis was suggested by the comparison of lymphocytes from lentivirus-infected primates suceptible (SIV-infected macaques) and resistant (HIV-infected chimpanzees) to AIDS . Altogether our results suggest that, during HIV or SIV infection, PCD may contribute in vivo to the deletion of reactive T cells after antigenic stimulation.

Br J Oral Maxillofac Surg, 1993 Jun, 31(3), 161 - 4
An in-vitro study of the comparative viability on different swab types of simulated specimens of bacteria commonly present in oro-facial infections; Smyth AG et al.; An in-vitro study was undertaken to investigate the survival on bacteriological swabs of three potentially pathogenic organisms found in oro-facial infections, by using simulated clinical specimens incubated in the presence or absence of Amies transport medium . Standard inocula of pure cultures of Streptococcus milleri, Prevotella melaninogenica and Peptostreptococcus anaerobius were soaked on to swabs and plated out on to solid media at various intervals up to 3 days, enabling an estimate of their viability to be made following further incubation . Differential survival of the three test organisms was observed, with Streptococcus milleri being generally the hardiest and Peptostreptococcus anaerobius the least hardy, whilst survival was consistently enhanced by the presence of a transport medium . Recovery of Prevotella melaninogenica was improved by incubation for 5 days . We conclude that transport swabs should be used in preference to plain swabs whenever immediate laboratory culture cannot be assured, to avoid loss of anaerobic bacteria.

J Dermatol Sci, 1993 Jun, 5(3), 182 - 9
Demonstration of antigen-specific immune response against Streptococcus sanguis; Ishii N et al.; The genetic control of Streptococcus sanguis antigen response was studied . Mice sensitized with inactivated S . sanguis organisms antigen-injected at the base of the tail developed footpad swelling . Those with an I-Ak,q,r region of H-2 showed a strong footpad response, whereas those with an I-Ab,d,s region showed a weak response to S . sanguis cell wall antigen . Footpad response was mediated by CD4+,8- T cells by using in vitro monoclonal antibody treatment . Similar evidence of genetic control was obtained with an in vitro T cell proliferation assay . However, quantitation of antibodies against S . sanguis showed that antibody production was not controlled by H-2 . These results indicated that both in vivo footpad swelling and in vitro T cell proliferation responses were functions of helper (CD3+,4+,8-) T cells and controlled by the I-A region of H-2.

Carbohydr Res, 1993 May 21, 244(1), 137 - 47
Essential amino acids involved in glucan-dependent aggregation of Streptococcus sobrinus; Singh JS et al.; The active site of the glucan-binding lectin (or agglutinin) (GBL) of Streptococcus sobrinus was probed by specific amino acid modifying reagents . Reagents specific for carboxylates, imidazolium, phenolic, and lysyl residues inactivated the cell bound GBL, whereas agents specific for sulfhydryl, disulfide, and guanidinium groups had no effect on the lectin . A low molecular weight alpha-(1-->6)-glucan provided partial protection against the reagents which inactivated the protein, whereas an alpha-(1-->4)-glucan, incapable of complexing with the lectin, afforded no protection . A reagent specific for tryptophan, 2-hydroxy-5-nitrobenzyl bromide (HNB) did not cause a loss of GBL activity, although N-bromosuccinimide, a reagent capable of oxidizing tryptophan and less selective than HNB, was a very effective inhibitor of the glucan-dependent cellular aggregation . In the latter case, alpha-(1-->6)-glucan did not protect . Hydroxylamine partially restored the loss of lectin activity due to treatment of the cells with N-acetylimidazole (highly specific for tyrosine), glycine methyl ester plus water-soluble carbodiimide (specific for carboxylates), and diethylpyrocarbonate (specific for histidine) . Because the soluble form of GBL rapidly loses activity when purified, it was necessary to perform the chemical modification of the amino acid side chains employing the cell-bound form of the lectin . Because specific ligand {alpha-(1-->6)-glucan} protected against the inactivation of the agglutinin by selected reagents and because lectin activity could be restored in some cases, it was possible to identify likely essential amino acid residues needed for glucan binding . The results, taken together, suggest that aspartic (and/or glutamic) acid, histidine, lysine, and tyrosine are critical amino acids responsible for agglutinin activity . Present efforts are directed to the design and synthesis of glucan analogues which may serve as affinity inactivating agents of the lectin . Such glucan derivatives may be of value in studies on the role of the lectin in cariogenesis.

J Immunol, 1993 May 15, 150(10), 4407 - 15
A functional analysis of the antigenicity of streptokinase using monoclonal antibody mapping and recombinant streptokinase fragments; Reed GL et al.; Streptokinase (SK), a bacterial product of pathogenic Streptococcus species, is now widely used as an effective therapy for the treatment of heart attacks . Because naturally occurring antibody to SK is ubiquitous, serious allergic reactions to SK therapy are common . To begin to identify regions of the molecule that are important for the antigenicity of SK we performed studies using a panel of 51 hybridomas producing anti-SK antibodies, recombinant SK fragments, and assays of SK activity . Antibodies generated from mice hyperimmunized with wild-type SK were shown to fall into six distinct complementation groups by competitive binding studies . Recombinant SK fragments were used to determine the peptide regions recognized by these complementation groups . Correlation of the effects of the mAb on SK function, with knowledge of their SK fragment-binding pattern, suggested regions of the SK molecule that are important for the construction and the catalytic function of the SK-plasminogen activator complex.

J Infect Dis, 1993 May, 167(5), 1131 - 7
Ethanol impairs neutrophil chemotaxis in vitro but not adherence or recruitment to lungs of rats with experimental pneumococcal pneumonia; Lister PD et al.; The effect of 7 days of ethanol ingestion on circulating neutrophil (PMNL) counts and PMNL adherence, chemotaxis, and recruitment was investigated . Pair-feeding of rats resulted in a significant decrease in PMNL counts in both ethanol-fed and control rats . The mean number of PMNL exhibiting chemotaxis in a modified Boyden chamber in response to lipopolysaccharide-activated normal rat serum was significantly decreased in ethanol-fed rats compared with controls . The percentage of adherence to nylon wool columns, however, was similar in both groups . To measure pulmonary PMNL recruitment, rats were infected transtracheally with 10(5) Streptococcus pneumoniae and sacrificed . Bronchoalveolar lavage fluid from both groups contained similar numbers of PMNL 8 h after infection . By 24 h, PMNL numbers in lavage fluid from ethanol-fed rats exceeded those in controls . PMNL recruitment continued in the ethanol-fed rats at 48 and 72 h, whereas values in controls had returned to baseline . Thus, the impaired pulmonary defense against S . pneumoniae in ethanol-fed rats is not due to defective PMNL recruitment.

Antimicrob Agents Chemother, 1993 May, 37(5), 1158 - 9
In vitro susceptibility of Streptococcus mutans to chlorhexidine and six other antimicrobial agents; Jarvinen H et al.; The susceptibility of Streptococcus mutans to chlorhexidine and to six commonly used, systemic antibacterial agents (amoxicillin, cefuroxime, penicillin, sulfamethoxazole-trimethoprim, tetracycline, and erythromycin) was studied for 424 clinical isolates from 116 children and students . The MIC of chlorhexidine for all isolates was < or = 1 micrograms/ml . No resistance to the other antimicrobial agents was detected . Although widely exposed to various antimicrobial agents, S . mutans has remained susceptible to common antimicrobial agents, most importantly to chlorhexidine.

Mol Gen Genet, 1993 May, 239(1-2), 77 - 80
The role of penicillin-binding protein 3 (PBP 3) in cefotaxime resistance in Streptococcus pneumoniae; Selakovitch-Chenu L et al.; A pneumococcal strain, with a reduced amount of penicillin-binding protein 3 (PBP 3), permitted an analysis of the role of this protein in cefotaxime resistance . We observed that reduced amounts of PBP 3 sensitize the bacteria to high temperature, to excess glycine and to some D-amino acids . These phenotypes suggest that the amount of PBP 3 may influence the membrane properties of the bacteria . The strain with reduced PBP 3 was transformed to cefotaxime resistance . We show that the PBP 3 mutation, in certain genetic backgrounds, decreases the level of resistance to cefotaxime by a factor of 2 . Models are presented to explain this result.

Mol Gen Genet, 1993 May, 239(1-2), 188 - 95
Cloning and sequencing of a gene involved in the synthesis of the capsular polysaccharide of Streptococcus pneumoniae type 3; Garcia E et al.; A 4.5 kb ScaI chromosomal DNA fragment of a clinical isolate of Streptococcus pneumoniae serotype 3 was cloned in Escherichia coli . Combined genetic and molecular analyses have allowed the localization, in a 781 bp EcoRV subfragment, of a gene (cap3-1) directly responsible for the transformation of an unencapsulated, serotype 3 mutant to the capsulated phenotype . Comparison of the deduced amino acid sequence of CAP3-1 with the protein sequences compiled in the data banks revealed that the CAP3-1 polypeptide was highly similar to the amino-terminus of the GDP-mannose dehydrogenase of Pseudomonas aeruginosa, an enzyme that participates in the synthesis of the mucoid polysaccharide of this species . In addition, the 32 N-terminal amino acids of CAP3-1 perfectly matched structures common to NAD(+)-binding domains of many dehydrogenases . Our results indicate that the 4.5 kb ScaI fragment might also contain genes common to 13 different pneumococcal serogroups or serotypes tested . To the best of our knowledge, this is the first time that a gene of the capsular complex of S . pneumoniae has been cloned and sequenced . The findings reported here provide new insights for the study of the molecular biology of the main virulence factor responsible for the pathogenesis of pneumococcal infections and might represent a basic step in the identification of cross-reactive antigens that should allow the preparation of new and improved vaccines.

J Dent Res, 1993 May, 72(5), 907 - 11
Effects of pH, potassium, magnesium, and bacterial growth phase on lysozyme inhibition of glucose fermentation by Streptococcus mutans 10449; Wang YB et al.; The effects of physiological (saliva and plaque fluid) concentrations of potassium and magnesium and growth phase on lysozyme inhibition of glucose fermentation by S . mutans 10449 were investigated . Glucose fermentations were carried out in a pH-stat at pH 7.0 or 5.5 . Cells were at least two times more sensitive to lysozyme in the early-to-middle exponential phase compared with the stationary phase . S . sobrinus 6715 exhibited three-fold greater lysozyme resistance than S . rattus BHT or S . mutans 10449 . The concentration of potassium which reduced lysozyme inhibition of S . mutans 10449 fermentation by 50% was 0.2 and 10 mmol/L for stationary and exponential phase cells, respectively . Corresponding values for magnesium were < or = 0.01 and 0.50 mmol/L . Potassium and magnesium exhibited little pH dependence in their reduction of lysozyme inhibition of fermentation by exponential- or stationary-phase S . mutans 10449 . The results suggest that: (i) lysozyme interaction with stationary-phase cells involves more non-inhibitory modes than with exponential-phase cells, and (ii) lysozyme may be more effective as an antibacterial agent in saliva than in plaque fluid.

J Dent Res, 1993 May, 72(5), 858 - 64
Simultaneous caries induction and calculus formation in rats; Tanzer JM et al.; Weanling specific pathogen-free Osborne-Mendel rats were fed a high-calcium, high-phosphorus diet with various levels of sucrose and inoculated with Streptococcus sobrinus strain 6715-13WT and Actinomyces viscosus strain OMZ-105 in order to determine whether calculus and caries could develop simultaneously . Rats consumed diets designated RC-16-5, RC-16-25, or RC-16-50 which partially replaced the corn starch component with progressively higher levels of sucrose, thus, to 5, 25, or 50% sucrose . In general, bacterial recoveries of A . viscosus declined with higher sucrose content of the diet, but a pattern of recovery for S . sobrinus was less clear with respect to dietary sucrose . S . sobrinus, however, was recovered at higher percentages from the tooth surface flora at the later two of three sampling dates . Most calculus--identified by the brittle quality, staining characteristics, and apatitic x-ray diffraction patterns of tooth surface deposits--was formed on the maxillary molars, and most carious lesions occurred on mandibular molars . While there was minimal association of the calculus score with the amount of sucrose in the diet, calculus scores increased greatly from 23 to 43 days after infectious challenge . Caries scores, of both fissure and smooth surfaces, by contrast, increased in a dose-response fashion with increasing dietary sucrose and with time . It is thus possible to induce calculus formation and caries simultaneously in specific pathogen-free Osborne-Mendel rats consuming a high-calcium and -phosphorus diet conducive to calculus formation and containing sucrose.(ABSTRACT TRUNCATED AT 250 WORDS)

J Clin Microbiol, 1993 May, 31(5), 1127 - 35
Isolation of gram-positive rods that resemble but are clearly distinct from Actinomyces pyogenes from mixed wound infections; Wust J et al.; Beginning in 1990, gram-positive rods resembling Actinomyces pyogenes were found with increasing frequency in mixed cultures from various infectious processes, most of them from patients with otitis, empyema, pilonidal cysts, perianal abscesses, and decubitus ulcers . Ribotyping and hybridization showed that these gram-positive rods could be divided into five groups not related to known Actinomyces species . Biochemical markers for reliable differentiation into these groups, however, could not be found . Therefore, naming new species is not warranted unless parameters are discovered that allow identification without DNA hybridization . These gram-positive rods have been isolated only in mixed cultures with anaerobes, Staphylococcus aureus, Streptococcus "milleri," enterococci, and gram-negative rods . Their exact role in these possibly synergistic infections needs further investigation.

Cornea, 1993 May, 12(3), 266 - 9
Recurrent corneal infections in a patient with the acquired immunodeficiency syndrome; Hemady RK et al.; A 29-year-old female intravenous drug abuser infected with the human immunodeficiency virus suffered recurrent, bilateral corneal infections over an 11-month period . Multiple infectious organisms were responsible, including capnocytophaga species, Candida albicans, Staphylococcus aureus, coagulase-negative staphylococcus, and a-streptococcus . One eye was eviscerated because of corneal perforation and loss of vision; the second eye has maintained good vision . Predisposing factors usually associated with corneal infections were absent . Treatment was complicated by extremely poor patient compliance, ongoing intravenous drug abuse, and concurrent multiple extraocular medical problems.

J Pharmacol Exp Ther, 1993 May, 265(2), 795 - 800
Arsenic in the sera of gallium arsenide-exposed mice inhibits bacterial growth and increases host resistance; Burns LA et al.; The objective of the present investigations was to evaluate whether the presence of gallium arsenide (GaAs) in the sera of exposed mice was sufficient to retard bacterial growth . Host resistance studies demonstrated that exposure of GaAs (50-200 mg/kg) produced an increased resistance to Streptococcus pneumoniae and Listeria monocytogenes (50-100 mg/kg GaAs) when microbial challenge occurred 24 hr after exposure . In contrast, exposed mice exhibited a profound and dose-related decrease in resistance to the B16F10 melanoma . Serial dilutions of GaAs (0.039-5 mg/ml) were added to BHI broth and cultures were innoculated with either S . pneumoniae or L . monocytogenes . GaAs slowed the growth of both organisms with a minimal inhibitory concentration (MIC) of 0.625 mg/ml . Sera from mice euthanized at various time intervals after exposure to vehicle (0.05% Tween 80 in saline) or GaAs (200 mg/kg) was also capable of retarding the growth of both organisms with the maximal inhibition noted for euthanization 24 hr after exposure . However, sera from GaAs-exposed mice (24 hr after exposure) was incapable of slowing the growth of the B16F10 melanoma . Addition of the arsenic-binding compound meso-2,3-dimercaptosuccinic acid (100 microM) to sera from mice exposed to GaAs followed by innoculation with L . monocytogenes resulted in growth of this organism, which was comparable to growth observed in vehicle cultures.(ABSTRACT TRUNCATED AT 250 WORDS)

J Periodontal Res, 1993 May, 28(3), 173 - 9
Characterization of hemolytic bacteria in subgingival plaque; Hillman JD et al.; Three-quarters of the patients with periodontal diseases surveyed in this study had one or more distinct types of hemolytic bacteria in their subgingival plaque . Twelve different species of bacteria were identified, belonging to five genera (Actinomyces, Streptococcus, Staphylococcus, Prevotella, and Actinobacillus) . Nine hemolytic isolates, consisting of four Prevotella denticola strains, two Actinomyces naeslundii genospecies 2 strains, and one each of P . melaninogenica, Streptococcus constellatus, and A . naeslundii genospecies 1 strains were characterized . Incorporation of pronase into blood agar medium inhibited hemolysis by all of the isolates, suggesting a proteinaceous component for each of their hemolysins . With one exception, hemolysin production appeared to be regulated by the concentration of environmental iron: exogenous hemin was found to inhibit hemolysin production, and the iron scavenging compound, 2,2'- dipyridyl, was found to promote hemolysin production by all of the strains except for the S . constellatus isolate . Genomic libraries of each of the hemolytic plaque isolates were prepared in Escherichia coli using pBR322 . Hemolytic clones were isolated on blood agar medium containing ampicillin at frequencies ranging from 1-6.7 x 10(-4) . Extensive restriction mapping revealed regions of homology in the case of clones derived from three P . denticola strains isolated from the same subjects . Two of the P . denticola-derived clones were virtually identical throughout the entrety of their > 5 Kb inserts . The clone derived from the third strain showed good homology to the other two within a 1.3 Kb region, but the flanking DNA showed no homology even though all three P . denticola isolates were shown to be clonally related by ribotyping.(ABSTRACT TRUNCATED AT 250 WORDS)

J Pediatr, 1993 May, 122(5 Pt 1), 774 - 9
Hyperimmune human IgG or recombinant human granulocyte-macrophage colony-stimulating factor as adjunctive therapy for group B streptococcal sepsis in newborn rats; Givner LB et al.; Group B streptococcus (GBS) continues to cause considerable morbidity and death in newborn infants despite the use of antibiotics . We investigated the use of adjunctive therapies to be used with antibiotics in the treatment of neonatal sepsis, using a neonatal rat model of established GBS disease . After the development of GBS bacteremia, a human IgG preparation hyperimmune for GBS, administered with penicillin, decreased the mortality rate compared with the use of penicillin alone (14% vs 57%; p = 0.02) . Similarly, recombinant human granulocyte-macrophage colony-stimulating factor, administered in a range of doses to animals with bacteremia, decreased mortality rates . The greatest effect was noted at a dose of 0.05 micrograms/kg (mortality rate 39% in combination with penicillin vs 76% for penicillin alone; p < 0.0001) . Thus adjunctive therapies such as those studied here may have the potential to improve the outcome of neonatal sepsis.

J Bacteriol, 1993 May, 175(10), 2844 - 52
Cloning and sequencing of the low-affinity penicillin-binding protein 3r-encoding gene of Enterococcus hirae S185: modular design and structural organization of the protein; Piras G et al.; The clinical isolate Enterococcus hirae S185 has a peculiar mode of resistance to penicillin in that it possesses two low-affinity penicillin-binding proteins (PBPs): the 71-kDa PBP5, also found in other enterococci, and the 77-kDa PBP3r . The two PBPs have the same low affinity for the drug and are immunochemically related to each other . The PBP3r-encoding gene has been cloned and sequenced, and the derived amino acid sequence has been compared by computer-assisted hydrophobic cluster analysis with that of the low-affinity PBP5 of E . hirae R40, the low-affinity PBP2' of Staphylococcus aureus, and the PBP2 of Escherichia coli used as the standard of reference of the high-M(r) PBPs of class B . On the basis of the shapes, sizes, and distributions of the hydrophobic and nonhydrophobic clusters along the sequences and the linear amino acid alignments derived from this analysis, the dyad PBP3r-PBP5 has an identity index of 78.5%, the triad PBP3r-PBP5-PBP2' has an identity index of 29%, and the tetrad PBP3r-PBP5-PBP2'-PBP2 (of E . coli) has an identity index of 13% . In spite of this divergence, the low-affinity PBPs are of identical modular design and possess the nine amino acid groupings (boxes) typical of the N-terminal and C-terminal domains of the high-M(r) PBPs of class B . At variance with the latter PBPs, however, the low-affinity PBPs have an additional approximately 110-amino-acid polypeptide stretch that is inserted between the amino end of the N-terminal domain and the carboxy end of the membrane anchor . While the enterococcal PBP5 gene is chromosome borne, the PBP3r gene appears to be physically linked to the erm gene, which confers resistance to erythromycin and is known to be plasmid borne in almost all the Streptococcus spp . examined.

J Infect Dis, 1993 May, 167(5), 1232 - 5
Direct inoculation of food as the cause of an outbreak of group A streptococcal pharyngitis; Farley TA et al.; An investigation was conducted of a food-related outbreak of group A streptococcal pharyngitis following an elementary school banquet . Of 166 surveyed banquet attendees, 71 (43%) reported outbreak-associated pharyngitis, and 21 (88%) of 24 tested attendees had evidence of group A streptococcus (GAS) in the throat . Attendees who ate macaroni and cheese were three times more likely to develop pharyngitis than those who did not (66/132 {50%} vs . 5/30 {17%}, P = .002) . None of the food handlers had GAS recovered by throat culture . However, the cook who prepared the macaroni and cheese had a hand wound; a wound culture grew GAS with the same T agglutination pattern and M- and/or opacity factor type as that of all available GAS strains from ill attendees . Under laboratory conditions, macaroni and cheese supported rapid growth of the outbreak-associated strain of GAS . To the authors' knowledge, this is the first documented foodborne outbreak of GAS pharyngitis in which the only apparent source of contamination was a food handler's skin lesion.

J Infect Dis, 1993 May, 167(5), 1118 - 22
Prevention of group B streptococcal colonization and bacteremia in neonatal mice with topical vaginal inhibitors; Cox F et al.; Pregnant Swiss-Webster mice were vaginally inoculated with 10(5) virulent and avirulent serotype III Streptococcus agalactiae and treated 4 days later with topical vaginal inhibitor solutions . Preparations containing lipoteichoic acid (LTA) or glycerophosphate (GP), the repeating linear backbone of LTA, significantly reduced neonatal colonization and bacteremia by the virulent isolate and colonization by the avirulent strain . Similar results were obtained if bacteria were preincubated with LTA or GP at 37 degrees C for 30 min before vaginal inoculation . Human serum albumin (HSA), a known inhibitor of binding of LTA to human fetal epithelial cells, also resulted in reduction in colonization and bacteremia of neonatal mice . However, maternal treatment with a combination of HSA (2%) and GP (1%) completely prevented neonatal colonization and bacteremia without altering the normal aerobic bacterial vaginal flora . These results provide impetus to the development of an alternative means of preventing neonatal group B streptococcal infections in humans without requiring maternal immunization or chemoprophylaxis.

Arch Otolaryngol Head Neck Surg, 1993 May, 119(5), 521 - 4
Peritonsillar abscess . Clinical and microbiologic aspects and treatment regimens; Savolainen S et al.; This prospective study shows that acute peritonsillar abscess can be successfully treated by three-point puncture and aspiration . The results (recurrence in 19%) are comparable with published data on drainage of the peritonsillar space through the incision procedure . By proper selection of patients, the rate of recurrences can be further reduced . Because the occurrence of Streptococcus pyogenes in the aspirate seems to be associated with a favorable prognosis of therapy with puncture and antibiotics only, testing for the presence of this bacterial species might give a useful clue to the type of treatment needed . If the bacterial culture shows mixed aerobic and anaerobic flora, but not S pyogenes, and if the patient has a history of recurrent tonsillitis, incision or proceeding directly to tonsillectomy may be the best therapeutical choice.

Am Rev Respir Dis, 1993 May, 147(5), 1080 - 6
Effect of inhaled nitric oxide during group B streptococcal sepsis in piglets; Berger JI et al.; Group B streptococcus (GBS), a common gram-positive pathogen, causes similar pathophysiologic changes in newborn humans and animals . Infusion of GBS into neonatal animals produces pulmonary hypertension and ventilation/perfusion (Va/Q) mismatch in both early-phase (< 1 h) and late-phase (2 to 6 h) responses . Contrary to early phase, late phase causes pulmonary vascular injury . Nitric oxide (NO) is an inhaled vasodilator whose effect on pulmonary hypertension and Va/Q matching during early and late phases of GBS sepsis is unclear . We hypothesized that inhaled NO (150 ppm) would: (1) reverse early-phase GBS-induced pulmonary hypertension; (2) demonstrate less effectiveness in reversing late-phase GBS-induced pulmonary hypertension because of vascular injury; (3) improve late-phase GBS-induced Va/Q mismatching . Anesthetized, mechanically ventilated piglets (n = 10; 14 +/- 4 days of age) received a 240-min infusion of GBS (1.5 x 10(9) CFU/kg/h) . Piglets received 30 min of NO (Study) or N2 (Control) at 30 and 210 min of GBS infusion . We found that inhaled NO selectively reversed early- and late-phase GBS-induced pulmonary hypertension and that NO was equally as effective in each phase . Inhaled NO did not reverse Va/Q mismatching during late-phase GBS . We conclude that 4 h of GBS sepsis does not injure neonatal pulmonary vascular smooth muscle sufficiently to impair its response to inhaled NO.

Am Heart J, 1993 May, 125(5 Pt 1), 1353 - 7
A new model for infective endocarditis of the mitral valve in rabbits; Imataka K et al.; To produce an experimental model of infective endocarditis without inserting catheters into the heart, we injected a bacterial suspension into rabbits in which mitral complex lesions had been induced by electrical stimulation of the cervical vagus . Typical infective vegetations grew on the surface of the mitral valves 1 week later . The formation of vegetations was related to the timing of the inoculation . Streptococcus viridans injected just after vagal stimulation produced vegetations in 10 of 17 animals (58.8%), but the same bacteria injected 14 days after vagal stimulation did so in only 2 of 11 animals (18.2%) . The incidence of infective endocarditis was significantly higher after early inoculation compared with delayed inoculation (p < 0.01) . The susceptibility to infection depended on the species of bacteria injected . Both S . viridans and Pseudomonas pseudoalkaligenes injected just after vagal stimulation produced vegetations in 10 of 17 (58.8%) and 6 of 13 (46.2%) animals, respectively, but Staphylococcus epidermidis injected just after vagal stimulation did not produce vegetations in any of the 10 animals . S . viridans injected into nine normal animals never produced vegetations . These findings indicate that infective endocarditis develops after intravenous injection of bacterial suspensions alone in rabbits with mitral complex lesions.

J Gen Microbiol, 1993 May, 139 ( Pt 5), 929 - 35
Biochemical properties of Streptococcus sobrinus reisolates from the gastrointestinal tract of a gnotobiotic rat; Willcox MD et al.; Streptococcus sobrinus strain 6715-13-201 was inoculated into the oral cavity of a gnotobiotic rat and then reisolated from different portions of the gastrointestinal tract . Fourteen isolates, selected on the basis of their colonial morphology, were then screened for their ability to adhere to saliva-coated hydroxyapatite (SHA) in vitro, and their ability to produce extracellular polysaccharide from sucrose, and low pH in glucose broth . Certain isolates were also tested for their cariogenic potential as monoinfectants in gnotobiotic rats . All isolates differed in their abilities to adhere to SHA, with most showing an increased level of adhesion in the presence of sucrose, but this did not correlate with their ability to be aggregated by dextran . Most isolates were capable of producing glucosyltransferases (with only one exception) and dextranases (also one exception) . There was more variability in the production of dextranase inhibitor . No isolate was capable of producing dextranase inhibitor in the absence of dextranase production . There were no correlations between the ability of isolates to adhere in vitro or produce/utilize polysaccharides and their ability to produce caries in vivo . Due to the differences between strains in their abilities to adhere, produce polysaccharides, utilize polysaccharides or produce a low pH and the lack of correlation between any of these parameters and cariogenicity, the results suggest that the ability of strains to colonize and produce caries depends on a number of different characteristics, no one of which is essential.

J Gen Microbiol, 1993 May, 139 ( Pt 5), 913 - 20
The ftf gene encoding the cell-bound fructosyltransferase of Streptococcus salivarius ATCC 25975 is preceded by an insertion sequence and followed by FUR1 and clpP homologues; Giffard PM et al.; Analysis of the region downstream of the ftf gene of Streptococcus salivarius led to the detection of two open reading frames (ORFs) . The deduced amino acid sequences of these ORFs were homologous to proteins encoded by genes not previously described and/or sequenced in Gram-positive bacteria . The deduced amino acid sequence of the first of these (orf2) showed strong homology to the product of the FUR1 gene of Saccharomyces cerevisiae, which codes for a uracil phosphoribosyltransferase . The over-expression of the product of this gene appeared to be the source of the detrimental effect observed with phagemids carrying orf2 in Escherichia coli hosts . The deduced amino acid sequence of the second ORF (orf3) was homologous to the ClpP family of proteases . Examination of the upstream region of the ftf gene led to the discovery of a new insertion sequence-like element which has been designated IS1161.

Chemotherapy, 1993 May-Jun, 39(3), 163 - 8
In vitro killing kinetics and postantibiotic effect of josamycin and other macrolides on several bacteria; Minguez F et al.; The antimicrobial activity {minimal inhibitory concentration (MIC) and killing kinetics} and postantibiotic effect (PAE) of different concentrations (MIC and 10 x MIC) of josamycin, erythromycin, midecamycin and azithromycin on Streptococcus pneumoniae, Staphylococcus aureus and Escherichia coli were studied in vitro . The MIC and killing kinetics were determined by standard methods . The PAE was measured after 1 h exposure to the drugs, which were removed by diluting the culture 1,000-fold . All tested macrolides had their lowest MIC against S . pneumoniae, and the most active against S . aureus was josamycin . In killing kinetics, using 10 x MIC, the macrolides exhibited a bactericidal effect against S . pneumoniae and E . coli, with reductions of 3 log10 in colony-forming units per milliliter with respect to the initial inoculum, while a bactericidal effect was not observed for S . aureus . The PAEs were concentration dependent, the greatest PAEs being obtained with S . pneumoniae . Although lower, the PAEs induced on E . coli were significant when high concentrations of the drug were tested . The assayed macrolides showed both more activity and PAEs on S . pneumoniae.

J Endod, 1993 May, 19(5), 232 - 5
Effects of the XeCl excimer laser on Streptococcus mutans; Stabholz A et al.; The effect of XeCl excimer laser irradiation on the growth of Streptococcus mutans in liquid media and on agar plates was studied . Bacterial suspensions of S . mutans were placed in 96 wells of well culture plates . The contents of 72 wells (three experimental groups of 24 wells each) were lased for different time durations (2, 4, and 8 s) . The remaining 24 wells were left unlased to be used as controls . Samples were withdrawn from all wells and examined for surviving bacteria . In addition, blood agar plates were inoculated with S . mutans and were lased with different energy densities (fluences) . Zones of bacterial inhibition were measured . Analysis of variance test was used to determine statistical differences . The bactericidal effect of the laser applications was directly related to the amount of radiation time . Laser irradiation for 4 and 8 s resulted in bactericidal effect that was statistically significant compared with no treatment or to 2-s exposure . The effect of different energy levels was studied by irradiating inoculated blood agar plates . The zones of inhibition produced by higher energy levels (0.5 J/cm2, 0.7 J/cm2, and 1.0 J/cm2) were larger in comparison to the lowest fluence used (0.1 J/cm2) . Application of the laser to the surface of the agar plates produced an indentation with a surrounding halo . The indentations and the zones of inhibition were more pronounced as the fluences increased . Based on our results it appears that the XeCl 308-nm excimer laser can kill S . mutans . This effect should be tested on other bacteria commonly present infected root canals.

Br J Haematol, 1993 May, 84(1), 95 - 100
Mechanisms of platelet aggregation by Streptococcus sanguis, a causative organism in infective endocarditis; Ford I et al.; The ability of certain strains of Streptococcus sanguis to aggregate human platelets in vitro may be related to their virulence in the pathogenesis of infective endocarditis . We have studied the mechanisms of aggregation of human platelets by S . sanguis strain NCTC 7863 . Platelet aggregation follows incubation of S . sanguis cells with platelet-rich plasma from normal, healthy adults, after a lag of 7-19 min . Platelet aggregation was accompanied by 5-hydroxytryptamine release and thromboxane B2 production . Aggregation was prevented by aspirin and by EDTA . Platelets from two patients with Glanzmann's thrombasthenia did not respond to bacteria . Fixed, washed platelets resuspended in normal plasma were not agglutinated by S . sanguis . Blocking the glycoprotein Ib receptor with a monoclonal antibody inhibited aggregation of PRP . However, S . sanguis did not induce von Willebrand factor (vWF) binding to platelets; nor did the bacteria prevent ristocetin-induced platelet agglutination or vWF binding . The aggregation response was not related to plasma vWF activity levels in normal subjects or in patients with von Willebrand's disease . The platelet response to S . sanguis therefore resembles true aggregation, requiring the cyclo-oxygenase pathway and the presence of glycoprotein IIb/IIIa . The mechanism also involves glycoprotein Ib, but not apparently through irreversible binding of vWF.

J Gen Microbiol, 1993 May, 139 ( Pt 5), 921 - 7
Isolation, characterization and sequence analysis of the scrK gene encoding fructokinase of Streptococcus mutans; Sato Y et al.; A gene encoding an ATP-dependent fructokinase from Streptococcus mutans GS-5 was identified within a 2 kb DNA fragment immediately downstream from the scrA gene . The gene cloned in Escherichia coli also expressed mannokinase activity . Insertional inactivation of this gene in S . mutans markedly decreased both fructokinase and mannokinase activities . Nucleotide sequence analysis of the 2 kb fragment revealed an ORF starting 199 bp downstream from the scrA gene, preceded by potential ribosome-binding (Shine-Dalgarno) and promoter-like sequences . This ORF specified a putative protein of 293 amino acids with a calculated M(r) of 31,681 . The deduced amino acid sequence of the fructokinase gene, scrK, from S . mutans exhibited no significant similarity to fructokinase genes from Klebsiella pneumoniae, E . coli plasmid pUR400 or Vibrio alginolyticus, but was similar to a comparable gene from Zymomonas mobilis.

J Antimicrob Chemother, 1993 May, 31 Suppl D, 55 - 60
The mouse peritonitis model: present and future use; Frimodt-Moller N; The mouse peritonitis model was the first experimental animal model to be used in antibiotic research in 1935, where it proved the effect of Prontosil and derivative sulphonamides against Streptococcus pyogenes in vivo . Since then the mouse peritonitis model has been a natural step in testing antibiotics in vivo before moving to larger animals or humans . Only a few bacteria are naturally virulent to mice, e.g . Streptococcus pneumoniae, but the mice can be rendered susceptible to most human pathogens by inhibition of one or more parts of the natural defence of the animals . For measuring the effect of antibiotics two parameters are usually considered: bacterial counts in fluids or tissues, or death/survival of the animal . Both parameters have flaws, but death is usually used, owing to the ease of observation and quantification by calculation of the 50% effective (protective or curative) doses . With these parameters a number of significant factors of importance for antibiotic effect have been detected or proven in this model . Together with the recent insight into the correlation of pharmacokinetic behaviour between these small animals and man, it is predicted that the mouse peritonitis model will continue to be an important means of studying the effect of antibiotics in vivo.

Nihon Kyobu Shikkan Gakkai Zasshi, 1993 May, 31(5), 636 - 42
{Spontaneously healed P . carinii pneumonia in the course of steroid therapy for interstitial pneumonia--many trophozoites in bronchoalveolar lavage}; Sato S et al.; A case in which P . carinii was observed in bronchoalveolar lavage fluid during steroid therapy for interstitial pneumonia in a 63-year-old man is reported, he had received steroid therapy for interstitial pneumonia of unknown origin . Three weeks later, he developed acute pneumonia with Streptococcus pneumoniae, and simultaneously P . carinii was detected in the bronchoalveolar lavage fluid . Both the pneumonic shadows and P . carinii disappeared following intravenous infusion of penicillin and rapid reduction of steroid . Electron microscopic analysis of P . carinii demonstrated numerous tubular expansions and endogenies of P . carinii, suggesting that P . carinii was growing in the intra-alveolar spaces . Phospholipid analysis demonstrated a transient increase in total phospholipid content during P . carinii pneumonia, suggesting that P . carinii can affect surfactant metabolism.

Pediatr Infect Dis J, 1993 May, 12(5), 368 - 71
Outbreak of pyogenic abscesses after diphtheria and tetanus toxoids and pertussis vaccination; Simon PA et al.; Nine children who received diphtheria and tetanus toxoids and pertussis vaccine from the same vial at a clinic in Colorado developed pyogenic abscesses at the site of injection . Eight abscesses required surgical drainage and five children were hospitalized . Group A Streptococcus (GAS) was cultured from eight wounds and Staphylococcus aureus was also isolated from four . Epidemiologic investigation revealed that within the hour of the first child's vaccination, three children had been diagnosed in the clinic with GAS pharyngitis . GAS recovered from repeat throat swabs from two of these children and the eight case-isolates were all serotype M-12, T-12 and had identical immunoblot patterns on sodium dodecyl sulfate-polyacrylamide gel electrophoresis . Laboratory simulation studies demonstrated that GAS can survive for at least 4 days on the external surface of a vaccine vial rubber stopper and contaminate needles inserted through the stopper . Swabbing the stopper with 70% isopropyl alcohol resulted in effective disinfection . To prevent potential contamination meticulous attention to sterile technique is important when withdrawing vaccine from multidose vaccine vials.

Enferm Infecc Microbiol Clin, 1993 May, 11(5), 255 - 9
{Treatment with vancomycin of experimental endocarditis caused by Streptococcus sanguis II resistant to penicillin}; Martinez F et al.; BACKGROUND: Streptococcus viridans continues to be the most frequent causal agent of infective endocarditis . Treatment has become more complicated due to the increase in resistance to penicillin and cephalosporins . In order to study the possible efficacy of vancomycin, this antibiotic was investigated in rabbits as a monotherapy and in association with gentamicin . The effects were compared with a control group and a group given classical penicillin-gentamicin treatment . MATERIAL AND METHODS: Minimum inhibitory concentration, minimum bactericidal concentration, lethality curves and synergism were determined against Streptococcus sanguis II . Infective endocarditis was induced in 80 rabbits, which were infected via catheter . Treatment was started 48 hours after infection, and lasted 5 days . The animals were divided into 4 groups of 20 rabbits each: 1, untreated controls; 2, penicillin-gentamicin; 3, vancomycin; 4, vancomycin-gentamicin . Response to therapy was evaluated with mortality curves, negativization of blood cultures, concentration of Streptococcus sanguis II in aortic vegetations, rate of sterilization of vegetations, body weight and serum bactericidal capacity . RESULTS: Vegetations weight was significantly lower in treated groups than in controls; lower weights were found in groups 2 and 4 . The lowest vegetation weight was recorded in group 4, the only treatment that sterilized 75% of vegetations . Death occurred only in the control group (10%) . Negativization of blood cultures was greatest and most rapid in group 4 . Serum bactericidal capacity was greater after the two combined treatments, and highest in group 4 . CONCLUSIONS: Combined treatment with vancomycin-gentamicin may be highly efficacious in patients with endocarditis caused by penicillin-resistant Streptococcus viridans.

Exp Lung Res, 1993 May-Jun, 19(3), 299 - 314
Factors that influence the suppression of pulmonary antibacterial defenses in mice exposed to ozone; Gilmour MI et al.; Exposure to ozone (O3) has been shown to increase susceptibility of mice to bacterial infection; however, the underlying mechanism has not been well elucidated . This study investigated the effect of O3 exposure on the ability of mice to combat an infectious challenge of Streptococcus zooepidemicus . Following a 3-h exposure to either air, 0.4 ppm O3, or 0.8 ppm O3, 5- and 9-week-old mice received an aerosol infection of bacteria . Intrapulmonary killing of the bacteria was impaired in the O3-exposed mice . The effect was most severe at the higher dose of O3 in the younger mice, and showed good correlation to subsequent mortality assessed over a 20-day period . Alveolar macrophages (AM) from O3-exposed mice had an impaired ability to phagocytose the bacteria . Additionally, prostaglandin E2 (PGE2) levels, which are known to depress AM function, were increased in the bronchoalveolar lavage fluid of the younger mice following exposure to O3, while pretreatment with indomethacin in the drinking water blunted the increased of PGE2 and reduced O3 enhanced mortality from 53 to 33% . The data show that O3 inhalation can reduce the defensive capability of the murine lung and that this is associated with a reduction in AM phagocytosis . The defect is more marked in young mice, suggesting that they may be more susceptible to oxidant exposure . Further studies are required to distinguish between direct toxicity of O3 on the AM and indirect suppression due to modulation of pharmacologic or inflammatory mediators.

Am J Vet Res, 1993 May, 54(5), 798 - 804
Radiotelemetry temperature responses of mammary gland and body to intramammary injection of Escherichia coli endotoxin or Streptococcus agalactiae in lactating dairy cows; Lefcourt AM et al.; To investigate the feasibility of using changes in body or mammary temperature to detect mastitis, radiotransmitters were implanted midway between rear udder quarters and in the peritoneal cavity of 5 Holstein cows (1 to 3 months in lactation) housed in an environmental chamber (16 +/- 2 C; lights on 7:00 AM to 11:00 PM) . After a 6-week control period, Escherichia coli endotoxin (0.5 mg) was injected after the morning milking into left rear teat cisterns via the teat canal . Wisconsin mastitis test score and somatic cell count in all quarters increased significantly (P < 0.01) by the next milking . Effects were greatest in the endotoxin-exposed quarters . Milk yields for all quarters decreased significantly (P < 0.01) by the first milking after endotoxin injection . Udder and body temperatures at milkings were similar and were not affected by treatment . When temperatures were averaged for the 5 cows for each of 120 time points/d, average temperatures, relative to time of injection of endotoxin, were increased by 0.5 C above baseline at 2.75 hours, peaked at +2.9 C at 6.50 hours, and remained high through 9.25 hours after injection . Power spectra calculated for individual cows on a daily basis universally indicated an increase in power at low frequencies on the day of injection . Subsequently, Streptococcus agalactiae (200 colony-forming units) was injected into right rear teat cisterns . Wisconsin mastitis test score increased at the second milking after injection . Cell count and quarter milk yield decreased by the third milking . As with endotoxin, injection of S agalactiae could not be detected via a change in temperature at milkings.(ABSTRACT TRUNCATED AT 250 WORDS)

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