J Med Microbiol, 1991 Nov, 35(5), 297 - 303 Restriction endonuclease digest patterns of chromosomal DNA from group B beta-haemolytic streptococci; Nagano Y et al.; Scanning densitometry and computer-assisted numerical analysis were used to examine restriction endonuclease digest patterns (RDPs) of chromosomal DNA from 26 infecting strains and 44 vaginal isolates of group B beta-haemolytic streptococci (GBS) . At the 95% similarity level, HindIII RDPs of serotype Ia and III strains clustered into four and three RDP types, respectively . Nine of 10 strains from neonates with early-onset septicaemia belonged to two particular RDP types (Ia-3 and III-3) . In contrast, serotype III GBS strains from meningitis cases were not characterised by particular RDP types . Associations between RDPs and certain phenotypic characteristics were also found. J Clin Pathol, 1991 Oct, 44(10), 824 - 5 Beta-D-glucuronidase activity assay for rapid differentiation of species within beta-haemolytic group C and G streptococci; Cimolai N et al.; Methylumbelliferyl-conjugated enzyme substrates were assessed for their ability to differentiate beta haemolytic streptococci in Lancefield groups C and G . Both Streptococcus equisimilis (group C) and large colony human biotype group G strains were consistently differentiated from group C and G "Streptococcus milleri group" bacteria by their ability to hydrolyse the beta-D-glucuronide substrate . The test was completed in less than one hour. J Appl Bacteriol, 1991 Oct, 71(4), 339 - 42 Applications of BLIS typing to studies of the survival on surfaces of salivary streptococci and staphylococci; Tagg JR et al.; A typing scheme based on detection of the production of bacteriocin-like inhibitory substances (BLIS) was a useful tool in a series of epidemiological studies of the spread and survival on surfaces of salivary streptococci and staphylococci . The organisms survived for longer periods on glass, plastic, stainless steel and latex surfaces than on unpainted wood or paper . The presence of saliva as a suspending medium prolonged the viability of Staphylococcus aureus C55 and Streptococcus pyogenes FF22 but not of Strep . salivarius Min 5 . Young children were shown to carry Strep . salivarius of identical BLIS-types on their fingers and in their saliva . BLIS typing of Strep . salivarius strains obtained from telephone mouthpieces and from the tongue-sealed flap of envelopes was used as a method of tracing the human source of the salivary deposits. J Dent Res, 1991 Oct, 70(10), 1375 - 9 Enumeration of oral streptococci on media containing different concentrations of sodium and potassium ions; Willcox MD et al.; Laboratory "type" strains of oral streptococci were screened for their ability to grow on mitis-salivarius agar (MSA) in the presence of increasing concentrations of either Na+ or K+ up to 500 mmol/L . Strains were generally better able to withstand increasing concentrations of Na+ than K+, although low numbers of colony-forming units (cfus) were seen with the highest concentration of either cation . Two strains of Streptococcus mutans, Ingbritt 162 and Ingbritt 175, behaved differently when the concentration of cation was increased from 50 to 200 mmol/L; the latter showed a marked increase in the number of cfus when the Na+ concentration was increased from 50 to 200 mmol/L, whereas there was a decrease with strain Ingbritt 162 . Strains of oral streptococci from the saliva of adults and children were isolated on modified MSA containing known concentrations of Na+ and K+ and further examined if they showed "mutans-like" colony morphology . The number of cfus generally dropped as the concentration of Na+ or K+ was increased from 200 to 350 or 500 mmol/L . Greater numbers of streptococci were tolerant to Na+ than to K+ . Half of the isolates were members of the Streptococcus sanguis group (SSG), either Streptococcus mitis or S . sanguis II, and these were more tolerant to high concentrations of Na+ or K+ than other isolates that were identified as Streptococcus morbillorum, Streptococcus acidominimus, and Streptococcus milleri. Infect Immun, 1991 Oct, 59(10), 3619 - 25 Subclass distribution of salivary secretory immunoglobulin A antibodies to oral streptococci; Ahl T et al.; The ability of specific secretory immunoglobulin A (S-IgA) antibodies to inhibit bacterial colonization of mucosal surfaces may be neutralized by the activity of bacterial IgA1 proteases . Because of the resistance of the IgA2 subclass to these enzymes, the biological effect of IgA1 proteases in vivo may depend on the subclass distribution of the bacterium-specific antibodies . We have estimated the subclass distribution of S-IgA antibodies in saliva samples from 13 individuals against IgA1 protease-producing (Streptococcus sanguis and Streptococcus oralis) and nonproducing (Streptococcus gordonii and Streptococcus mitis bv . 2) oral streptococci . IgA1 was found to be the predominant subclass of antibodies against these four bacteria in most of the saliva samples, corroborating previous data suggesting a role of IgA1 proteases in plaque formation . However, variation in the subclass distribution of S-IgA antibodies against the same strain was observed . In one individual, IgA2 was the predominant subclass of antibodies against all four streptococci and of total salivary S-IgA, pointing to the possible significance of genetic variations . The study also addresses methodological problems related to the quantitation of salivary antibodies by solid-phase immunoassays. Am J Clin Pathol, 1991 Oct, 96(4), 459 - 63 Comparison of API Rapid Strep, Baxter MicroScan Rapid Pos ID Panel, BBL Minitek Differential Identification System, IDS RapID STR System, and Vitek GPI to conventional biochemical tests for identification of viridans streptococci; Hinnebusch CJ et al.; Viridans group streptococci (36 stock strains and 167 single patient blood culture isolates) were assessed using API Rapid Strep, Baxter MicroScan Rapid Pos ID Panel, BBL Minitek Differential Identification System, IDS RapID STR System, and Vitek GPI methods . Identification data obtained with these systems were compared with those indicated by conventional biochemical procedures . API, Baxter MicroScan, BBL, IDS, and Vitek corresponded with conventional biochemical identification in 74%, 66%, 65%, 50%, and 61% of the isolates, respectively; using recommended supplemental tests, agreement was augmented in 9%, 11%, 20%, 11%, and 21% of the isolates, respectively . Disagreement with conventional biochemical methods occurred in 14%, 17%, 14%, 32%, and 10% of the commercial techniques, respectively; no identification was possible in 2%, 5%, fewer than 1%, 6%, and 8% of specimens, respectively . BBL, API, and Baxter MicroScan systems provided the most reliable rapid identification, although supplemental testing often was required . Until a higher percentage of correct identification data can be obtained without supplemental procedures, conventional biochemical techniques will remain the methods of choice for identification of viridans streptococci. Curr Opin Dent, 1991 Oct, 1(5), 577 - 82 Dental management of the pediatric oncology patient; Fleming P; Acute oral problems that frequently occur during oncologic therapy include mucositis, infection, and hemorrhage . Certain chemotherapeutic agents consistently produce significant mucositis . Herpes simplex virus infection is a frequent cause of oral ulceration . Gram-negative oral bacilli can cause severe local necrosis of oral tissues and lethal bacteremia and sepsis . Sepsis with oral streptococci is common in the early postengraftment period following bone marrow transplant . A case report describes the successful use of a new hemostatic agent to control hemorrhage in a patient with severe thrombocytopenia in leukemic relapse . Long-term dental complications of oncologic therapy include abnormal dental and craniofacial development . Dental abnormalities in children treated for acute lymphoblastic leukemia are more severe if oncologic therapy begins before 5 years of age and if cranial irradiation is used . The combination of high-dose cranial irradiation (2400 cGy) and chemotherapy before 5 years of age results in deficient mandibular growth . In children with reduced growth hormone production and deficient mandibular growth due to treatment with bone marrow transplantation, stimulation of mandibular condylar growth is reported following the use of growth hormone. Oral Microbiol Immunol, 1991 Oct, 6(5), 292 - 4 Human leukocyte antigens in relation to colonization by mutans streptococci in the oral cavity; Wallengren ML et al.; Mutans streptococci are well established as caries-inducing microorganisms in man . Most humans carry the bacteria, but in highly different numbers . This cannot be explained by environmental factors only . The aim of this study was to investigate a possible association between levels of colonization by mutans streptococci and the presence of certain B and DR human leukocyte antigens (HLA) . Altogether, 170 subjects who had their HLA antigens determined (76 renal transplant patients and 94 healthy blood donors) were selected for the investigation . Paraffin-stimulated saliva samples were taken using the wooden spatula method with subsequent cultivation of mutans streptococci on mitis salivarius bacitracin agar plates . An association between the absence of HLA-DR 4 antigens and low, or undetectable, levels of mutans streptococci was found . This was statistically significant for the immunosuppressed renal transplant subjects . The same trend was observed among the healthy blood donors. Oral Microbiol Immunol, 1991 Oct, 6(5), 284 - 7 Mutans streptococci in saliva and interdental spaces after topical applications of an antibacterial varnish in schoolchildren; Petersson LG et al.; The effect of a chlorhexidine-containing varnish on the levels of mutans streptococci in saliva and in interdental spaces was investigated in 33 15-year-old schoolchildren . Each child was treated with an active (1% chlorhexidine; 1% thymol) and a placebo varnish preparation following the split-mouth technique . The varnishes were applied twice in small amounts into upper interdental areas with a 2-d interval . Mutans streptococci in saliva and interdental plaque was sampled and enumerated during 3 months . The results showed an immediate reduction of the number of interdental mutans streptococci on both test and placebo side after the varnish applications . The levels, however, were significantly lower in the test quadrants compared with the placebo-treated sides after 8, 30 and 90 d . Thus, the findings indicate a slower recolonization in interdental spaces treated with the active preparation . The levels of mutans streptococci in saliva were significantly reduced 1 and 3 months after varnish treatment, suggesting a long-term effect of the antibacterial varnish. Oral Microbiol Immunol, 1991 Oct, 6(5), 280 - 3 Prevalence of mutans streptococci in one-year-old children; Grindefjord M et al.; Colonization with mutans streptococci was studied in 1095 1-year-old children living in suburban Stockholm . During a scheduled vaccination appointment at a child health centre, a bacterial sample was obtained from the child's tongue and a structured questionnaire was completed by the accompanying parent . Six percent of the subjects were colonized with mutans streptococci . The variables most strongly correlated with presence of mutans streptococci were: non-Swedish background, consumption of sugar-containing beverages at night and total consumption of sugar-containing beverages . The results indicate that, by the age of 1 year, maternally influenced behaviour patterns such as dietary habits that may predispose to early colonization of mutans streptococci are already established . Such early colonization with mutans streptococci may predict high caries risk in the primary dentition. Oral Microbiol Immunol, 1991 Oct, 6(5), 275 - 9 A modified mitis salivarius medium for a caries diagnostic test; Kimmel L et al.; A new medium, MSKB, composed of mitis salivarius agar base, sorbitol, kanamycin sulfate and bacitracin, has been developed that is more selective for recovery of mutans streptococci (mutans) than the so called mitis salivarius bacitracin (MSB) medium . MSB and MSKB were compared for recovery and selectivity of mutans by plating saliva samples as well as pure cultures on both media . Sixty saliva samples were plated and counted for mutans and non-mutans colonies . Thirty-six samples had greater numbers of non-mutans on MSB than on MSKB, and 14 of the 36 had non-mutans colonies that could be visually confused with mutants . The recovery of mutans on MSKB was approximately 13% less than on MSB . The selectivity and recovery of MSB and MSKB were evaluated over 1-5 months of storage at 4 degrees C . Streptococcus anginosus grew on MSB after 1 month, but not on MSKB . Streptococcus milleri type 2 grew on both media after 4 months. Indian J Pathol Microbiol, 1991 Oct, 34(4), 265 - 9 Beta hemolytic streptococcal carriers among school children in western Orissa; Pati SB et al.; Detection of carriers of Beta hemolytic streptococci and serogrouping of the strains isolated from throat of School Children helps in the epidemiological serosurveillance of the disease . With this in view the carriers among otherwise healthy school children in and around Buria, a small town in western Orissa, have been detected and the Streptococci isolated are grouped and typed. J Assoc Physicians India, 1991 Oct, 39(10), 774 - 6 Crescentic glomerulonephritis associated with puerperal sepsis; Gupta KL et al.; Acute renal failure developed in a young female having puerperal sepsis due to beta-haemolytic streptococci . The patient succumbed to her illness and an autopsy revealed extensive crescentic glomerulonephritis . The association between chronic visceral sepsis and glomerulonephritis is discussed. Med Lab Sci, 1991 Oct, 48(4), 244 - 55 Human monoclonal antibodies: analysis of two antibodies derived from lymphocytes of a patient with acute rheumatic fever; Hughes EJ et al.; Human monoclonal antibodies were produced by fusion of peripheral blood lymphocytes from a patient with acute rheumatic fever, with the HGPRT-non-secreting murine (Balb-c) cell line SP2/0Ag14 . Heterohybridomas were selected by screening against rheumatic fever-associated group A streptococci using an ELISA, and against paraffin wax-embedded human heart sections using an immunoperoxidase technique . Two human IgM monoclonal antibodies were selected for further analysis by Western blotting and ELISA . Both antibodies demonstrated multispecificity by immunoblotting and ELISA . One of the monoclonals bound to 48 kD and 83 kD bands common to group A streptococcal and heart antigen preparations . Both human monoclonal antibodies bound to a 43 kD constituent band common to human heart and sarcolemma membrane extract . Inhibition studies performed using a competitive solid phase immunoassay confirmed shared epitopes between group A streptococci and human heart . The significance of these monoclonal antibodies to the pathogenesis of rheumatic fever is uncertain. J Dent, 1991 Oct, 19(5), 263 - 71 Can the oral flora adapt to sorbitol? Hogg SD, Rugg-Gunn AJ. The number of non-sugar sweeteners that are approved for use in foods and drinks is increasing and manufacturers are using these as alternatives to cariogenic sugar . These non-sugar sweeteners are generally classed as non-cariogenic . The most frequently used non-sugar sweetener is sorbitol, and concern has been expressed that the oral flora may adapt to sorbitol so that it looses its 'safe for teeth' property . The purpose of this review is to describe the mechanisms whereby oral microorganisms, and mutans streptococci in particular, might metabolize sorbitol and to summarize published research into changes in plaque acid production and changes in plaque flora after exposure to sorbitol . Finally, the possibility that some groups of people may be especially 'at-risk' from adaptation of oral microorganisms to sorbitol is considered . It is concluded that frequent or long-term use of sorbitol is unlikely to present any increased risk of dental caries in normal people, but that frequent use of sorbitol may present a small cariogenic risk in people with low salivary flow. Acta Odontol Scand, 1991 Oct, 49(5), 311 - 6 Influence of delmopinol on bacterial zeta-potentials and on the colloidal stability of bacterial suspensions; Simonsson T et al.; Delmopinol is a low molecular weight surface-active compound that has been shown to be effective against dental plaque both in vitro and in vivo and against gingivitis in vivo . To study the mode of action of delmopinol, the influence of the compound on the stability of bacterial suspensions, both with and without saliva, and on the zeta-potentials of oral streptococci was studied . The results showed that delmopinol reduced the magnitude of the zeta-potentials, but, in contrast, the colloidal stability of the bacterial suspensions without saliva was increased . The explanation of these observations could be that non-DLVO interaction components, such as repulsive hydration/steric forces, have come into effect at very close distances between two approaching bacterial cells . To judge from the present results, it is possible that delmopinol forms films on bacterial cells in a plaque, thereby facilitating mechanical removal. Mikrobiyol Bul, 1991 Oct, 25(4), 326 - 9 {Comparison of latex agglutination and bacitracin-SXT methods used for the identification of 142 beta-hemolytic streptococci}; Kiraz N et al.; We compared the latex agglutination and bacitracin-SXT methods to identify Group A Streptococci (GAS) from throat cultures . In our study all 118 GAS strains identified by latex agglutination method were found susceptible to bacitracin, 115 were found resistant and 3 were susceptible to SXT . All beta hemolytic streptococci rather than GAS were found resistant to bacitracin . As a result bacitracin method is found valuable in rutin studies in GAS identification. Zentralbl Bakteriol, 1991 Oct, 275(4), 513 - 20 Induction of human cord blood lymphocyte proliferation by type III group B streptococci; Gantenberg R et al.; In a preceding communication, the authors have described the selective adherence of group B streptococci (S . agalactiae) to human neonatal lymphocytes . In the present one, it has been shown that cord blood lymphocytes obtained from healthy newborns possess the ability to develop proliferative responses in the presence of type III group B streptococci . When investigating the influence of these bacteria on both adult and neonatal mononuclear cells (MNC), the following patterns of adherence and lymphocyte reactivity could be observed: (1) Type III group B streptococci adhered spontaneously to lymphocytes (11.4 +/- 5.7%, n = 14) of healthy newborns but not to those from adults, (2) The capacity to proliferate was restricted to cord blood lymphocytes giving a mean peak response at day five of culture in the presence of the bacteria (6.8 +/- 2.8 times over the background, n = 15), (3) The correlation between streptococcal adherence and cord blood lymphocyte proliferation was statistically significant for 10 independent experiments (r = 0.75, p = 5%), and (4) Type III group B streptococci inhibited the Pokeweed mitogen (PWM)-induced lymphocyte proliferation in adult but not in neonatal MNC cultures . The different pattern of reactivity between adult and cord blood MNC towards group B streptococci will be discussed. Ann Pediatr (Paris), 1991 Oct, 38(8), 545 - 8 {Antibiotic treatment of pharyngitis}; Begue P; Antimicrobial therapy of pharyngitis focuses mainly on eradicating group A streptococci and treating recurrent pharyngitis . The French strategy rests on routine treatment of all cases of childhood pharyngitis; in the United-States, rapid tests are used to identify group A streptococci in the throat before treating . Antibiotics used against group A streptococci include beta-lactams and macrolides . Among beta-lactams, the reference drug is still penicillin, e.g., penicillin V for 10 days . However, numbers of carriers with positive throat cultures for Streptococcus pyogenes seem to be growing in the United States, with a 10-20% increase over the last twenty years . Duration of therapy could be reduced from 10 to 5 days with the new oral cephalosporins but these drugs are more expensive than penicillin . Recurrent pharyngitis is caused by a variety of organisms which are often penicillinase-producers . It follows that penicillin should not be used in these cases, which require oral cephalosporins or the amoxicillin-clavulanic acid combination . Maintenance antimicrobial therapy between acute episodes should be considered. Ann Pediatr (Paris), 1991 Oct, 38(8), 539 - 43 {Antibiotic therapy in maternal-fetal infections}; Aujard Y; The selection of first-line antimicrobial therapy in neonates with maternofetal infection is based on probability data from epidemiologic studies of bacterial infections . Because of the high prevalence of ampicillin-resistant E . coli strains and of the lack of susceptibility of Listeria and group D streptococci to cephalosporins, combined use of two complementary drugs, such as amoxicillin and cefotaxime with an aminoglycoside, is recommended . Each dose should be increased twofold in patients with meningeal involvement . The interval between aminoglycoside doses depends on the degree of renal maturity and therefore on gestational age . Discontinuation of treatment on the third day when clinical and biologic monitoring disproves the suspected infection avoids the occurrence of untoward effects, especially on the intestinal flora . In other cases, administration of two drugs selected on the basis of bacteriologic findings is needed beyond the third day . Specific therapy is required in infrequent infections (Candida, tuberculosis, syphilis, Helicobacter) . The dosage of antimicrobials with narrow therapeutic margins (vancomycin, aminoglycosides) should be adjusted on the basis of serum assays performed at four-day intervals . Duration of therapy is usually ten days but may reach 21 days in neonates with meningitis . Prevention, in the absence of specific vaccines, rests on antenatal and perinatal treatment of women at high risk for infection . Management of neonates with group B streptococcal infection is controversial; close clinical and biologic monitoring over 48 hours may allow to reduce the use of antimicrobials. Vet Microbiol, 1991 Oct, 29(2), 173 - 80 Tetracycline resistance determinants in streptococcal species isolated from the bovine mammary gland; Brown MB et al.; Seventy-one streptococci isolated from dairy cows with clinical mastitis were tested for tetracycline resistance . Twenty-one (30%) isolates were tetracycline resistant (Tcr), and eight hybridized with the Tet O, one hybridized with the Tet L, and one hybridized with both the Tet L and Tet K determinants . The remaining Tcr isolates did not hybridize with any of the 5 Gram-positive Tet determinants tested . The Tet O determinants were plasmid-mediated, and four selected strains transferred the Tet O determinant at frequencies of 10(-6) to 10(-8) . Strains which did not hybridize with known probes were tested for resistance to minocycline . All of the Streptococcus dysgalactiae had low minimum inhibitory concentrations (MICs) for minocycline, while the S . agalactiae and the one S . uberis showed high MICs to minocycline . This suggests that at least two different uncharacterized Tet determinants exist in these isolates, one conferring high resistance to both tetracycline and minocycline and one conferring only tetracycline resistance. Trop Doct, 1991 Oct, 21(4), 169 - 70 Bacterial agents in neonatal septicaemia in Calabar, Nigeria: review of 100 cases; Antia-Obong OE et al.; This study of bacterial isolates in 100 cases of proven neonatal septicaemia has shown Staphylococcus aureus and coliform bacteria as the dominant Gram-positive and Gram-negative organisms respectively . Most Gram-negative bacteria and Staphylococcus aureus were sensitive to gentamicin, while streptococci were sensitive to ampicillin and penicillin . On the basis of this antimicrobial sensitivity pattern, the combination of gentamicin with either ampicillin or penicillin appears appropriate in initial therapy of neonatal septicaemia. Int J Syst Bacteriol, 1991 Oct, 41(4), 483 - 6 Intraspecies variations in nutritionally variant streptococci: rRNA gene restriction patterns of Streptococcus defectivus and Streptococcus adjacens; Bouvet A et al.; The rRNA gene restriction patterns of two species of nutritionally variant streptococci, Streptococcus defectivus and Streptococcus adjacens, were determined, and the results were compared with the electrophoretic migration profiles of penicillin-binding proteins . Reference strains belonging to various streptococcal species were used as controls . Our results correlated with the results of DNA-DNA hybridization experiments and confirmed the delineation of these two species . Moreover, they demonstrated that intraspecies variations occur and suggested that there are two subspecies of S . defectivus. J Hosp Infect, 1991 Oct, 19(2), 129 - 36 Increased number of sporadic nosocomial group A streptococcal bacteraemias during a community epidemic; Strobaek S et al.; An increased morbidity rate due to Lancefield group A streptococci (GAS) in the Scandinavian countries, beginning late in 1987, led to the present retrospective survey of bacteraemias with GAS in Denmark . Among 242 reported cases from January 1987-December 1989, 94 were found to have been nosocomially acquired, and their occurrence mirrored the pattern of the epidemic with T-type 1 and the seasonal variation of other serotypes in the community . The 27 nosocomial cases from 1988 were studied further . Eighty percent were associated with postoperative wound infection, erysipelas, puerperal or neonatal infection . Of the 52 community-acquired cases in 1988, 80% comprised erysipelas, respiratory tract infection, meningitis, gastrointestinal disease or arthritis . The bacteraemic patients were promptly treated with antibiotics, but the use of penicillin was in some cases delayed because the clinical signs of streptococcal infection were misinterpreted by the attending clinician . Ideally, the nosocomial infections should have been prevented by hygienic measures in the hospitals . When an epidemic situation of this type exists in the community, handwashing routines become vitally important . A warning for epidemics should be extended to the hospital. Proc Natl Acad Sci U S A, 1991 Oct 1, 88(19), 8317 - 21 Hyaluronic acid capsule is a virulence factor for mucoid group A streptococci; Wessels MR et al.; Mucoid strains of group A Streptococcus have been associated with recent outbreaks of acute rheumatic fever . The mucoid colony morphology of these strains is a result of abundant production of capsular polysaccharide, which is composed of hyaluronic acid . To study the role of the hyaluronic acid capsule in virulence, we derived an acapsular mutant from a mucoid strain of group A Streptococcus by transposon mutagenesis . M protein expression was not altered in the mutant strain . The mucoid wild-type strain grew in fresh human blood and was resistant to phagocytic killing in vitro . In contrast, the acapsular mutant failed to grow in fresh human blood and was sensitive to phagocytic killing in vitro . Loss of capsule was associated with a 100-fold reduction in virulence of the organisms in mice . We conclude that the hyaluronic acid capsule protects mucoid group A streptococci from phagocytosis and has an important role in virulence. FEBS Lett, 1991 Sep 23, 290(1-2), 111 - 4 Binding sites in fibronectin for an enterotoxigenic strain of E . coli B342289c; Visai L et al.; The binding of fibronectin and fibronectin fragments to the enterotoxigenic strain E . coli B34289c was studied . E . coli cells bound to two distinct sites of fibronectin, one being the N-terminal domain, which also contains the binding sites for staphylococci and streptococci, and the other located within the central heparin binding region . In addition, the N-terminal and the heparin binding domain mediated the attachment of bacteria in a solid phase binding assay . E . coli cells expressed two classes of receptors, the first, a 17 kDa protein, recognized by the N-terminal fragment and the second, having a mol . mass of 55 kDa, which interacts with the internal heparin binding domain . Bacterial receptors, which bind the N-terminal end of fibronectin, may be structurally related. Br Dent J, 1991 Sep 21, 171(6), 170 - 3 Failure of two macrolide antibiotics to prevent post-extraction bacteraemia; Cannell H et al.; Two macrolide antibiotics, erythromycin and josamycin, were compared in a double-blind trial to examine their efficacy in the prevention of post-dental extraction bacteraemia in a group of healthy patients . An in vitro blood culture system was used . Isolates of streptococci were identified to species level . Minimum inhibitory concentrations (MICs) of erythromycin and of josamycin for each isolate were estimated by an agar dilution technique, with controls . Levels of drug in the serum of volunteers and of patients were assayed after oral doses of the macrolide antibiotics . Levels found achieved early peaks and satisfactory concentrations for activity against streptococci . Within the specified parameters, the results demonstrated that the antibiotics failed to prevent survival in blood culture of various strains of streptococci for up to 24 hours following collection of the blood . It is recommended that an alternative antibiotic to either erythromycin or to josamycin be used to achieve prophylaxis against streptococci in infective endocarditis risk patients who are allergic to penicillin. Am J Ophthalmol, 1991 Sep 15, 112(3), 322 - 5 Infectious crystalline keratopathy caused by Candida albicans; Wilhelmus KR et al.; Two patients developed corneal opacities resembling infectious crystalline keratopathy . Predisposing factors included a recent corneal transplant with suture replacement in one patient and postradiation keratoconjunctivitis with disposable therapeutic contact-lens wear in the other patient . Both patients were using a topically applied corticosteroid and an aminoglycoside antimicrobial . Smears of corneal scrapings showed numerous yeasts without inflammatory cells . Culturing yielded Candida albicans and Staphylococcus haemolyticus in the first case and C . albicans and S . epidermidis in the second case . Combined antifungal and antimicrobial therapy, with initial withdrawal of corticosteroid use, was effective . The microbial cause of pauci-inflammatory keratitis includes not only viridans streptococci and other bacteria but fungi as well. Am J Med, 1991 Sep 12, 91(3A), 23S - 26S A comparison of azithromycin and penicillin V for the treatment of streptococcal pharyngitis; Hooton TM; The safety and efficacy of azithromycin was compared with that of penicillin V in a multicenter study of the treatment of streptococcal pharyngitis in outpatients . Patients were randomized in a 2:1 ratio to either azithromycin 500 mg once on day 1 followed by 250 mg once daily for 4 days, or penicillin V (V-Cillin K) 250 mg every 6 hours for 10 days . Two hundred and forty-two patients from 29 centers were evaluable at the 11th day after enrollment . Five of 229 (2.2%) azithromycin-treated patients were not evaluable because their enrollment isolates of group A beta-hemolytic streptococci (GABHS) were resistant to the drug . In both treatment groups, 99% of patients were clinically cured or improved . Eradication of GABHS occurred in 91% of azithromycin-treated patients compared with 96% of penicillin-treated patients (p = 0.21) . Of the patients who had a recurrence of GABHS, clinical evidence of infection occurred in 3 of 13 (23%) patients who had been treated with azithromycin and in 7 of 10 (70%) patients treated with penicillin . Adverse events, generally mild to moderate gastrointestinal complaints, were significantly more common in the azithromycin-treated patients (16.6%) than in penicillin-treated patients (1.7%) (p less than 0.001) . Discontinuation because of side effects occurred with similar frequency in both groups . Azithromycin appears to be a safe and effective alternative treatment for streptococcal pharyngitis in adult outpatients. Biochemistry, 1991 Sep 3, 30(35), 8568 - 77 Complete structure of the cell surface polysaccharide of Streptococcus oralis C104: a 600-MHz NMR study; Abeygunawardana C et al.; Specific lectin-carbohydrate interactions between certain oral streptococci and actinomyces contribute to the microbial colonization of teeth . The receptor molecules of Streptococcus oralis, 34, ATCC 10557, and Streptococcus mitis J22 for the galactose and N-acetylgalactosamine reactive fimbrial lectins of Actinomyces viscosus and Actinomyces naeslundii are antigenically distinct polysaccharides, each formed by a different phosphodiester-linked oligosaccharide repeating unit . These streptococci all coaggregated strongly with both A . viscosus and A . naesludii strains, whereas S . oralis C104 interacted preferentially with certain strains of the latter species . Receptor polysaccharide was isolated from S . oralis C104 cells and was shown to contain galactose, N-acetylgalactosamine, ribitol, and phosphate with molar ratios of 4:1:1:1 . The 1H NMR spectrum of the polysaccharide shows that it contains a repeating structure . The individual sugars in the repeating unit were identified by 1H coupling constants observed in E-COSY and DQF-COSY spectra . NMR methods included complete resonance assignments (1H and 13C) by various homonuclear and heteronuclear correlation experiments that utilize scalar couplings . Sequence and linkage assignments were obtained from the heteronuclear multiple-bond correlation (HMBC) spectrum . This analysis shows that the receptor polysaccharide of S . oralis C104 is a ribitol teichoic acid polymer composed of a linear hexasaccharide repeating unit containing two residues each of galactopyranose and galactofuranose and a residue each of GalNAc and ribitol joined end to end by phosphodiester linkages with the following structure . {----6)Galf(beta 1----3)Galp(beta 1----6)Galf(beta 1----6)GalpNAc(beta 1----3) Galp(alpha 1----1)ribitol(5----PO4-}n Eur J Pediatr, 1991 Sep, 150(11), 776 - 9 Beta-haemolytic non-group A streptococci and pharyngitis: a case-control study; Cimolai N et al.; A case-control study was conducted to examine the association of beta-haemolytic non-group A streptococci and pharyngitis in a paediatric population (n = 502) . No association could be found between disease and traditional Lancefield groups B, C, F, or G . When the analysis included the clustering of genetically related subgroups from different Lancefield groups, an association was evident for moderate and heavy quantitations of beta-haemolytic "large colony" group C and G streptococci (Streptococcus equisimilis and human biotypes of large colony group G streptococci) (p = 0.021) . This study further defines a subset of the beta-haemolytic non-group A streptococci that merit recognition by both the laboratory and physician. J Ophthalmic Nurs Technol, 1991 Sep-Oct, 10(5), 207 - 10 Ciloxan for the management of corneal ulcers; Scott A; Bacterial keratitis (corneal ulcer) is a sight-threatening condition if not treated with the appropriate anti-infective agent . Treatment needs to be initiated with a broad-spectrum agent deemed to be most appropriate until culture results are obtained . If the suspected pathogen is staphylococci, streptococci, or Pseudomonas, Ciloxin is a new generation anti-infective agent considered highly effective against these pathogens. Rev Med Brux, 1991 Sep, 12(7), 253 - 6 {Recurrent erysipelas}; Dangoisse C et al.; Erysipelas is clinically defined as a febrile skin infection with a sudden onset of a red indurated expanding plaque with distinct border . A typical erysipelas presents various degrees of cutaneous erythema, oedema and is characterized by less well-defined margins . The responsible agent can be a beta-hemolytic streptococcus (group A), Staphylococcus aureus and other streptococci (group B, C and D) . Common predisposing factors are venous insufficiency, lymphatic obstruction and underlying illnesses . Guidelines for the diagnosis and the management of erysipelas are proposed . The episodes of erysipelas ordinarily respond promptly to penicillin or a beta-lactamase resistant antibiotic . Prevention of recurrent erysipelas by means of an antibiotic prophylaxis is discussed. J Laryngol Otol, 1991 Sep, 105(9), 743 - 5 Management of peritonsillar abscess; Maharaj D et al.; A prospective, randomized clinical trial was conducted on 60 patients with confirmed peritonsillar abscess to: (1) compare the safety and efficacy of permucosal needle aspiration with that of incision and drainage; (2) assess whether admission to hospital and treatment with intravenous antibiotics is necessary; (3) culture the pus obtained, in order to decide on a rational antibiotic regime . Of the 60 patients, 30 were randomized to the needle aspiration group, and 30 to the incision and drainage group . The initial success rate was 87 per cent (26 of 30 patients) with needle aspiration, and 90 per cent (27 of 30 patients) with incision and drainage . Two patients required hospital admission, for rehydration and intravenous antibiotics . The commonest organisms cultured were streptococci (62 per cent); 97 per cent of all patients responded to penicillin . This study indicates that most patients with peritonsillar abscess may successfully and safely be treated by permucosal needle aspiration, and oral penicillin, on an out-patient basis. Hosp Pract (Off Ed), 1991 Sep, 26 Suppl 5, 24 - 30; discussion 55-7 Ceftriaxone in treatment of serious infections . Skin and soft tissue infections; Gainer RB 2nd; Ceftriaxone is generally recognized to be safe and effective when administered either intravenously or intramuscularly to both adults and children as a single drug for skin and skin structure infections . An advantage of ceftriaxone over the other third-generation cephalosporins is its long serum half-life, which allows it to be given every 12 hours in children and every 24 hours in most adults . There is no question that ceftriaxone is effective for skin and soft tissue infections, particularly those caused by staphylococci and streptococci . The drug's sales to home infusion companies around the country attest to its widespread use for such infections . The fact remains, however, that the data required to substantiate efficacy and safety for ceftriaxone or for any of the other third-generation cephalosporins are just not available in large numbers. J Med Microbiol, 1991 Sep, 35(3), 148 - 51 Biochemical properties of group G streptococci isolated from cats and man; Reitmeyer JC et al.; The biochemical characteristics of group G streptococci isolated from cats were markedly similar to the characteristics of group G streptococci from man . Both cat and human isolates of group G streptococci were also very similar in biochemical characteristics to group A streptococci so that to identify the source of group G streptococci by biochemical reactions is not a reliable procedure . The group G streptococci found in many cats could be pathogenic to man, since their physiological and biological characteristics are very similar to those of group A streptococci. J Oral Maxillofac Surg, 1991 Sep, 49(9), 976 - 80 An epidemiologic and anatomic survey of odontogenic infections; Haug RH et al.; An 81-month review of patients with infections of odontogenic origin admitted to the oral and maxillofacial surgery service at a county hospital and teaching facility in northeast Ohio is presented . Age, sex, race, etiology, pathogens isolated, admission temperature, and admission white blood cell count were identified and related to the anatomic space(s) encountered . Multispace and single-space infections occurred with equal distribution . In both the multispace and single-space infections, the submandibular and buccal spaces were most frequently involved . Males were affected with single-space infections twice as often as females . An equal distribution among sexes was found in multispace infections . The most common age range for all infections was 25 to 30 years . alpha-Hemolytic streptococci, Bacteroides melaninogenicus, and beta-hemolytic streptococci were the most frequently isolated pathogens . Third molars were the prevalent cause in both multispace and single-space infections that required hospital admission. Infect Immun, 1991 Sep, 59(9), 2948 - 54 Delineation of a segment of adsorbed salivary acidic proline-rich proteins which promotes adhesion of Streptococcus gordonii to apatitic surfaces; Gibbons RJ et al.; Cells of several strains of Streptococcus gordonii attached in much higher numbers to experimental pellicles formed from samples of submandibular or parotid saliva on hydroxyapatite (HA) beads than to buffer controls . The nature of the salivary components responsible were investigated by preparing experimental pellicles from chromatographic fractions of submandibular saliva obtained from Trisacryl GF 2000M columns . Adhesion of S . gordonii Blackburn was promoted by two groups of fractions . The adhesion-promoting activity in the first group of fractions was associated with the family of acidic proline-rich proteins (PRPs), while that of the second group is as yet unidentified . Experimental pellicles prepared by treating HA with 2 micrograms of pure 150-amino-acid-residue PRPs (PRP-1, PRP-2, and PIF-s) promoted adhesion of S . gordonii Blackburn cells to an extent comparable to that obtained with unfractionated saliva . However, pellicles prepared from a 106-residue PRP (PRP-3) were significantly less effective, and those prepared from the amino-terminal tryptic peptide (residues 1 to 30) of the PRP and the salivary phosphoprotein statherin were completely ineffective in promoting adhesion . Although adhesion of several strains of S . gordonii was promoted by adsorbed PRP-1, the adhesion of several strains of Streptococcus sanguis or Streptococcus oralis was either not affected or only weakly enhanced by this protein . S . gordonii cells bound avidly to PRPs adsorbed onto HA beads, but the streptococci did not appear to bind PRPs in solution, since concentrations of PRP as high as 200 micrograms/ml did not inhibit binding of bacterial cells to pellicles prepared from pure PRP . S . gordonii cells also attached well to PRP or a synthetic decapeptide representing residues 142 to 150 of the PRP when the peptide was linked to agarose beads . Studies with a series of synthetic decapeptides indicated that the minimal segment of PRP which promoted high levels of S . gordonii adhesion was the carboxy-terminal dipeptide Pro-Gln (residues 149 and 150). Obstet Gynecol, 1991 Sep, 78(3 Pt 1), 397 - 401 Evaluation of a rapid enzyme immunoassay test for detection of group B Streptococcus; Gentry YM et al.; The purpose of this study was to determine the reliability of the ICON immunoassay in detecting vaginal group B Streptococcus in pregnant women . Vaginal cultures were obtained at the time of sterile speculum examinations from 300 laboring women . The frequency of vaginal group B streptococcal colonization was 10% . A duplicate vaginal swab was used in the immunoassay, which required less than 10 minutes for completion . The immunoassay could reproducibly detect 3+ to 4+ growth (greater than 10(5) colony-forming units per milliliter of vaginal fluid), which was considered heavy colonization . The overall sensitivity, specificity, positive predictive value, and negative predictive value were 33, 95, 43, and 93%, respectively, compared with culture . For heavy colonization (3+ to 4+ growth), the sensitivity, specificity, positive predictive value, and negative predictive value were 100, 95, 32, and 100%, respectively . The immunoassay is a highly sensitive and specific test for detection of heavy vaginal colonization by group B streptococci in obstetric patients, but cultures are required to detect light group B streptococcal colonization. J Infect Dis, 1991 Sep, 164(3), 522 - 6 A streptococcal erythrogenic toxin preparation augments natural killer activity of peripheral blood mononuclear cells; Sacks LV et al.; Natural killer (NK) activity in peripheral blood mononuclear cells is augmented by products released by two different strains of streptococci . This property is due at least in part to an erythrogenic toxin (ET) . A preparation of physiologically active ET from strain NY5 group A beta-hemolytic streptococci and streptococcal products (SP) derived from the culture supernatants of ATCC strain 19165 group A streptococci were both potent inducers of NK activity . An anti-serum to ET reacted with two polypeptides in SP, one of which comigrated with ET when analyzed by SDS-PAGE . Using an affinity column with an antiserum to ET known to neutralize its mitogenic properties, the NK-enhancing activity of ET and SP was partly absorbed and was recovered upon elution . These findings suggest that immunologically related ETs in different streptococcal strains play a role in the activation of NK cells . This novel property of streptococci may feature in the pathogenesis of streptococcal infections and their protean manifestations. J Infect Dis, 1991 Sep, 164(3), 515 - 21 Streptokinases produced by pathogenic group C streptococci demonstrate species-specific plasminogen activation; McCoy HE et al.; The species specificities of plasminogen activation and binding of plasmin by pathogenic group C streptococci isolated from humans, horses, and pigs were examined . Of 56 streptococcal isolates, 52 elaborated plasminogen activator activity and 49 of these had specificity for plasminogen of the homologous host . Analysis of supernatants from 13 isolates indicated that the plasminogen activator activity resulted from secreted streptokinases . These 13 streptokinases were antigenically related and bound all three plasminogens, indicating that the binding recognition sites were conserved despite the observed species-specific activation . In addition, all group C isolates tested demonstrated surface receptors that bound human, equine, and porcine plasmin . Species-specific plasminogen activation may be an early step in events resulting in infection and may account for the species preference of certain streptococci. Infection, 1991 Sep-Oct, 19(5), 324 - 7 Pharmacokinetics of teicoplanin in hemodialysis patients; Hoffler D et al.; As only insufficient knowledge about the dosage of teicoplanin in hemodialysis patients exists, a clinical trial was performed on 26 patients . An initial dose of 800 mg teicoplanin, followed by doses of 400 mg on day 8 and day 15, was administered . In addition to the common clinical parameters (fever, white blood cell count, C-reactive protein), the plasma concentrations of this substance were determined . The HLTterm was 159 +/- 35 h, the Vss 104 +/- 25 1/100 kg and the CLtot 5.3 +/- 1.3 ml/min . It could be shown that the dosage regimen mentioned above produced long-lasting and highly effective levels, sufficiently surpassing the MICs of the expected bacteria (streptococci and staphylococci) . The easily administered substance showed no adverse side effects, based on clinical criteria . The above-mentioned therapy nearly always resulted in success according to clinical criteria . Therefore, and due to its easy administration, it seems advantageous to start treatment with teicoplanin in hemodialysis patients obviously suffering from bacterial infections. Am J Otolaryngol, 1991 Sep-Oct, 12(5), 292 - 6 Pharyngeal and tonsil infections caused by non-group A Streptococcus; Dudley JP et al.; Non-group A streptococci are members of the genus Streptococcus but do not share the notoriety of their cousin from group A . Most physicians, including otolaryngologists and head and neck surgeons, do not associate them with upper respiratory tract and head and neck infections . Some laboratories do not bother to report their presence on culture . At the University of California, Los Angeles they have been shown to cause (1) tonsillitis, painful tonsils lacking exudate and erythema (group C, one case; group F, one case), (2) acute nonexudative tonsillitis (group B, two cases; group C, one case; group F, one case), and (3) acute exudative tonsillitis (group C, one case) . It should be remembered when there is a report of their presence that they are usually vulnerable to penicillin and its analogs . By judicious use of these drugs, morbidity can be diminished. Diagn Microbiol Infect Dis, 1991 Sep-Oct, 14(5), 367 - 72 Comparison of TestPack Plus Strep A with selective and nonselective culture media for detection of group-A streptococci; Schwabe LD et al.; The TestPack Plus Strep A (TPPSA), an immunoassay method, was compared with conventional culture methods including nonselective trypticase soy agar with 5% sheep blood and selective SXT blood agar for detection of group-A streptococci (GAS) . A total of 452 throat swabs was evaluated, of which 261 (57.7%) and 191 (42.3%) were compared with culture using nonselective and selective media, respectively . Of 261 specimens evaluated on nonselective media, 71 (27.1%) were culture positive for GAS . TPPSA demonstrated a sensitivity of 91.6% and a specificity of 94.2% with positive and negative predictive values of 85.5% and 96.8%, respectively . Of 191 specimens evaluated on selective media, 44 (23.0%) were culture positive for GAS . TPPSA demonstrated a sensitivity of 93.2% and a specificity of 98.0% with positive and negative predictive values of 93.2% and 98.0%, respectively . The performance of TPPSA when compared with nonselective and selective media demonstrated a similar sensitivity, but a higher specificity was seen when compared to selective media . Overall, TPPSA was extremely easy to perform, had built-in procedural controls, required minimal technologist time, and was easy to interpret . With an accuracy of 93.5% when compared with nonselective media and 96.9% when compared with selective media, TPPSA could be recommended as a reliable method for detection of GAS. J Clin Periodontol, 1991 Sep, 18(8), 598 - 604 Effect of surgical and non-surgical periodontal treatment on periodontal status and subgingival microbiota; Pedrazzoli V et al.; The purpose of this study was to evaluate, on a short-term basis, the clinical and microbiological effects of a single course of scaling and root planing as compared with those obtained by flap surgery in patients with moderate to advanced periodontitis . 11 patients participated in the study . Using a split-mouth design, one quadrant of the mouth was treated with reverse bevel flap surgery, whereas the contralateral one was subjected to a single course of scaling and root planing . 2 approximal sites on single-rooted teeth with a pocket depth greater than or equal to 5 mm were monitored clinically and microbiologically for 16 weeks after active treatment . Both techniques resulted in a gain of probable attachment levels, a reduction in bleeding on probing and a reduced mean pocket depth, although 31.2% of the sites in the scaling and root planing group still had 6-7 mm deep pockets at 8 and 16 weeks after treatment . Both techniques reduced median relative proportions and frequencies of detection of black-pigmented Bacteroides species . A highly statistically significant increase (p less than 0.01) in median proportions of oral streptococci was recorded only for surgery within the 1st month post-operatively . No correlation was found between residual pocket depth and any of the microbiological parameters considered in the study, suggesting that residual pocket depth does not exert a significant influence on bacterial subgingival recolonization after therapy . The results from this study suggest that surgery can be as effective as scaling and root planing in favoring the establishment of micro-organisms compatible with periodontal health, although this effect is limited to the 1st month after therapy. J Clin Microbiol, 1991 Sep, 29(9), 2084 - 5 Selective streptococcal agar versus blood agar for detection of group A beta-hemolytic streptococci in patients with acute pharyngitis; Bellon J et al.; In a study on acute pharyngitis in general practice, we compared a selective group A streptococcal agar (ssA) for the recovery of group A beta-hemolytic streptococci (GABHS) with sheep blood agar . All plates were incubated at 36 degrees C in an atmosphere reinforced with 5% CO2 for 48 h with a first reading after 24 h . A total of 197 GABHS isolates were obtained from 721 throat cultures on both media . The recovery of GABHS was significantly higher after 48 h of incubation for both media . With the ssA plate, we detected significantly more GABHS after 24 h as well as after 48 h of incubation . The ssA plate reduced normal flora qualitatively and quantitatively . In conclusion, ssA is more sensitive and specific for the detection of GABHS than sheep blood agar and moreover easier to read . We recommend incubation for 48 h. J Hosp Infect, 1991 Sep, 19 Suppl B, 27 - 30 Overview of the role of mupirocin; Lamb YJ; Mupirocin is a novel antibiotic, for topical use only, which is unrelated in chemical structure and mode of action to any known class of antibacterial agent . It is active against a wide range of Gram-positive bacteria, including staphylococci and most streptococci, and is moderately active against Gram-negative bacteria . Mupirocin 2% ointment applied 2 or 3 times daily has demonstrable efficacy for the treatment of both primary and secondary skin infections and compares favourably with other topical and systemic treatments . In clinical studies, both elimination of the bacterial pathogen and clinical cure or improvement has been usual in over 90% of patients . Up to 40% of the normal population carry Staphylococcus aureus in the anterior nares and this carriage rate is often increased in hospitalized patients and their attendants . The increasing incidence of multiply- and methicillin-resistant S . aureus (MRSA) has been associated with hospital outbreaks leading to considerable morbidity and disruption of hospital services . Intranasal 2% calcium mupirocin has been shown to be effective in the eradication of nasal carriage; in bacteriologically controlled studies elimination of S . aureus, including MRSA, was achieved in over 95% of subjects . The role of mupirocin in preventing staphylococcal infection is currently undergoing evaluation. J Dent Res, 1991 Sep, 70(9), 1252 - 7 Changes in strains of mutans streptococci induced by treatment with chlorhexidine varnish; Kozai K et al.; Isolates of mutans streptococci were obtained from the dental plaque of ten subjects before and after the subjects had been free of detectable mutans streptococci for a mean period of 14.6 weeks (range, from two to 36 weeks) . The mutans streptococci had been rendered undetectable by chlorhexidine varnish treatment . Examination of the restriction endonuclease analysis (REA) patterns of the isolates revealed that all ten subjects had one strain (REA type) after re-appearance of the mutans streptococci that was identical to one that had been present before the varnish treatment . In six of the ten subjects, only one strain was detected both before and after treatment . Each of the other four subjects appeared to gain a new strain after treatment; one of the four appeared to lose one strain, and another, four strains . The ability of strains to persist after the period of undetectability seemed unrelated to their resistance to chlorhexidine or to their ability to exhibit insoluble glucan-mediated adhesion . In the subjects harboring multiple REA types, one-seventh of the tooth surfaces sampled harbored two strains simultaneously, suggesting an inability of either strain to exclude the other aggressively . Overall, the study indicated that every subject receiving chlorhexidine varnish therapy had a primary strain of mutans streptococcus that re-emerged after treatment . In contrast, secondary strains were highly susceptible to being lost or gained. Biochim Biophys Acta, 1991 Aug 30, 1079(2), 222 - 8 Purification of the proteinase from group B streptococci that inactivates human C5a; Bohnsack JF et al.; We previously reported that group B streptococci (GBS) possess a cell-associated activity that inactivates the chemotactic activity generated in zymosan-activated serum by cleaving a specific site within the carboxy termini of C5a and C5adesarg . This inactivates the major chemoattractants for neutrophils that are generated when serum complement is activated . We now report the isolation of the enzyme responsible for the proteolytic cleavage of C5a . Treatment of GBS with mutanolysin, an endo-N-acetyl muramidase, released activity from GBS which destroyed the functional activity of C5a . The soluble activity was purified to homogeneity by hydroxyapatite, ion-exchange and gel-filtration chromatography . Analysis by SDS-PAGE showed that the enzyme (GBS C5a-ase) has an Mr of approx . 120,000 . The GBS C5a-ase appears to be a serine esterase on the basis of its sensitivity to di-isopropyl fluorophosphate . This enzyme is distinct from the C5a-cleaving enzyme produced by group A streptococci, since the two bacterial products migrate differently on SDS-PAGE, and lack antigenic cross reactivity . This enzyme may play a role in the pathogenesis of group B streptococcal disease through its ability to rapidly inactivate the potent neutrophil agonist, C5a, at sites of infection. Vet Microbiol, 1991 Aug 15, 28(3), 295 - 302 Inhibitory effects of fibrinogen on phagocytic killing of streptococcal isolates from humans, cattle and horses; Traore MY et al.; The effects of fibrinogen on phagocytic killing of Streptococcus dysgalactiae from cattle and S . equi from horses were studied in comparison to that of S . pyogenes from humans . Phagocytic killing was determined by a fluorometric microassay using glass adherent polymorphonuclear neutrophils (PMN) from the respective host species, preopsonization with homologous sera led to a dose-dependent increase in phagocytic killing of all streptococcal cultures, preincubation of streptococci with fibrinogen significantly inhibited their phagocytic killing . Fibrinogen had no effect on phagocytic killing of non-fibrinogen binding S . agalactiae cultures . Further characterization studies with S . dysgalactiae and S . pyogenes revealed that a partial inhibition of phagocytic killing could also be achieved by preincubation with monomeric beta-chains of fibrinogen . Digestion of the fibrinogen binding sites on streptococci with proteases resulted in an almost complete loss of the inhibitory effects of fibrinogen on phagocytic killing . It could thus be concluded that by binding fibrinogen animal pathogenic streptococci could evade phagocytic killing in a similar manner as M protein carrying S . pyogenes isolates from human infections. Arch Intern Med, 1991 Aug, 151(8), 1655 - 7 Lung abscess with group A beta-hemolytic Streptococcus . Case report and review; Frieden TR et al.; Invasive infections with group A beta-hemolytic streptococci became less common in the early 20th century prior to the widespread use of antibiotics . From the early 1960s until the mid-1980s, reports of invasive infections continued to decline . In the past 5 years, there has been a resurgence of invasive infections and, possibly, also of postinfectious sequelae from this organism . We describe a patient with lung abscess from group A beta-hemolytic Streptococcus . Lung abscess from hemolytic streptococci was not uncommon in Osler's day, but it was not reported in the English-language literature for 20 years until recently . Clinicians should be aware of the broad and growing spectrum of infections with this pathogen. J R Coll Surg Edinb, 1991 Aug, 36(4), 227 - 32 Intra-abdominal abscesses in children; Adejuyigbe O et al.; Forty-one intra-abdominal abscesses in 30 Nigerian children seen over a 2-year period at the Obafemi Awolowo University Teaching Hospital were studied prospectively to determine their location, aetiology, microbiology and clinical course . Thirty-four abscesses (83%) were intraperitoneal with the subphrenic spaces and pelvis being the commonly involved intraperitoneal sites . Six abscesses (15%) were retroperitoneal while there was only one visceral abscess (2%) . Diseases of the gastrointestinal tract occurring in 20 patients (67%) were responsible for the majority of intraperitoneal abscesses, while suppurating external iliac adenitis was the major cause of retroperitoneal abscesses . There were 62 microbiological isolates, with 52% being anaerobic bacteria and 47% aerobic bacteria . A fungus, Candida, was isolated once (2%) . Escherichia coli and Staphylococcus aureus were the commonest aerobic bacteria, while Bacteroides and anaerobic streptococci were the commonest anaerobes . Sixteen patients (53%) had a mixed flora of aerobic and anaerobic bacteria, while in seven patients each (23%) only aerobic or anaerobic bacteria were isolated . The mortality rate in this series was 23% . Association of an intra-abdominal abscess with remote organ failure, postoperative anastomotic leakage, non-localization of the abscess within the peritoneal cavity and gastrointestinal perforation due to typhoid enteritis was found to portend poor prognosis. Dent Today . 1991 Aug;10(6):26, 29. Identification of pathogens in the condensates from air pressure systems in dental offices; Stout FW et al.; We examined the air pressure systems in 23 dental offices and found growth of Group A Streptococci and/or Staphylococcus Aureus in 91 percent of them . We also examined nine handpiece lines from these 23 offices and found growth of pathogens in 78 percent of them . Correlation of the growth found in the handpiece lines and the growth found in the air pressure tanks needs further study to determine if an interrelationship exists between these two areas of contamination . However, contamination does exist in both areas and these areas deliver contaminated air under pressure to the oral environment . We need to consider mechanisms for filter entrapment or sterilization of these pathogens. Burns, 1991 Aug, 17(4), 309 - 12 Microbiological aspects of burns at Mount Vernon Hospital, UK; Nakhla LS et al.; Bacterial infection in 100 burned patients over a 10-month period has been studied . The commonest colonizing organism was Staph . aureus (69 per cent), followed by E . coli (35 per cent) . Pseud . aeruginosa accounted for only 28 per cent of isolates . The role of the different bacterial species in burns pathology is discussed . Group G haemolytic streptococci were isolated from 10 per cent of patients and caused graft failure in some cases . Only 3 per cent of patients developed septicaemia and all were due to Staph . aureus . Our approach to management of infection in burns, especially the policy on systemic antimicrobial chemotherapy, is described. Kansenshogaku Zasshi, 1991 Aug, 65(8), 983 - 91 {A study on hemolytic streptococci (group A, B, C and G) isolated from throat of the middle-aged and advanced-aged--especially as compared with elementary school children}; Nakajima K et al.; Hemolytic streptococci were isolated from throat of middle-aged and advanced-aged and these organisms were classified into groups A, B, C and G . 1) Persons 15 to 39 years old were included in one group and persons from 40 years of age upward were divided into 5 groups every 10 years . Comparison of these groups were done . Generally, group B organisms were most often isolated . The detection rate of group B organisms was higher in the older age group . The detection rates of group A and G organisms were approximately equal, but both organisms were isolated from a few persons . No organism of group C was isolated from males, while only two strains belonged to group C organism were isolated from females . 2) A number of strains of group A hemolytic streptococci were isolated from school children, particularly in the lower classes . But the proportion of group B organism to isolated streptococci showed an increase in upper classes, noticeably in females . 3) For middle-aged and advanced-aged, blood samples were obtained simultaneously on examination of the throat, and ASO value and ASK titer were determined . ASO values were higher in persons infected with groups A, C or G organisms than in persons infected with group B organism or no hemolytic streptococcus . ASK titers revealed a similar results to ASO values, though the relation between ASK titers and isolated hemolytic streptococci was less positive. Kansenshogaku Zasshi, 1991 Aug, 65(8), 970 - 6 {An epidemiological survey of group A, B, C & G hemolytic streptococci isolated from the Throat of Diabetic Children Streptococcicosis Study Group}; Okuyama M et al.; The incidence of group A, B, C & G hemolytic streptococci residing in the throat of children with diabetes was surveyed . The survey was carried out in August, 1982 and August, 1983 . Included in the surveys were 136 diabetic children . The survey was also carried out with healthy school children at the same term as the contrast . The detection rate of the streptococci among the diabetic children was significantly higher than the healthy school children . A great portion of streptococci detected from these diabetic children was classified into group B, on the other hand, from the healthy school children, group A . Although from healthy school children, BIII, BIa and several other types were isolated, from diabetic children only BIa and BIII were isolated . The detection rate of the streptococci among the diabetic children was significantly higher in the early days in camp for improvement of diabetes than in the last day . In the latter case the detection rate was similar to that among healthy children . In the other words following antidiabetic therapy as diabetes improved the detection rate were also improved . Among these 136 diabetic children examined 31 gave positive cultures at both surveys each year . Serogroups or serotypes in each year examinations, isolates, were identical in 26 cases . Most of these groups were group B and the types were Ia and III. Kansenshogaku Zasshi, 1991 Aug, 65(8), 960 - 9 A study of haemolytic streptococci isolated from outpatients in dermatological clinics; Murai T et al.; A total of 44 patients suspected of streptococcal infections were studied in outpatient clinics in Tokyo during the one year from December 1988 to December 1989 . Employing bacteriological culturing and serodiagnosis, the following results were obtained . 1) There were 9 cases of impetigo and 15 cases of erysipelas with typical clinical manifestations and age distributions . 2) It seemed that some of the skin infections were caused by group A streptococci whose M-types were different from those of upper respiratory infections typically occurring in Japan . 3) The type distribution of group A streptococci found were quite similar to those isolated in Thailand or Malaysia . 4) There were found group A streptococci exhibiting unique combinations of T- and M-types, such as T11 and M9, T11 and M62 or T13-49 and MOD8 (Provisional type) . 5) As for serodiagnostic method, ADNB (anti-deoxyribonuclease B) titer reflected infection by group A streptococcus only, while ASK (anti-streptokinase) and ASO (anti-streptolysin O) reflected not only group A streptococcal infections but group G infections as well. Kansenshogaku Zasshi, 1991 Aug, 65(8), 945 - 52 {Serotype and antibiotic susceptibilities of group A hemolytic streptococci isolated in Osaka, 1988-1989}; Katsukawa C et al.; A total of 386 strains of Group A hemolytic Streptococci isolated from the patients in Osaka in 1988 and 1989 were type-classified by both T-agglutination and M-precipitin methods and were examined for drug-sensitivity . The results were summarized as follows . 1 . From T-typing result, T-1 (28.2%) was revealed as the most dominant serotype in 1988, followed by T-4 (24.9%), and T-12 (23.2%), although not as much difference was found in the isolation rate among these three types . A similar tendency was observed in the results of 1989 . The order was T-4 (30.3%), T-1 (24.8%), and T-12 (22.1%) . 2 . In the isolated Group A hemolytic Streptococci, 177 out of 241 strains (73.4%) in 1988 and 126 out of 145 strains (86.9%) in 1989 were M-typable with seven kinds of M-typing sera (Anti-M-1, 3, 4, 6, 12, 13, 18) . The result of M-typing was similar to that of T-typing, because the coincidence rate between T and M types was very high among the most prevalent serotypes such as 1, 4, 6, and 12 (type-1: 98.1%, type-4:89.4%, type-6:91.7%, type-12:94.3%) . 3 . The number of antibiotic-resistant strains decreased . It was especially prominent in the resistant strains to erythromycin, lincomycin and chloramphenicol . While the incidence of tetracycline resistant strains in type-4, 11 and 13 remained at a high level, it decreased in type-12 and 1 . All strains were sensitive to the beta-lactam antibiotics . 4 . No resistant strains were detected to enoxacin (ENX) and ofloxacin (OFLX), new quinolone . MIC90 values of ENX and OFLX were 16 micrograms/ml and 2 micrograms/ml, respectively, although difference of MIC90 was observed among some strain types: MIC90 of ENX against type-6 strain was 8 times higher than that against type-12 strain. Kansenshogaku Zasshi, 1991 Aug, 65(8), 938 - 44 {Serotypes and antibiotic susceptibility of group A and B streptococci clinically isolated in Sapporo in the last five years}; Takazawa Y et al.; During the last five-year period between 1985 and 1989, serotypes of 671 strains of group A and 238 strains of group B streptococci isolated from clinical specimens in Sapporo city general hospital were studied . Results of serotyping were given as under; Type T4 (25.8%), T12 (25.6%), T1 (11.5%), T3 (9.2%), T6 and T28 (6.3% each), T8 and T22 (0.6% each), T13 (0.4%), T9 and B3264 were found in group A . Type T4 and T12 formed main types up to this time and T1, T3, T6 and T28 were other predominant types . The elevated isolation rates of type T3 and T28 were remarkable in this period . In group B, Ia (31.5%), III (16.8%), Ib (14.3%), II (8.0%) and V (4.2%) were observed . On 617 samples (391 group A, 226 group B) out of these strains, antibiotic susceptibility to 9 drugs were examined . No resistant strain (MIC greater than or equal to 25 micrograms/ml) to beta-lactam antibiotics was found in each group . Resistant strains in group A streptococci were demonstrated 24.3% to TC, 0.5% to OL . No resistant strain, however, was observed to CP or EM . In group B, resistant strains were found in 39.8% to TC, 6.6% to CP, 2.2% to EM . Strains resistant to only TC (31.0%) were most prevalent followed by TC.CP (6.2%) and TC.MLs (2.7%) . Multi-resistant strain (to TC.CP.MLs) was not found. Kansenshogaku Zasshi, 1991 Aug, 65(8), 928 - 37 {Isolation trends on group A streptococci isolated from clinical specimens in hospitals in Saitama, 1979-1989}; Okuyama Y et al.; On 4,864 group A streptococci isolated from throat culture of patients in hospitals in Saitama from 1979 to 1989, we have done an epidemiological analysis of the T-type detection rates and the T-type epidemic, the monthly isolation rates, and the isolation rates by sex and age of patients . 1 . The T-type detection rates of 4,864 isolates of group A streptococci showed type T12 in 22.6%, type T4 in 16.4%, type T1 in 10.8%, type T13 in 8.5%, type T6 in 7.6%, type T28 in 6.9%, type T3 in 6.1% and type T18 in 5.3% etc, and the largest number of isolates was type T12 among 16 T-types . 2 . The main epidemic T-type during the investigation was type T12, and it was at the top from 1980 to 1981 and from 1984 to 1985 . The others, type T4 was at the top from 1982 to 1983 and from 1983 to 1989, type T3 was in 1986, type T6 was in 1987, and type T1 was in 1988, especially it has been suggested that there are the high epidemic T-types and low epidemic T-types among the T-types of throat group A streptococci . 3 . Monthly epidemic pattern of throat group A streptococci in each year showed two small epidemic peaks on March and June, a large epidemic peak from November to December since a turn on August . Further, the monthly epidemic pattern has been repeated every year . 4 . Throat group A streptococci isolated from patients occupied 87 per cent by the patients from 0 to 14 years, the peak of age distribution showed by age group from 5 to 7 years . The sexual ratio of male to female was in the ratio 1:0.9 . Further, the throat group A streptococci isolated from patients of age greater than 15 years was occupied about 50 per cent by age group from 30 to 39 years . A sexual ratio of male to female in the age group was in the ratio 1:1.8. Kansenshogaku Zasshi, 1991 Aug, 65(8), 919 - 27 {Antibiotic sensitivity and serotypes of group A hemolytic streptococci isolated from clinical specimens and healthy pupils in Japan, 1986-1988}; Endo M et al.; As an epidemiological survey for streptococcal infection, antibiotic sensitivity test and T-serotyping were made on 2,735 strains of group A hemolytic streptococci isolated from clinical specimens and healthy pupils between 1986 through 1988 in Japan . Most dominant serotype in clinical isolates was T-4 (26.8%) and it was followed T-12 (25.5%), T-1 (11.2%) and T-3 (8.5%), on the other hand, dominant serotypes of the isolates from healthy pupils were T-12 (30.4%), T-1 (19.3%), T-4 (15.3%) and T-28 (13.4%) . All of the isolates tested were sensitive to the beta-lactam antibiotics which was found as same as consequence of the previous surveys . However 36.4% to tetracycline, 2.1% to chloramphenicol and 1.4% to oleandomycin of the clinical isolates were resistant . Similarly, 16.2% to tetracycline, 2.3% to chloramphenicol 1.7% to oleandomycin, of the isolates from healthy pupils were resistant . Multi-resistant strains were found 1.4% in clinical isolates and 1.7% in the isolates from healthy pupils . Relation between distribution of multiresistant strain and T-serotypes was found . In T-12, multiresistant strains were encountered at a relatively high rate compared with other serotypes, representing 3.5% in clinical isolates and 5.6% in the isolates from healthy pupils . However this tendency was decreased than previous surveys, while incidence of tetracycline resistant strains in T-4 remained at high level, representing about 94% as same as in the past. Kansenshogaku Zasshi, 1991 Aug, 65(8), 909 - 12 {Preparation of monoclonal antibodies agglutinating group A, type 4 streptococci}; Arai H et al.; BALB/C mice were immunized with a partially purified M-protein fraction prepared from hot acid-extracts of a type 4, group A streptococcus, strain SS91 . Two samples of monoclonal antibodies (MAb) were obtained from hybridoma cells of antibody producing spleen cells fused with NS-1 myeloma cells . Both MAb were of the subclass IgG1 having kappa-type light chains . The MAb agglutinated trypsin-digested cells of type 4 strains, but not of types 1, 2, 18, 28 and 41 . This type 4-cell agglutination was inhibited by extracts of type 4 cells; strongly by hot acid-extract and partially by trypsin-extract . Hot acid-extract of type 41 cells had no inhibitory effect . Sandwich-enzyme-linked immunosorbent assay of the MAb and partially purified M-protein preparation combination against commercial T-typing sera showed that only T-type 4 antiserum reacted with the combination system . From these data, we thought that the MAb preparations were not directed to M-protein but to T-protein of type 4, group A streptococci. Kansenshogaku Zasshi, 1991 Aug, 65(8), 1003 - 8 {Alpha-hemolytic streptococcal septicemia and meningitis in immunocompromised children}; Sasaki H et al.; Many kinds of microorganisms can produce toxic septicemia in immunocompromised hosts . We are reporting alpha-hemolytic streptococcal septicemia and meningitis in two children with hematological malignancies . {Case 1} 6 year old girl who had been suffering from acute lymphocytic leukemia . She had sepsis and bacterial meningitis in maintenance-therapy for leukemia . Streptococcus sanguis was isolated from the blood and cerebrospinal fluid (CSF) . {Case 2} 11 year old girl who had had malignant lymphoma (non-Hodgkin type) . She also had sepsis and bacterial meningitis due to Streptococcus mitis which was isolated from blood and CSF in maintenance-therapy . Both cases had been treated with anti-cancer drugs and had severe granulocytopenia . Positive rate of blood cultures during the recent 6 years (1984.1-1989.12) at our department was 6.0% (total number of cultures were 2,019, positive cultures were 121) . Strains of 131 bacteria were determined; Gram-positive cocci were 70 strains (53.4%) and Gram-negative rods were 52 strains (39.7%) . Fifteen strains (11.5%) of alpha-hemolytic Streptococci were isolated during 6 years . One hundred thirteen cases of septicemia were analysed in medical charts and 12 cases of alpha-hemolytic streptococcal septicemia were observed (5 cases with infective endocarditis and 7 cases in immunocompromised states). Immunol Today, 1991 Aug, 12(8), 271 - 6 The Mycoplasma arthritidis T-cell mitogen, MAM: a model superantigen; Cole BC et al.; The superantigens are receiving a great deal of attention as a new group of potent immunomodulatory molecules . They are produced by diverse microbial agents including staphylococci, streptococci and mycoplasmas and are also encoded by murine tumor viruses (the Mls antigens) . Superantigens activate T cells by a unique pathway which can lead to modification of the T-cell repertoire and induction of autoimmunity . Here, Barry Cole and Curtis Atkin review their observations on the Mycoplasma arthritidis superantigen, MAM, and discuss how MAM might contribute to the acute and chronic inflammatory disease mediated by this organism. J Clin Pathol, 1991 Aug, 44(8), 670 - 5 Streptococci from primary isolation plates grouped by reverse passive haemagglutination; Farrington M et al.; Reverse passive haemagglutination, a novel microtitre based assay, was compared with the Streptex (Wellcome UK) latex slide agglutination kit for streptococcal grouping in a diagnostic microbiology laboratory . Three hundred and fifty two extracts from 349 consecutive primary isolation plates were assayed by both methods . Reverse passive haemagglutination gave identical grouping results for 98.0% of the 345 streptococci identified by Streptex, and the kappa coefficient of agreement between the methods for all 352 extracts tested was 0.973 . Cross reactions with Listeria spp seen with Streptex were not found by reverse passive haemagglutination . In the reverse passive haemagglutination method 11 streptococci could be grouped on each 96-well plate and most reactions were stable for at least 30 minutes . Reverse passive haemagglutination is more rapid to perform than latex slide agglutination when many organisms are to be grouped, and the patterns of haemagglutination are easily recognised . If the method was taken into routine use in a diagnostic laboratory, the persistence of reverse passive haemagglutination reactions would enable grouping results to be checked for quality control purposes. Aust N Z J Surg, 1991 Aug, 61(8), 570 - 5 Experience with biliary audit; Battersby C et al.; Experience with an audit of surgery for gallstones is discussed . Three hundred and forty-six patients were treated in a three and a half year period . There was no mortality . There was a duct exploration rate of 17%, an infection rate of 8.6%, and a re-operation rate for retained bile duct stone of 1.6% . Bile was cultured from 278 gall-bladders and culture was positive in 66 cases (23.7%) . The most common organisms grown were coliforms and streptococci . Our antibiotic policy has changed as a result of this study . Audit is becoming increasingly necessary in surgical practice, not only for research purposes, but also to monitor performance . The design can be broad, to identify groups of patients for further study, or narrow, to concentrate on a particular problem . Someone must be responsible for checking the completed forms for accuracy before the data are entered into the computer . It is important that the form be as simple as possible . Forms which are too detailed will be filled in inaccurately or not at all. J Infect Dis, 1991 Aug, 164(2), 320 - 30 Pathophysiology and histopathology of group B streptococcal sepsis in Macaca nemestrina primates induced after intraamniotic inoculation: evidence for bacterial cellular invasion; Rubens CE et al.; Four pregnant Macaca nemestrina dams at 140-145 days of gestation received an intraamniotic inoculation of group B streptococci (GBS) . All four premature infants were born by cesarean delivery, were bacteremic at birth, and showed symptoms of GBS sepsis similar to infected human infants with early-onset disease . Three infants did not receive antibiotics and died of GBS sepsis by 10 h of age despite mechanical ventilation and fluids for blood pressure support . Penicillin treatment of the fourth infant prolonged survival and decreased the requirement for supportive therapy . Quantitative cultures and histopathology were done on all four infants . Transmission electron microscopy of lung tissue demonstrated GBS within membrane-bound vacuoles of type I and II alveolar epithelium and interstitial fibroblasts . This model should be useful for studying the early steps in the pathogenesis of early-onset GBS infections . GBS may enter alveolar epithelial cells to transit this barrier and ultimately disseminate via the blood-stream. Infect Immun, 1991 Aug, 59(8), 2686 - 94 Conservation of the gene encoding streptococcal antigen I/II in oral streptococci; Ma JK et al.; The spaP gene of Streptococcus mutans serotype c encodes a major cell surface protein, streptococcal antigen (SA) I/II, with an Mr of 185,000, that is thought to be involved in bacterial adhesion to teeth . Proteins with significant amino acid sequence homology to SA I/II have also been found in S . sobrinus and S . sanguis . The objectives of this study were to investigate the conservation of the spaP gene in the mutans groups of streptococci and to determine whether homologous genes were present in other species of alpha-hemolytic streptococci . DNA extracted from representative strains of 19 streptococcal species was examined by Southern hybridization and partial DNA sequence analysis . A series of five overlapping DNA probes from the spaP gene were amplified by the polymerase chain reaction and used in the Southern hybridizations . The entire gene was found to be well conserved in all strains of S . mutans serotypes c, e, and f investigated . A probe from the 3' region of the gene, which encodes residues 857 to 1207 of the SA I/II protein, hybridized with DNA from a number of mutans streptococci, as well as with DNA from nonmutans alpha-hemolytic streptococci . Conservation within this region was further demonstrated by sequencing gene fragments of two strains of S . intermedius and S . oralis . The results show that some regions of the spaP gene are highly conserved not only in the mutans group of streptococci but also in other nonmutans alpha-hemolytic streptococci . This suggests that a family of cell surface proteins which, by analogy with the 185,000-Mr SA I/II of S . mutans, could be involved in bacterial adhesion might exist. Infect Immun, 1991 Aug, 59(8), 2638 - 44 Phenotypic diversity in the alpha C protein of group B streptococci; Madoff LC et al.; Group B streptococci (GBS) is the leading cause of neonatal sepsis and meningitis . C proteins are an immunologically important group of surface-associated antigens in GBS that remain incompletely characterized . Two C proteins have been designated alpha and beta on the basis of protease susceptibility . We recently used a monoclonal antibody to describe a protective epitope of the GBS alpha (or trypsin-resistant) C protein in the prototype Ia/c GBS strain . In the present study, we examined 51 GBS isolates for expression of C-protein alpha and beta antigens . The alpha antigen, as detected with monoclonal antibody in sodium dodecyl sulfate (SDS) extracts, appears as a heterogeneous series of proteins spaced 8 kDa apart on SDS-polyacrylamide gel electrophoresis, but has a maximum molecular mass that varies among strains from 62.5 to 167 kDa . By immunoblotting with human immunoglobulin A, polyclonal antiserum, or monoclonal antibody, the beta antigen, in contrast, appears as a single protein of molecular mass between 124 and 134 kDa . The amount of alpha antigen expressed by each strain was quantified by enzyme immunoassay inhibition and was found to vary markedly from strain to strain . The susceptibility of strains of GBS to opsonization and killing by human polymorphonuclear leukocytes in the presence of either complement alone or complement with alpha-specific monoclonal antibody was examined . Strains expressing the alpha antigen were less readily killed in the absence of specific antibody than were alpha-negative strains . Killing in the presence of alpha-specific monoclonal antibody was found to correlate directly with the maximum molecular mass of the alpha antigen and with the quantity of antigen on the bacterial cell surface . Isolates of GBS that express the alpha C protein vary widely in the quantity and molecular mass of the alpha antigen produced, and this heterogeneity appears to have biologic importance. Dtsch Zahnarztl Z, 1991 Aug, 46(8), 561 - 2 {Oral streptococci affecting Ca-phosphate precipitation}; Bergmann JE et al.; The precipitation of Ca-compounds in ageing dental plaque leads to the formation of calculus . Bacterial lipoteichoic acid (LTA) has been discussed as Ca-carrier in this process (Zoon et al., 1989) . Therefore in this study, LTA was isolated from oral streptococci and tested for its influence on the precipitation of Ca-phosphate . LTA-containing bacteria, LTA-free bacteria and isolated LTA were added to the reaction mixtures for Ca-phosphate precipitation and the amount of precipitated mineral was measured . LTA-containing cells and, above all, LTA, inhibited Ca-phosphate precipitation in a distinct pH-range just above the acid solubility of the mineral by complexing Ca(2+)-ions . Experiments with Ca-fluoride in place of Ca-phosphate showed that LTA did not affect the precipitation of this mineral. J Med Assoc Thai, 1991 Aug, 74(8), 313 - 22 Native valve infective endocarditis at Siriraj Hospital, 1982-1989; Thamlikitkul V et al.; During January 1982 to June 1989, there were 105 evaluable adult cases of native valve infective endocarditis admitted to Department of Medicine, Siriraj Hospital . The incidence was approximately 2.6 per 1,000 admissions . The male to female ratio was 1.4 and the mean age was 31.6 years . Thirty (28.5%) were cases associated with intravenous drug abuse . All non-addicts had pre-existing cardiac lesions susceptible to endocarditis especially rheumatic mitral regurgitation, aortic regurgitation, VSD and PDA . The clinical features of cases without intravenous drug abuse were low grade fever for few weeks, malaise, dyspnea and heart murmur . The addicts with endocarditis presented with acute febrile illness and pulmonary symptoms . Mucocutaneous embolic lesions were detected in one third of the patients . Echocardiography detected vegetations in 50 per cent of the patients . Streptococci were the most common causative agent in 93 per cent of non-addicts whereas the same percentage in addicts were caused by S . aureus . Most of the patients were treated with beta lactams (pen G, ampicillin or cloxacillin) alone or combined with aminoglycosides (streptomycin or gentamicin) for a duration from 10 days to 16 week . Six cases had valve replacement operation due to intractable heart failure and valve ring abscess, 2 had embolectomy of major arteries and 2 had craniotomy due to intracerebral hemorrhage . The overall case fatality rate was 14 per cent . The causes of death were heart failure, cerebral complications and severe pulmonary infections . Clinical response was observed sooner in non-addict patients. J Protein Chem, 1991 Aug, 10(4), 369 - 84 Heptad motifs within the distal subdomain of the coiled-coil rod region of M protein from rheumatic fever and nephritis associated serotypes of group A streptococci are distinct from each other: nucleotide sequence of the M57 gene and relation of the deduced amino acid sequence to other M proteins; Manjula BN et al.; Streptococcal M protein, a dimeric alpha helical coiled-coil molecule, is an antigenically variable virulence factor on the surface of the bacteria . Our recent conformational analysis of the complete sequence of the M6 protein led us to propose a basic model for the M protein consisting of an extended central coiled-coil rod domain flanked by a variable N-terminal and a conserved C-terminal end domains . The central coiled-coil rod domain of M protein, which constitutes the major part of the M molecule, is made up of repeating heptads of the generalized sequence a-b-c-d-e-f-g, wherein "a" and "d" are predominantly apolar residues . Based on the differences in the heptad pattern of apolar residues and internal sequence homology, the central coiled-coil rod domain of M protein could be further divided into three subdomains I, II, and III . The streptococcal sequelae rheumatic fever (RF) and acute glomerulonephritis (AGN) have been known to be associated with distinct serotypes . Consistent with this, we observed that the AGN associated M49 protein exhibits a heptad motif that is distinct from the RF associated M5 and M6 proteins . Asn and Leu predominated in the "a" and "d" positions, respectively, in subdomain I of the M5 and M6 proteins, whereas apolar residues predominated in both these positions in the M49 protein . To establish whether the heptad motif of M49 is unique to this protein, or is a general characteristic of nephritis-associated serotypes, the amino acid sequence of M57, another nephritis-associated serotype, has now been examined . The gene encoding M57 was amplified by PCR, cloned into pUC19 vector, and sequenced . The C-terminal half of M57 is highly homologous to other M proteins (conserved region) . In contrast, its N-terminal half (variable region) revealed no significant homology with any of the M proteins . Heptad periodicity analysis of the M57 sequence revealed that the basic design principles, consisting of distinct domains observed in the M6 protein, are also conserved in the M57 molecule . However, the heptad motif within the coiled-coil subdomain I of M57 was distinct from M5 and M6 but similar to M49 . Similar analyses of the heptad characteristics within the reported sequences of M1, M12, and M24 proteins further confirmed the conservation of the overall architectural design of sequentially distinct M proteins.(ABSTRACT TRUNCATED AT 400 WORDS) J Prosthet Dent, 1991 Aug, 66(2), 256 - 60 The effect of sucralfate on the growth of cariogenic streptococci; Brown DT et al.; Sucralfate, an aluminum salt of sucrose octasulfate, has been shown to be effective in reducing the discomfort of radiation therapy-induced oral mucositis . This study was done to determine whether sucralfate could be used as a nutritional source for dental caries-producing organisms . Three Streptococcus strains were cultured in a defined medium . Sucralfate powder was evaluated for its ability to be used as a carbohydrate food source by these organisms . The addition of sucralfate alone did not stimulate the organism's growth . The addition of sucralfate and glucose resulted in less growth than the addition of glucose alone . Increasing the sucralfate concentration from 1% to 10% in the glucose-containing cultures resulted in statistically significant growth inhibition (p less than 0.02) . Sucralfate appears to have no cariogenic potential and may have some cariostatic potential. Mol Microbiol, 1991 Aug, 5(8), 1993 - 2002 Interspecies recombinational events during the evolution of altered PBP 2x genes in penicillin-resistant clinical isolates of Streptococcus pneumoniae; Laible G et al.; Penicillin resistance in pneumococci is due to the appearance of high molecular-weight penicillin-binding proteins (PBPs) that have reduced affinity for the antibiotic . We have compared the PBX 2x genes (pbpX) of one penicillin-susceptible and five penicillin-resistant clinical isolates of Streptococcus pneumoniae isolated from various parts of the world . All of the resistant isolates contained a low-affinity form of PBP 2x . The 2 kb region of the two penicillin-susceptible isolates differed at only eight nucleotide sites (0.4%) and resulted in one single amino acid difference in PBP 2x . In contrast, the sequences of the PBP 2x genes from the resistant isolates differed overall from those of the susceptible isolates at between 7 and 18% of nucleotide sites and resulted in between 27 and 86 amino acid substitutions in PBP 2x . The altered PBP 2x genes consisted of regions that were similar to those of susceptible strains (less than 3% diverged), alternating with regions that were very different (18-23% diverged) . The presence of highly diverged regions within the PBP 2x genes of the resistant isolates contrasts with the uniformity of the sequences of the amylomaltase genes from the same isolates, and with the uniformity of the PBP 2x genes in the two susceptible isolates . It suggests that the altered PBP 2x genes have arisen by localized interspecies recombinational events involving the PBP 2x genes of closely related streptococci, as has been suggested to occur for altered PBP 2b genes (Dowson et al., 1989b) . The PBP 2x genes from the resistant isolates could transform the susceptible strain R6 to increased levels of resistance to beta-lactam antibiotics, indicating that the altered forms of PBP 2x in the resistant isolates contribute to their resistance to penicillin. Eur Heart J, 1991 Aug, 12 Suppl D, 158 - 62 Autoimmune determinants of rheumatic carditis: localization of epitopes in human cardiac myosin; Dell A et al.; Rheumatic carditis is a sequela of group A streptococcal throat infection . Although the pathogenic mechanisms which lead to heart damage in acute rheumatic fever (ARF) are not well understood, autoimmune processes have been implicated, involving molecular mimicry between streptococci and the human heart . We have studied the immunological cross-reactions between the group A Streptococcus and human heart to understand their molecular and immunological basis . Human and mouse monoclonal antibodies (mAb) and affinity-purified anti-myosin antibodies from acute rheumatic fever sera were characterized and shown to cross-react with group A streptococcal M protein and myosin . Studies of proteolytic fragments of human cardiac myosin identified sites of cross-reactivity in the rod region of the myosin heavy chain . Murine monoclonal antibodies cross-reactive with streptococcal M protein and myosin recognized epitopes located in the S2 and light meromyosin (LMM) subfragments of the heavy chain . None of the cross-reactive monoclonal antibodies recognized the S1 subfragment . One broadly cross-reactive monoclonal antibody was highly cytotoxic for heart cells in vitro and reactive with the LMM fragment . The data suggest that the cross-reactive epitopes recognized by these antibodies are conformational, dependent upon their alpha-helical structures, and potentially damaging to host tissues. J Clin Microbiol, 1991 Aug, 29(8), 1562 - 7 Molecular analysis of pyrogenic exotoxins from Streptococcus pyogenes isolates associated with toxic shock-like syndrome; Hauser AR et al.; Toxic shock-like syndrome (TSLS) is characterized by hypotension or shock, fever, multiorgan system involvement, and a concurrent group A streptococcal infection . We analyzed 34 streptococcal strains isolated from patients with clinically well-documented TSLS for their pyrogenic toxin profiles and M-protein types . Although strains of nine different M types were represented in the sample, 74% of the isolates were of either M type 1 or 3 . It was determined that 53% produced streptococcal pyrogenic exotoxin type A under in vitro growth conditions and that 85% contained the gene encoding this toxin . These values are in contrast to the published value of 15% for the incidence of this gene in a sample of general group A streptococcal isolates . As has been found with all group A streptococci examined to date, regardless of disease association, 100% of TSLS-associated isolates contained the gene encoding pyrogenic exotoxin type B . This toxin was detectably produced by 59% of isolates . The gene encoding pyrogenic toxin type C was found in only 21% of isolates . We conclude that the pyrogenic exotoxin type A gene is associated with group A streptococcal strains isolated from patients with TSLS and may play a causative role in this illness . However, other factors are also likely to be important, since not all strains from patients with TSLS contained the A toxin gene. Biochemistry, 1991 Jul 2, 30(26), 6528 - 40 Complete structure of the cell surface polysaccharide of Streptococcus oralis ATCC 10557: a receptor for lectin-mediated interbacterial adherence; Abeygunawardana C et al.; Lectin-carbohydrate binding is known to play an important role in a number of different cell-cell interactions including those between certain species of oral streptococci and actinomyces that colonize teeth . The cell wall polysaccharides of Streptococcus oralis ATCC 10557, S . oralis 34, and Streptococcus mitis J22, although not identical antigenically, each function as a receptor molecule for the galactose and N-acetylgalactosamine reactive fimbrial lectins of Actinomyces viscosus and Actinomyces naeslundii . Carbohydrate analysis of the receptor polysaccharide isolated from S . oralis ATCC 10557 shows galactose (3 mol), glucose (1 mol), GalNAc (1 mol), and rhamnose (1 mol) . 1H NMR spectra of the polysaccharide show that is is partially O-acetylated . Analysis of the 1H NMR spectrum of the de-O-acetylated polysaccharide shows that it is composed of repeating subunits containing six monosaccharides and that the subunits are joined by a phosphodiester linkage . The 1H and 13C NMR spectra were completely assigned by two-dimensional homonuclear correlation methods and by 1H-detected heteronuclear multiple-quantum correlation (1H{13C}HMQC) . The linkage of the component monosaccharides in the polymer, deduced from two-dimensional 1H-detected heteronuclear multiple-bond correlation spectra (1H{13C}HMBC), shows that the repeating unit of the de-O-acetylated polymer is a linear hexasaccharide with no branch points . The complete 1H and 13C assignment of the native polysaccharide was carried out by the same techniques augmented by a 13C-coupled hybrid HMQC-COSY method, which is shown to be especially useful for carbohydrates in which strong coupling and overlapping peaks in the 1H spectrum pose difficulties . The fully assigned spectra of the native polymer show that each of two different positions is acetylated in one-third of the repeating subunits and that the acetylation is randomly distributed along the polymer . The exact positions of acetylation were assigned by a carbonyl-selective HMBC method that unambiguously defines the positions of O-acetylation . The complete structure of the native polysaccharide in S . oralis ATCC 10557 is {formula: see text} Comparison of this structure with those previously determined for the polysaccharides of strains 34 and J22 suggests that the similar lectin receptor activities of these molecules may depend on internal galactofuranose linked (beta 1----6)- to Gal(beta 1----3)GalNAc(alpha) or GalNAc(beta 1----3)Gal(alpha). APMIS, 1991 Jul, 99(7), 602 - 8 Early response in septicemia in newborns and their mothers . Effect of Escherichia coli, Streptococcus agalactiae and tumor necrosis factor on lactoferrin release and the generation of tissue thromboplastin; Gutteberg TJ et al.; Using a whole blood in vitro model, we have investigated the effect of Escherichia coli (E . coli), Streptococcus agalactiae (group B streptococci, GBS) and tumor necrosis factor alpha (TNF) on the generation of lactoferrin (LF), interleukin-1 beta (IL-1) and tissue thromboplastin (TPL) in healthy newborns at term and their mothers . E . coli (at a final concentration of 10(7)/ml) significantly increased the release of LF in whole blood from newborns after 20 as well as 60 min stimulation, and in samples from their mothers after 60 min stimulation . A significant increase in the release of LF was observed in both newborns and their mothers after 20 and 60 min stimulation with TNF (at a final concentration of 1000 pg/ml) . A combination of TNF/E . coli or TNF/GBS never gave any significant additional stimulatory effect . After stimulation with E . coli or GBS (both at a final concentration of 10(7)/ml) for 60 min a significant increase in production of TNF and TPL was observed in newborns . In newborns a significant increase in production of TNF and TPL was observed also after 20 min stimulation with E . coli . TNF (at a final concentration of 1000 pg/ml) significantly increased the generation of TPL after 20 and 60 min stimulation in both groups . There was a tendency for a greater release of LF and generation of TNF and TPL in samples from newborns compared with their mothers, but the differences were not statistically significant . E . coli, GBS and TNF had no significant effect on the production of IL-1. J Dent Res, 1991 Jul, 70(7), 1041 - 4 Synergistic degradation of mucin by Streptococcus oralis and Streptococcus sanguis in mixed chemostat cultures; Van der Hoeven JS et al.; Oral streptococci can grow in mucin by utilizing the oligosaccharide chains as a source of carbohydrate . The degradation of the oligosaccharides by these species is accomplished by exoglycosidase activities . In this experiment, it was investigated whether strains from different species could cooperate in the release of sugars from the mucin oligosaccharide . To this end, Streptococcus sanguis Ny 584 and Streptococcus oralis strain Ny 586 were grown continuously in a chemically-defined medium, with pig gastric mucin as the growth-limiting source of carbohydrate . In pure cultures, strain Ny 586 attained approximately three-fold-higher cell densities than did strain Ny 584 in the mucin medium . This was in accordance with the observation that S . oralis Ny 586 exhibited fucosidase activity, as indicated by the presence of fucose in the culture fluid . In contrast, strain Ny 584 has no fucosidase activity against mucin, and therefore cannot attack fucose-ending oligosaccharide chains . Stable mixed cultures of the strains were obtained . It appeared that S . sanguis Ny 584 reached significantly higher cell densities in mixed cultures with S . oralis Ny 586 than in pure culture . Stimulation of the growth of strain Ny 584 was probably due to the generation of non-fucose-ending oligosaccharide chains by fucosidase from strain Ny 586 . It is concluded that the synergistic degradation of oligosaccharides in glycoproteins is a potential factor influencing the streptococcal populations in the mouth. Infect Immun, 1991 Jul, 59(7), 2305 - 10 Virulent human strains of group G streptococci express a C5a peptidase enzyme similar to that produced by group A streptococci; Cleary PP et al.; Specific proteolytic destruction of the human chemotaxin, C5a, is a property of group A and B streptococcal pathogens . Here we show that virulent group G streptococci from human sources also express C5a peptidase activity . The enzyme responsible for this activity is approximately the same size as and is antigenically similar to that produced by group A streptococci . On the basis of Southern hybridization analysis with an internal fragment of the group A C5a peptidase gene (scpA) as a probe, a copy of this gene was found in the genome of all group G human isolates tested . Comparison of partial restriction maps of scpA and scpG revealed significant similarity between the two genes . Group G strains isolated from dogs and cows were found to lack C5a peptidase activity and did not hybridize to the scpA-specific probe . The association of this activity with three streptococcal species suggests that elimination of phagocyte chemotactic attractants is a more universal virulence mechanism than originally anticipated. Indian J Med Res, 1991 Jul, 93, 222 - 4 Application of serum opacity factor in subtyping of group A streptococci & identification of new M-types; Prakash K et al.; Out of 742 isolates of group A streptococci (GAS), 34.0 per cent were positive for production of serum opacity factor (SOF) . The T and M typability of these GAS strains was 93.3 and 10.8 per cent respectively . Clustering of the strains under the T patterns 5/12/27, 8/25/Imp . 19 and 3/13/B3264 and low M typability indicated the utility of SOF testing as an additional marker in epidemiological characterisation of GAS . SOF was further found to be useful in identification of new M type and simplified M typing by saving time, labour and sera. N Z Dent J, 1991 Jul, 87(389), 80 - 3 The prevention of dental caries by BLIS-mediated inhibition of mutans streptococci; James SM et al.; Many of the strategies that have been formulated to decrease the incidence of dental caries have focused upon attempting to reduce either the numbers or the acidogenic activities in dental plaque of the mutans streptococci .