Streptococcal

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 . In recent years there has been a growing interest in a new method of caries control which depends upon exploiting the ability of certain bacteria to produce antibiotics called bacteriocin-like inhibitory substances (BLIS) with killing activity for mutans streptococci . The approaches under investigation include either the regular oral administration of the purified BLIS or the genetic modification of existing plaque bacteria such that they produce the antimutans BLIS in situ.

Postgrad Med J, 1991 Jul, 67(789), 666 - 71
A new hypothesis for the aetiology of Crohn's disease--evidence from lipid metabolism and intestinal tuberculosis; Roediger WE; The stimulus for the immune response in Crohn's disease is unknown . In each of 19 cases of Crohn's disease evaluated by electron microscopy, epithelial cells of the ileum contained phagolysosomes with lamellar layers of lipid . These structures, now termed R or reactant bodies, are the proffered antigenic stimulus . They are proposed to be an amalgam of lipid (cholesterol esters, or phospholipids) and bacterial fragments (mycoplasma, mycobacteria or streptococci), which in combination are hypothesized to produce a powerful immunological response analogous to the adjuvant effect . For disease expression to occur, lipids and specific bacterial populations are needed in the bowel lumen . These factors may account for the success of elemental diets that are low in fat in the treatment of Crohn's disease and for the regional distribution of disease along the intestinal tract.

Microbiologica, 1991 Jul, 14(3), 223 - 8
Streptococcus mutans: classification in bacteriocin-types; Bondi M et al.; A sample of S . mutans bacteriocins was studied to obtain a useful outline of strain typing since their synthesis has proved stable and not under plasmidial control . The inhibiting effectiveness against 9 oral streptococci and the sensitivity of mutacins produced by 49 S . mutans strains to heat, chloroform and proteasic activity were evaluated . On the basis of our results the producing strains are classified into five different types . We examine the possibility of obtaining a useful typing with bacteriocins and we discuss the choice of the most suitable number of indicators to arrange the strains in a limited cluster number for epidemiological purpose, or to classify freshly isolated S . mutans strains into bacteriocin-types.

J Periodontol, 1991 Jul, 62(7), 439 - 44
Isolation and purification of bacteriocin from Prevotella intermedia (Bacteroides intermedius); Takada K et al.; Thirty-three out of 46 strains of Prevotella intermedia (Bacteroides intermedius) isolated from gingival deposits of patients with adult periodontitis possessed the ability to inhibit growth of P . intermedia strain ATCC 25611, and 6 of the 33 showed strong inhibitory activity . Thirteen isolates did not have the ability to inhibit the growth of P . intermedia strain ATCC 25611 . An inhibition factor from one of the isolates, P . intermedia TH14 which had strong inhibition, was purified and characterized . Bacteriocin TH14 activity was effective against only P . intermedia ATCC 25611 and Fusobacterium nucleatum, but not against other crevicular bacteria, including P . intermedia ATCC 33563, Porphyromonas gingivalis (Bacteroides gingivalis), Capnocytophaga sputigena and Actinobacillus actinomycetemcomitans . Streptococci, actinomyces, and veillonellas were not inhibited by bacteriocin TH14 . Bacteriocin TH14 was heat sensitive, proteinaceous with molecular weight of 1,700 daltons and inhibited the growth of strain ATCC 25611 in 15 minutes . The growth inhibition of P . intermedia ATCC 25611 by bacteriocin TH14 was found to be due to the bactericidal activity of the bacteriocin.

Kansenshogaku Zasshi, 1991 Jul, 65(7), 820 - 32
{A 23-year longitudinal study on the antibiotic sensitivities of group A streptococci from the scarlet fever patients--1956-1978}; Kashiwagi Y; Among the group A streptococci isolated during the period 1956 to 1978 from the pharynx and the nostril of the scarlet fever patients quarantined in the Tokyo Metropolitan Toshima Hospital within 1 week of hospitalization, 1,586 strains of types 4, 6 and 12, the most prevalent serotypes, were estimated for their sensitivities to various antibiotics . Among the sensitivities, those to tetracycline (TC), chloramphenicol (CP) and erythromycin (EM), these being in close relation to prevalent serotypes, are to be reported . The first appearance of TC-resistant strain was seen in one strain (type 6) isolated in 1959, and, in 1964, the resistant strain increased in proportion in accordance with the prevalence of type 4 . The resistant strain decreased a little in 1968 and in 1969, increased again from 1970, exceeded over 90% from 1973, and reached 100% in 1978 . The first appearance of CP-resistant strain was seen in one strain (type 4) isolated in 1969, and then the resistant strain increased year by year along with the prevalence of type 12 . The first appearance of EM-resistant strain was seen in 30 strains (type 12) isolated in 1972, and then, similarly to the case of CP-resistance, the resistant strain increased year by year together with the prevalence of type 12 . Meanwhile, among the 1,586 strains isolated at the time of hospitalization and estimated of their minimum inhibitory concentrations (MIC), 932 strains (58.8%), 452 strains (28.5%), and 574 strains (36.2%) showed resistance to TC, CP, and EM, respectively . Variations of drug-resistance by serotypes were as follows: TC-resistant strains increased in accordance with the prevalence of type 4 in 1964; CP- and EM-resistant strains increased in accordance with the prevalence of type 12 in 1972; and type 6 strains were low in the rate of resistant strain to any of the three drugs . So far, prevalence of a serotype of group A streptococci has been considered to be caused by the accumulation of the subjects non-immune to the serotype . In the present study, a phenomenon was observed that prevalence of a serotype was effected by the state of resistance-acquisition to commonly used drugs . It would be clear that the resistance-acquisition plays, in addition to the immune state, a great role in evoking prevalence of a serotype.

Pediatr Res, 1991 Jul, 30(1), 118 - 23
The role of C3 in mediating binding and ingestion of group B streptococcus serotype III by murine macrophages; Noel GJ et al.; To understand how complement effects phagocytosis of type III group B streptococcus, we assessed the specific role of C3 in mediating binding and ingestion of these bacteria by macrophages . Phagocytosis of bacteria by resident mouse peritoneal macrophages was measured under conditions in which C3 deposition on bacteria was inhibited or after blockade of C3-ligands or of complement receptor type three (CR3) with specific antibodies . C3 depletion, incubation with F(ab')2 fragments of antibody to C3, or blockade of CR3 completely inhibited the binding of bacteria that was seen in the presence of nonimmune serum . Immune serum increased the number of associated organisms 6-fold compared to that seen with nonimmune serum . With this serum, 82% of organisms were ingested . C3 depletion or CR3 blockage had a modest effect, but this interaction could be ablated completely only after Fc receptors were blocked . Using varied concentrations of an IgG2a MAb against type III capsular antigen, it was possible to show that small amounts of antibody incapable of mediating bacterial binding by itself directed an interaction that also depended upon C3 . Phagocytosis of group B streptococci by macrophages in the presence of little or no antibody requires complement and C3 opsonization specifically . C3-dependent binding may be important in determining mononuclear phagocyte-dependent clearance of these pathogens from blood, particularly in patients with little or no type-specific serum antibody.

J Clin Microbiol, 1991 Jul, 29(7), 1536 - 8
Evaluation of a rapid screening test for detecting group B streptococci in pregnant women; Granato PA et al.; The QUIDEL Group B Strep Test is an enzyme immunoassay (EIA) that was compared with culture for the rapid detection of moderate to high levels of group B streptococci (GBS) colonization in pregnant women . A total of 331 pregnant women were included in the study protocol, and GBS were cultured from 19 of these patients in moderate or greater amounts (incidence of 5.7%) . Compared with culture, the EIA had a sensitivity, specificity, and positive and negative predictive values of 89, 99, 89, and 99%, respectively . With a sensitivity of 89%, the 95% confidence interval for this assay is 88 to 90% . The QUIDEL EIA test can be performed in less than 10 min and appears to be a reliable method for detecting moderate or greater amounts of GBS in vaginal or cervical specimens.

J Laryngol Otol, 1991 Jul, 105(7), 553 - 5
The microbiology of peritonsillar sepsis; Snow DG et al.; Pus obtained by needle aspiration of 91 peritonsillar abscesses was examined microbiologically . A positive culture was obtained in 55 patients (60 per cent) . Sixty-four bacteriological isolates were grown . Forty patients had a pure growth of a single organism, of which 21 (53 per cent) were beta Haemolytic streptococci . Pure growths of Staphylococcus aureus were found in only three patients . Fifteen patients had mixed organisms, including anaerobes, in their pus and the resistance to penicillin was low . Only the bacteroides species were generally penicillin resistant . The vast majority of patients made a good recovery following needle drainage of the abscess and treatment with parenteral penicillin . The patients with a mixture of penicillin sensitive and penicillin resistant organisms also made a good clinical recovery following needle drainage and administration of parenteral penicillin . The relevance of these findings in the pathogenesis and management of peritonsillar sepsis is discussed.

Br J Dermatol, 1991 Jul, 125(1), 38 - 42
Altered cell-mediated immunity to group A haemolytic streptococcal antigens in chronic plaque psoriasis; Baker BS et al.; The proliferative lymphocyte response to sonicated group A, beta-haemolytic streptococci (Strep-A) was measured by thymidine incorporation in 78 patients with psoriasis (guttate, chronic plaque or both) . Lymphocytes from 72 of these patients were also cultured with streptokinase/streptodornase (SK/SD), and 20 of the patients with chronic plaque psoriasis were further tested with PPD, Candida albicans and sonicated Streptococcus mutans, a bacterial type not associated clinically with psoriasis . The median stimulation index (SI) of the psoriasis group to the Strep-A preparation was significantly higher than that of a group of 27 non-psoriatic individuals (P less than 0.05) . Within this group, only the patients with chronic plaque psoriasis (n = 42) showed a significantly increased proliferative response compared to the non-psoriatic controls (median SI = 123.8 and 31.9, respectively, P less than 0.01) . Although the lymphocyte response of the chronic plaque group to SK/SD was also markedly higher than that of the control group, this difference did not reach statistical significance . In addition, these patients did not show significantly increased responses to any of the other antigens tested, including S . mutans . No correlation was observed between the degree of proliferation to Strep-A and disease extent or activity . Similarly, ASO titres, which were raised in 11 out of 23 guttate and three out of nine chronic plaque psoriasis patients tested, did not correlate with the proliferative responses observed.

Clin Oral Implants Res, 1991 Jul-Sep, 2(3), 135 - 44
Microbial differences in 2 clinically distinct types of failures of osseointegrated implants; Rosenberg ES et al.; The microflora associated with osseointegrated implants suspected of failing from infection or trauma were evaluated . Of 75 patients examined, 11 demonstrated failing fixtures . 22 of 48 fixtures failed in 6 fully edentulous patients and 10 of 34 failed in 5 partially edentulous patients . The etiology of failure was attributed to infection if there was bleeding, suppuration, pain, high plaque and gingival indices and granulomatous tissue upon surgical removal . Traumatic etiology was suspected in the absence of these signs . Direct phase-contrast microscopy and culture analysis were performed on samples from the implant sulcus, the implant itself and the extraction socket . The 2 failure types exhibited distinct bacteriologic profiles . For implants failing with infection, spirochetes and motile rods averaged 42% of total morphotypes . Many suspected periodontopathic organisms including Peptostreptococcus micros, Fusobacterium species, enteric gram-negative rods and yeasts, constituted high proportions of the cultivable microflora . In contrast, implants failing from suspected traumatic etiology demonstrated a morphotype profile consistent with periodontal health and cultivable microflora predominated by streptococci . When evaluating the time of failure after initial insertion, it was found that fixture loss resulting from infection occurred most often between initial placement and second-stage surgery, whereas failure in the absence of infection occurred primarily after insertion of the final prosthesis . The terms infectious and traumatic failure have been introduced to describe these 2 clinically and microbiologically distinct phenomena.

Mol Microbiol, 1991 Jul, 5(7), 1727 - 34
Expression of the fibronectin-binding components of Streptococcus pyogenes in Escherichia coli demonstrates that they are proteins; Talay SR et al.; The fibronectin-binding components (fbcs) of two clinical isolates and a culture collection strain of Streptococcus pyogenes have been analysed . Western immunoblotting of bacterial lysates which had been fractionated on polyacrylamide gels revealed trypsin-sensitive fibronectin-binding species . The genes specifying the fbcs were cloned from all three strains and expressed in Escherichia coli using a lambda EMBL3 vector . An fbc gene from the culture collection strain was subcloned and expressed in the E . coli expression vector pJLA601, and subjected to deletion analysis . The fibronectin-binding domain was thereby localized within a 40 kDa truncated peptide encoded by the 1000 bp C-terminal region of the gene . Southern hybridization experiments demonstrated that the analysed gene was present in the parental S . pyogenes chromosome, but not in the DNA of fbc expressing lambda clones obtained from the two clinical isolates . Further evidence for the existence of at least two different types of fbcs in group A streptococci was provided by Western blot analysis of recombinant phage lysates which revealed a complex series of fibronectin-binding species ranging from 120 to 200 kDa in size and showing strain-dependent variation in their patterns . As was the case with parental streptococcal strains all of the recombinant fbcs were protease-sensitive, and treatment with trypsin or pronase resulted in a total loss of fibronectin-binding activity . Competitive inhibition experiments indicated that lipoteichoic acid was not a significant fbc in the tested streptococcal strains.(ABSTRACT TRUNCATED AT 250 WORDS)

Neurology, 1991 Jul, 41(7), 1015 - 20
Neurologic complications of infective endocarditis; Kanter MC et al.; Neurologic syndromes often complicate the management of infective endocarditis (IE) . We retrospectively reviewed 166 episodes of native valve endocarditis to assess the occurrence and implications of nonfocal encephalopathy, meningitis, salient headache, back pain, and brain abscess . Neurologic complications occurred in 35% (58/166) of patients: 41% (54/133) of mitral or aortic valve IE and 12% (4/33) of tricuspid valve IE . Of 133 cases of mitral or aortic valve IE, encephalopathy occurred in 14%, meningitis in 5%, and salient headache in 3% . All neurologic complications occurred more often with Staphylococcus aureus infection (67%) than with viridans streptococci (22%), including encephalopathy (22% versus 7%), meningitis (17% versus 0%), stroke (39% versus 16%), and death (39% versus 9%) . Encephalopathy was associated with virulent organisms, increased patient age, and uncontrolled infection . Clinical, radiologic, and neuropathologic data all suggest that infective microemboli are often etiologic in IE-related encephalopathy . There were no macroscopic brain abscesses clinically identified . Meningitis occurred only with virulent organisms . While many clinical aspects of IE have changed in recent years, the frequency and gravity of neurologic complications have not.

Revmatologiia (Mosk), 1991 Jul-Sep, (3), 11 - 5
{The detection of streptococci, the study of their immunobiological properties and the determination of lipoproteinase antibodies and anti-immunoglobulins in patients with acute rheumatic fever}; Dzhuzenova BS et al.; Bacteriological confirmation of the presence of group A Streptococcus (GAS) in patients with acute rheumatic fever (ARF) by means of the express method was achieved only in 15.1% of the cases and the positive growth of the culture was observed only in 12.1% . Streptococci isolated from the patients showed a low IgG-Fc receptor activity just as in the negative control . The blood serum of patients exhibited the presence of antibodies to 18 OF-serotypes among which serotypes 2, 4, 22, 28, 48, 68, 75, 77, 78, PT 2841 prevailed; their content fluctuated from 12.5 to 48.4% . There were no differences between the nature of distribution of the given antibodies depending on the presence and level of ASL-O in the blood and the presence of concomitant chronic tonsillitis . Antibodies to IgG in titres 1:10-1:40 were revealed in the blood of only 18.1% of the patients; there was some dependence of the frequency of their detection on the markedness of carditis and the presence of cardiac defects.

Acta Pathol Jpn, 1991 Jul, 41(7), 567 - 72
Necrotizing fasciitis rapidly diagnosed by aspiration cytology; Hirokawa M et al.; A case of necrotizing fasciitis caused by beta-hemolytic streptococci is reported . A 66-year-old man was admitted because of pain and swelling in the right buttock . Rapid application of aspiration cytology made it possible to diagnose necrotizing fasciitis with bacterial infection . Unfortunately, however, the patient died of cardiac arrest due to hyperpotassemia 11 h after admission . Mortality from this disease is most often related to failure in recognizing it early . Rapid diagnosis and early treatment is mandatory in order to save the patients' life . We emphasize the usefulness of rapid aspiration cytology, despite the unfortunate outcome in the present case.

Anal Biochem, 1991 Jul, 196(1), 24 - 30
Quantitative determination of the intracellular concentration of the various forms of HPr, a phosphocarrier protein of the phosphoenolpyruvate: sugar phosphotransferase system in growing cells of oral streptococci; Vadeboncoeur C et al.; A simple procedure for quantitative estimation of the different phosphorylated forms of the phosphocarrier protein HPr in growing cells of oral streptococci is described . The growth of the cells was rapidly stopped by acidification of the medium and concomitant addition of the ionophore Gramicidin D . This procedure inactivated Enzyme I, HPr(Ser) kinase, HPr(Ser-P) phosphatase, and the enzymes involved in the metabolism of the allosteric effectors as well as the substrates of HPr phosphorylation . The cellular concentrations of HPr (His approximately P), HPr (Ser-P), HPr (His approximately P) (Ser-P), and free HPr were then determined by crossed immunoelectrophoresis.

J Exp Med, 1991 Jul 1, 174(1), 285 - 8
T cell receptor V gene usage by human T cells stimulated with the superantigen streptococcal M protein; Tomai MA et al.; M proteins, the major virulence factor of group A streptococci, have been implicated in the pathogenesis of acute rheumatic fever (ARF) and other streptococcal related autoimmune diseases . A 22-kD fragment of M type 5 protein is a potent stimulant of human T cells and has recently been shown by our laboratory to belong to the newly designated family of superantigens . Using flow cytometry and the polymerase chain reaction, we demonstrate that this molecule reacts with subsets of human T cells expressing specific T cell receptor (TCR) V beta elements, namely V beta 2, 4, and 8 . We employed similar techniques to analyze the TCR V alpha usage of pep M5-stimulated T cells . These studies revealed that the preferential usage of particular V alpha elements is not specific for the superantigen; rather, it may reflect the repertoire of the individual being tested . The expansion of a large number of T cells bearing specific TCR V beta sequences by M protein may account for its role in mediating the pathogenesis of post-streptococcal diseases . Furthermore, the preferential usage of TCR V alpha elements in certain individuals may be an important factor that predisposes them to development of self-reactivity.

Eur J Obstet Gynecol Reprod Biol, 1991 Jun 5, 40(1), 57 - 62
Intrapartum chemoprophylaxis of early-onset group B streptococcal disease; Matorras R et al.; A randomized study in 121 pregnant women carrier of group B streptococci is undertaken in order to assess the administration of 500 mg of intrapartum ampicillin intravenously to interrupt mother-to-fetus group B streptococcal transmission . In the prophylaxis group there was a significant reduction in neonatal colonization (3.7 vs . 42.9%) and in severe neonatal colonization (0 vs . 25%) . There was no case of group B streptococcal sepsis in the prophylaxis group compared to 4.6% (3 cases) in the control group (P greater than 0.05) . Clinically infected newborns represented 3.3% in the prophylaxis group vs . 13.8% in the control group . When the organism was isolated during delivery in the vagina or amniotic fluid, prophylaxis was quickly followed by second negative cultures . Ampicillin levels in the amniotic fluid were detected early, and they increased significantly till the third hour . Bactericidal levels in the umbilical cord were detected in 60% of newborns . All these findings support the usefulness of ampicillin prophylaxis in the prevention of early-onset group B streptococcal sepsis.

Eur J Immunol, 1991 Jun, 21(6), 1481 - 90
Molecular characterization of an IgA receptor from group B streptococci: sequence of the gene, identification of a proline-rich region with unique structure and isolation of N-terminal fragments with IgA-binding capacity; Heden LO et al.; Certain strains of group B streptococci express a cell surface protein that binds IgA and acts as a virulence factor . This IgA receptor is referred to here as protein Bac . The gene for protein Bac was cloned and expressed in Escherichia coli, and the complete nucleotide sequence was determined . The deduced amino acid sequence of 1134 residues includes a signal sequence of 37 amino acids and a putative membrane anchor region at the C-terminal end . The processed form of the receptor, 1097 residues, has a calculated molecular weight of 123,786 . There are no cysteines in protein Bac, suggesting a fibrillar structure . The C-terminal half of the protein includes a 90 residues long region with a novel type of periodic structure, the "XPZ motif", in which every third amino acid is proline . Unlike other bacterial immunoglobulin-binding proteins, there are no long repeats in protein Bac . Clones which express only part of the protein Bac gene were used to show that IgA-binding takes place in the N-terminal part of the molecule . Protein Bac was originally described as an antigen called beta, but N-terminal fragments that bind IgA do not react with a reference serum against the beta antigen . These and other data indicate that protein Bac can be divided into two regions with different functions: an N-terminal IgA-binding region and a C-terminal region corresponding to the beta antigen . The IgA-binding region of protein Bac does not show any homology to protein Arp, the IgA receptor from group A streptococci, although these receptors have similar binding properties . This indicates that convergent evolution has favored the appearance of these two structurally different streptococcal IgA receptors.

Infect Immun, 1991 Jun, 59(6), 1978 - 83
Deposition and degradation of C3 on type III group B streptococci; Campbell JR et al.; Antibody to the polysaccharide capsule of type III group B streptococci (GBS) and complement are essential to host defense against systemic infection in neonates . Interactions between C3 degradation products and specific neutrophil receptors mediate the attachment and ingestion of these organisms . To evaluate the influence of capsule on C3 disposition, we compared the C3 fragments released from a highly encapsulated clinical isolate (M861) with those from an unencapsulated mutant (COH 31-15) and an asialo mutant (COH 31-21) of type III GBS after opsonization with hypogammaglobulinemic serum . Upon sodium dodecyl sulfate-polyacrylamide gel electrophoresis and Western blot (immunoblot) analysis, the three strains displayed similar patterns of C3 degradation; both C3b and iC3b were detectable . However, as the duration of opsonization increased, C3 fragment bands became more prominent on the encapsulated strain . The capsule, and specifically sialylation of the capsular polysaccharide of type III GBS, promotes C3 fragment deposition . However, C3 was deposited and degraded to iC3b in the absence of capsule . Opsonization of strain M861 with serum containing antibody specific for the polysaccharide capsule facilitated C3 fragment deposition in the early phases of opsonization . Because iC3b is one of the C3 fragments on an encapsulated strain of type III GBS, the relative deficiency of neonatal neutrophil receptors for this ligand may contribute to the virulence of this organism . Sufficient concentrations of antibody may enhance opsonization by facilitating C3 deposition as well as by interacting with Fc receptors on neutrophils.

Oral Microbiol Immunol, 1991 Jun, 6(3), 177 - 81
Antineoplastic agents inhibit the growth of Streptococcus mutans and Streptococcus sanguis in vitro; Meurman JH et al.; The effect of methotrexate (MTX) and doxorubicin on the growth, metabolism and ultrastructure of Streptococcus mutans and Streptococcus sanguis was studied in vitro . Both anticancer drugs exerted an inhibitory effect on the oral streptococci . MTX was more inhibitory than doxorubicin . The minimum inhibitory concentrations (MICs) of MTX to S . mutans were 0.25-2.5 micrograms/ml and that of doxorubicin 0.2 mg/ml . The MICs of MTX and doxorubicin to S . sanguis were 0.025 micrograms/ml and 2.0-0.02 mg/ml, respectively . When saliva samples of patients with malignant tumors receiving various doses of MTX were analyzed, MTX was found to be secreted into the oral cavity at concentrations ranging from 0.014 to 4.486 micrograms/ml . The saliva of these patients was also found to inhibit the growth of S . mutans, and the inhibition zones were in accordance with the MIC values observed . The results suggest that anticancer therapy must be taken into account when the salivary microbiological findings of cancer patients are interpreted.

Oral Microbiol Immunol, 1991 Jun, 6(3), 134 - 8
Crevicular IgG antibodies and recovery of locally implanted Streptococcus mutans in humans; Camling E et al.; This study was undertaken with the aim of examining the effect of highly different IgG antibody activities in gingival crevicular fluid (GCF) on the elimination of a streptomycin-resistant strain of Streptococcus mutans (S . mutans) topically implanted on the tooth . Two groups of people were selected for the study, one with high and one with low specific IgG antibody activity (IgG antibody activity against S . mutans) in GCF . During an experimental period of 15 d the specific IgG antibody activity in GCF in the same individual stayed on a relatively constant level . Between individuals, however, the specific IgG antibody activity varied considerably . The number of indigenous mutans streptococci and the number of implanted bacteria on the same tooth surface were strongly correlated . The implanted S . mutans strain was rapidly eliminated in all subjects . No difference in the elimination of the implanted strain of S . mutans could be demonstrated between the groups of high and low specific IgG antibody activity.

Oral Microbiol Immunol, 1991 Jun, 6(3), 129 - 33
Ecology of viridans streptococci in the oral cavity and pharynx; Frandsen EV et al.; Recently published taxonomic studies of viridans streptococci have resulted in several changes in the nomenclature and definition of oral streptococcal species . With this background, the ecology of streptococci in the oropharyngeal cavities was reinvestigated . The results based on the examination of 1426 streptococcal isolates confirmed and extended earlier findings . Apart from mature supragingival plaque, which contained a mixture of all orally encountered streptococci, each site showed a characteristic streptococcal flora . Initial dental plaque formation is primarily associated with Streptococcus sanguis, Streptococcus mitis biovar 1 and Streptococcus oralis . Our investigation showed that S . sanguis and S . mitis biovar 1 were the most prominent streptococci, also on buccal mucosa . In contrast, S . oralis was almost exclusively found in initial dental plaque . Streptococcus gordonii, formerly part of S . sanguis, was found in small numbers on the oropharyngeal mucosa and in mature supragingival plaque . The dorsum of the tongue was dominated by S . mitis biovar 2 and Streptococcus salivarius, the latter of which was predominant also on the pharyngeal mucosa . Streptococcus anginosus was by far the most predominant streptococcus in subgingival plaque . Immunoglobulin A1 (IgA1) protease-producing streptococci were primarily isolated from initial dental plaque and from the buccal mucosa . This lends further support to the concept of IgA1 proteases being important for the ability of streptococci to evade the local immune defence during their initial colonization of certain oral surfaces.

Klin Monatsbl Augenheilkd, 1991 Jun, 199(1), 45 - 7
{Group G streptococci as pathogens of postoperative endophthalmitis}; Posenauer B et al.; We report an exceptional case of fulminant endophthalmitis after uncomplicated extracapsular cataract extraction with posterior chamber lens implantation . The first unusual finding was the causative organisms, group G streptococci . These organisms are commonly found as normal flora of the skin, pharynx and gastrointestinal tract . They are also well known as pathogens of neonatal sepsis, otitis media and pneumonia, but there are only three case reports describing a streptococcus G endophthalmitis . The second unusual finding was the delayed onset of the fulminant endophthalmitis, occurring later than 9 days after surgery . A retrospective analysis of 17 additional cases showed that endophthalmitis occurred either during the first 5 days after surgery or later than 35 days after surgery . If endophthalmitis developed shortly after surgery it progressed rapidly and with intense inflammation . The other cases showed more chronic inflammatory reaction . From the latter finding we conclude that long postoperative monitoring remains necessary even if at first no signs of intraocular inflammation are detectable.

J Dairy Sci, 1991 Jun, 74(6), 1855 - 9
Effect of naturally occurring coagulase-negative staphylococci infections on new infections by mastitis pathogens in the bovine; Matthews KR et al.; Microbiological data from 1123 uninfected quarters and 216 quarters with preexisting coagulase-negative staphylococci infections were analyzed to determine the influence of infection status on subsequent new infection rate . Overall, prevalence of new infections in uninfected quarters was approximately two times that in quarters already harboring a coagulase-negative Staphylococcus infection . New infections by coagulase-negative staphylococci were greater in uninfected quarters than in quarters with preexisting coagulase-negative staphylococci infections . However, no differences were observed between uninfected and infected quarters in number of new infections by major pathogens (Staphylococcus aureus, streptococci, and coliforms) . No differences were observed in uninfected or coagulase-negative Staphylococcus-infected quarters in infections with minor pathogens compared with major pathogens . The influence of individual coagulase-negative Staphylococcus species on new infections was also analyzed . However, numbers of existing infections by Staphylococcus species other than Staphylococcus chromogenes were limited . Therefore, the protective capacity of each coagulase-negative Staphylococcus species was difficult to assess . Overall, a significant restriction of bacterial invasion was observed in quarters with a preexisting infection . These results suggest that quarters harboring a coagulase-negative Staphylococcus infection suppress colonization of the mammary gland by mastitis-causing pathogens.

Av Odontoestomatol, 1991 Jun, 7(6), 471 - 4
{"In vitro" study of the bacteriocinogenic capacity of Streptococcus mutans}; Baca Garcia P et al.; In our paper the bacteriocinogen ability of some subspecies of Streptococci mutans has been studied . We have obtained a production percentage of 50% . That production ability was bigger for subspecies mutans than sobrinus in a significative way, who strength the increasing differences between these microorganisms . A brief revision of the role that bacteriocins look like to play in oral ecologist equilibrium and their feasible utilization in dental caries prevention has been done.

Acta Odontol Scand, 1991 Jun, 49(3), 175 - 81
Effects of lysozyme-thiocyanate combinations on the viability and lactic acid production of Streptococcus mutans and Streptococcus rattus; Lumikari M et al.; Effects of human lysozyme (HLZ) combined with thiocyanate (SCN-) ions on mutans streptococci, both in physiologic salivary concentrations, were studied . The bacteria were incubated for 75 min either in HLZ-supplemented sterilized human whole saliva (pH 5 and 7) or in neutral buffer in the presence or absence of HLZ (30 mg/l)-SCN- (1-5 mM) combinations . HLZ had no inhibitory effect on the viability of Streptococcus mutans, serotype c, either in saliva or in buffer, not even at pH 5, in the presence of salivary bicarbonate or in higher (up to 240 mg/l) concentrations of HLZ . In contrast, HLZ significantly decreased the viability of S . rattus in both media . HLZ also effectively blocked the lactic acid production of S . rattus but not that of S . mutans . Thiocyanate ions, which have been proposed to enhance the antimicrobial activity of lysozyme, did not affect the antibacterial activity of HLZ or HLZ-HCO3- combinations . It is concluded that the in vivo levels of SCN- ions, which constitute an integral part of the peroxidase antimicrobial system in saliva, may not be high enough to trigger the lysis of S . mutans by lysozyme in human saliva . The very low prevalence of S . rattus compared with S . mutans in human populations may be associated with their different susceptibility to lysozyme-mediated inhibition in saliva.

Biotechniques, 1991 Jun, 10(6), 748 - 55
Protein B: a versatile bacterial Fc-binding protein selective for human IgA; Faulmann EL et al.; Protein B, a selective bacterial IgA Fc-binding protein isolated from group B streptococci, has been used to quantify fluid phase and immobilized human IgA . Protein B detects both human IgA1 and IgA2 subclasses and is also reactive with secretory IgA . Protein B can be used immobilized to microtiter plates to capture IgA or following biotinylation as a tracer for fluid phase or immobilized human IgA . The studies presented here suggest protein B will prove to be a valuable reagent for quantitative immunochemical procedures involving human IgA antibodies and facilitate a variety of studies of IgA responses in man.

Aust Dent J, 1991 Jun, 36(3), 231 - 5
Effects of pulsing with xylitol on mixed continuous cultures of oral streptococci; Rogers AH et al.; Continuous culture is a means whereby organisms can be grown at rates approaching those occurring naturally . Moreover, the effect of adding transient excesses of various nutrients to the culture vessel ('pulsing') simulates the effect of dietary challenge on dental plaque organisms . Mixed cultures of Streptococcus mutans T8 and Streptococcus milleri B448 were grown glucose-limited in a chemically defined medium under an atmosphere of 5 per cent carbon dioxide in nitrogen, at a dilution rate of D = 0.1 h-1 and controlled pH of 7.0 . The level of arginine in the medium reservoir was adjusted so that Strep . milleri predominated over Strep . mutans in a stable coexistence . After equilibration, the culture vessel was pulsed with various carbohydrates to a final concentration of 5 x 10(-2)mol/L . Samples were then taken at regular intervals and differential viable counts of Strep . mutans and Strep . milleri were done on mitissalivarius agar . Results demonstrated that pulsing with glucose, fructose, 'coupling sugar', lactose, xylose and sorbitol gave Strep . mutans a clear ecological advantage . In direct contrast, pulsing with xylitol resulted in a marked antimicrobial effect on Strep . mutans while Strep . milleri was essentially unaffected . This supports recent findings by other workers that uptake of this pentitol by Strep . mutans in batch culture sets up a 'futile cycle', leading to depressed growth or even cell death.

Bone Marrow Transplant, 1991 Jun, 7(6), 415 - 9
Streptococcal septicaemia following autologous bone marrow transplantation in children treated with high-dose chemotherapy; Valteau D et al.; A total of 251 patients were given 326 courses of high-dose chemotherapy followed by autologous bone marrow transplantation between February 1979 and August 1988 . Ninety-one cases of septicaemia developed in 84 patients, 33 of these cases (36%) were due to streptococci . The outcome was fatal for four patients (12.1%) . No specific risk factors were identified which might account for this septicaemia and no clinical feature was significantly associated with these cases of bacterial infection . Pulmonary and neurologic septic complications, however, were of very poor prognosis since all patients with these complications died . The high rate of streptococcal septicaemia and the poor outcome for patients with prolonged and profound neutropenia led us to modify our choice of initial broad-spectrum antibiotic therapy.

Community Dent Oral Epidemiol, 1991 Jun, 19(3), 151 - 4
Caries prevalence and salivary mutans streptococci in 0-2-year-old children of Japan; Fujiwara T et al.; The prevalence of caries and the number and species distribution of salivary mutans streptococci in 356 children (aged 0-2 yr old) in Japan were examined twice at an interval of 1 yr . No mutans streptococci were isolated from the predentate children . The detection rate of mutans streptococci and the prevalence of caries increased with age . Mutans streptococci were isolated from 39.9% of the subjects . The majority of isolates were identified as Streptococcus mutans . The concentration of mutans streptococci correlated with the number of erupted teeth (r = 0.339) . In addition, the concentration of mutans streptococci was more closely correlated to the caries prevalence of the next year (r = 0.465) than that of the year when the salivary concentration of mutans streptococci was first evaluated (r = 0.368) . The children who had no caries but harbored mutans streptococci in the first year showed significantly higher caries prevalence in the next year than did the children with neither caries nor mutans streptococci . These results indicate that the establishment of mutans streptococci is associated with caries initiation in early childhood.

J Electron Microsc (Tokyo), 1991 Jun, 40(3), 176 - 80
Immunoelectron microscopy of Fc receptors on the surface of clinical isolates of streptococci; Yamada S et al.; The distribution of Fc receptors on the surface of clinical isolates of streptococci was examined by immunoelectron microscopy . A unique two-layered ferritin tagging was observed on the surface of isolate MS-4 (group A) . The spacing between the layers (10-40 nm) was narrower than that of the layered protein A (30-70 nm) on Staphylococcus aureus . Labeling on the other isolates, IP-28 (group A) and ES-21L (group C), showed similar rough layers, but the labeling were clearly different in thickness and density . The labeling on isolate IP-28 was also similar to that on strain AR1 (group A), reported previously, while the labeling on ES-21L was similar to that on protein G producing strain G148 (group G) in thickness . However, it was obviously thinner than that on IP-28 and AR1 . These results strongly suggest that there are at least three distribution patterns of Fc receptors on streptococci, and these are distinct from that of protein A.

Exp Hematol, 1991 Jun, 19(5), 352 - 8
Effect of recombinant human granulocyte colony-stimulating factor administration in normal and experimentally infected newborn rats; Iguchi K et al.; We investigated the effects of repetitive recombinant human granulocyte colony-stimulating factor (rhG-CSF) administration at three different doses (every 12 h times six doses, starting at 12-24 h of age) on the kinetics of neutrophil production in Sprague-Dawley rats . We determined WBC counts, differentials, the number of total nucleated cells, the myeloid mitotic pool cells (promyelocytes and myelocytes), the storage pool cells (metamyelocytes, bands, and polymorphonuclear cells {PMNs}) and the granulocyte-macrophage (granulocyte-macrophage colony-forming units, CFU-GM) and macrophage (macrophage colony-forming units, CFU-M) progenitor cells of the bone marrow, spleen, and the liver before the first dose of rhG-CSF administration and 12 h after the second, fourth, and sixth dose . Control animals were given the diluent by the same schedule . Recombinant human G-CSF-treated rats showed a significant dose-dependent increase in the number of total WBC and neutrophil counts at all time points compared to control rats . The total number of CFU-GM and myeloid mitotic pool cells (marrow plus spleen plus liver) progressively increased with age in both control and G-CSF groups, but the G-CSF treated groups showed a significantly larger number of mitotic pool cells at hour 24, continuing up to hour 72, compared to the control group . However, there was no significant difference at any time point in the number of CFU-G/GM as detected by the granulocyte-macrophage colony-stimulating factor (GM-CSF)-supported culture system . Priming of newborn rats with injections every 12 h of rhG-CSF times two doses, or six doses followed by inoculation of group B streptococci (GBS) did not significantly change the sepsis death rate of animals, although the neutrophil counts in infected rhG-CSF-primed animals were significantly larger than the infected control animals . Injection of human i.v . gammaglobulin 3 h following inoculation with GBS significantly improved the survival of animals compared to G-CSF administration or administration of the diluent alone (control) . Thus G-CSF alone may not be beneficial for the treatment of neonates with sepsis . Additional work is needed to determine whether combination of G-CSF with antibiotics or other cytokines, such as GM-CSF or interleukin 6 (IL-6) may be of benefit.

Infect Immun, 1991 Jun, 59(6), 2023 - 8
Cloned alpha and beta C-protein antigens of group B streptococci elicit protective immunity; Michel JL et al.; Streptococcus agalactiae (group B streptococci {GBS}) is the leading cause of neonatal sepsis and meningitis in the United States . The surface-associated C proteins of GBS play a role in immunity, but their number, size, structure, function, and virulence properties have not been well characterized . A recombinant library of DNA fragments from GBS strain A909 (type Ia/C) was prepared in the plasmid pUX12, a specially constructed Escherichia coli expression vector . The library was screened with a rabbit antiserum shown to be protective for passive immunity to GBS infection in a mouse lethality model . Clones were divided into two distinct groups on the basis of DNA-DNA cross-hybridization, restriction enzyme analysis, and the expression of antigenic proteins in E . coli . A characteristic clone from each group was chosen for further study . Clone pJMS23 expresses gene products that biochemically and immunologically correspond to the trypsin-resistant, C-protein alpha antigen . Clone pJMS1 expresses a gene product that binds to immunoglobulin A and is similar to the trypsin-sensitive, C-protein beta antigen . Antisera raised in rabbits against E . coli containing each of the plasmid clones were able to elicit protective immunity in mice challenged by GBS strains carrying the C proteins but not by non-C-protein-bearing strains . Southern blot analysis shows no DNA homology between the clones, and there is no immunological cross-reactivity between the antigens they express . Therefore, pJMS23 and pJMS1 encode two different C proteins that define unique protective epitopes.

Rev Med Brux, 1991 Jun, 12(6), 222 - 9
{Rapid diagnosis in infectious diseases}; Van der Auwera P; Rapid detection of infectious agents has recently received a lot of interest . The aim of this article is to review its various aspects in terms of real impact on the medical handling of the infected patient as well as economical impact . Few examples are developed in detail, including technical strategies: sexually transmitted diseases due to Chlamydia trachomatis; gastroenteritis due to rotavirus and adenovirus, bacterial pneumonia and meningitis, and acute tonsillitis due to beta-hemolytic group A streptococci.

FEMS Microbiol Lett, 1991 May 15, 64(2-3), 141 - 5
Purification of the protein X of Streptococcus agalactiae with a monoclonal antibody; Lautrou Y et al.; The protein X of Steptococcus agalactiae is a surface antigen included in the typing scheme of group B streptococci (GBS) . We have developed a monoclonal antibody to the protein X and used it to purify this antigen by affinity chromatography . Electrophoresis in polyacrylamide, and immunoblotting using the monoclonal antibody or a rabbit antiserum raised with the affinity purified protein X, revealed a major band in the region of 200 kDa and a smaller one at 100 kDa . The isolated protein X will make possible investigations of its potential role in virulence and protection.

Science, 1991 May 3, 252(5006), 724 - 7
Effect of light chain V region duplication on IgG oligomerization and in vivo efficacy; Shuford W et al.; A human immunoglobulin G1 (IgG1) antibody oligomer was isolated from a transfected myeloma cell line that produced a monoclonal antibody to group B streptococci . Compared to the IgG1 monomer, the oligomer was significantly more effective at protecting neonatal rats from infection in vivo . The oligomer was also shown to cross the placenta and to be stable in neonatal rats . Immunochemical analysis and complementary DNA sequencing showed that the transfected cell line produced two distinct kappa light chains: a normal light chain (Ln) with a molecular mass of 25 kilodaltons and a 37-kilodalton species (L37), the domain composition of which was variable-variable-constant (V-V-C) . Cotransfection of vectors encoding the heavy chain and L37 resulted in production of oligomeric IgG.

Rev Infect Dis, 1991 May-Jun, 13 Suppl 7, S591 - 3
Efficacy of aztreonam in the treatment of neonatal sepsis; Sklavunu-Tsurutsoglu S et al.; In Greece the majority of infections that affect the neonatal population are caused by gram-negative bacteria rather than by group B streptococci as in the United States . The present study investigated the efficacy of aztreonam, a beta-lactam antibiotic that is effective against gram-negative organisms, in this population . Fifty-five neonates aged 2 hours to 36 days who had sepsis were enrolled in this open study . Laboratory tests were extensive, and follow-ups were detailed . Aztreonam (90-125 mg/{kg.d}) administered in two or three doses was given in combination with penicillin (100,000 U/{kg.d}) for 6-15 days . Fifty-two infants were cured, one improved, and two did not improve and received other, more effective regimens . Adverse effects were minimal, and tolerance of aztreonam was excellent.

Pediatr Infect Dis J, 1991 May, 10(5), 351 - 4
Association of exotoxin-producing group A streptococci and severe disease in children; Belani K et al.; Clinical features and microbiologic data on all cases of serious (hospitalized) Group A streptococcal infections in children managed at our institution between 1985 and 1988 are presented . All 6 cases were caused by toxin-producing strains . Four of 6 were toxin A-producing strains whereas none of 58 community-acquired (Group A streptococcal) pharyngeal isolates in the same period was a toxin A producer . A review of the literature on the incidence of toxin A-producing strains provides information suggesting a resurgence of such strains in the late 1980s after a relative disappearance of toxin B production in isolates from these patients was also significantly greater than in the isolates acquired from the community in uncomplicated pharyngitis . These findings suggest a role for exotoxin in severe manifestations of Group A streptococcal disease in children.

APMIS, 1991 May, 99(5), 460 - 6
Post-streptococcal glomerulonephritis: studies on the interaction between nephritis strain-associated protein (NSAP), complement and the glomerulus; Peake PW et al.; Nephritis strain-associated protein (NSAP), a streptokinase produced by strains of streptococci isolated from patients with acute glomerulonephritis, is believed to be a specific antigen which participates in the production of glomerular injury . In order to investigate the mechanisms by which NSAP induces damage we have examined its potential to activate complement in vitro and to bind to isolated human glomeruli . NSAP, both alone and in combination with specific antibody, caused depletion of complement in normal human serum as measured by total haemolytic complement activity and generation of the complement breakdown products . C3a and C4a . Furthermore, Scatchard analysis showed that NSAP bound tightly to human glomeruli (Ka of 400 +/- 240 x 10(6) M) when compared to non-nephritic streptokinase (Ka of 7.3 +/- 4.1 x 10(6) M) and fully cationized human serum albumin (Ka of 0.6 +/- 0.04 x 10(6) M) . These findings are consistent with the hypothesis that the deposition of streptococcal antigens within the glomerulus may precede the fixation of complement and specific antibody.

Am J Obstet Gynecol, 1991 May, 164(5 Pt 1), 1317 - 26
Progress in pathogenesis and management of clinical intraamniotic infection; Gibbs RS et al.; In the past decade, gratifying progress has been achieved in our understanding of clinical intraamniotic infection . With a usual incidence of 1% to 4%, clinical intraamniotic infection mainly develops as an ascending process after prolonged rupture of the membranes and labor, but other cases may be hematogenous in origin whereas still others complicate intrauterine procedures . The most common organisms isolated in amniotic fluid of cases of intraamniotic infections are anaerobes, genital mycoplasmas, group B streptococci, and Escherichia coli . The latter two are found most commonly in maternal or neonatal bacteremia complicating intraamniotic infection . Although the diagnosis remains largely a clinical one, laboratory tests have been suggested to confirm the diagnosis in women with symptoms . These include amniotic fluid Gram stain, gas-liquid chromatography, and leukocyte esterase measurement . Maternal treatment consists of antibiotic therapy and delivery . Studies to date have used a penicillin plus an aminoglycoside, with some authors advocating the addition of clindamycin after cesarean delivery . Other broad-spectrum regimens may be equally effective . Complications of clinical intraamniotic infections include an increase in cesarean section rate and in maternal and neonatal bacteremia . Poor neonatal outcomes in intraamniotic infection are more likely in the following cases: (1) when E . coli or group B streptococci are present in the amniotic fluid; (2) when the infant has a low birth weight; (3) when maternal antibiotic therapy is delayed until after delivery.

Ann Otol Rhinol Laryngol, 1991 May, 100(5 Pt 1), 361 - 5
Abscesses of the neck in infants and young children . A review of 112 cases; Hawkins DB et al.; A review of 112 patients 5 years of age and younger with cervical abscesses is reported . Staphylococcus aureus and group A beta-hemolytic Streptococcus were cultured most often: in 39% and 17% of patients, respectively . Sixteen patients (14%) had unusual abscesses such as infected congenital cysts, cat-scratch disease, or myocobacterial abscesses . One patient had a necrotizing infection with group A streptococci and anaerobic streptococci . Intravenous antibiotic therapy was used in 104 patients, with 94% of these patients receiving a penicillin derivative, usually an antistaphylococcal penicillin . Ninety-six percent of the patients had incision and drainage of their abscesses; 8 patients required more than one incision and drainage . Two patients required airway intervention, 1 by intubation and 1 by trachetomy . Most pediatric cervical abscesses respond well to appropriate intravenous antibiotic therapy and incision and drainage.

Pediatrics, 1991 May, 87(5), 598 - 603
Community-wide outbreak of group G streptococcal pharyngitis; Gerber MA et al.; Although several outbreaks of group G beta-hemolytic streptococcal (GGBHS) pharyngitis have been described, doubt still remains regarding the etiologic role of GGBHS in acute pharyngitis beyond a limited number of situations . In the winter/spring of 1986/87, throat cultures were obtained from 222 consecutive children seen at a private pediatric office with acute pharyngitis and group A beta-hemolytic streptococci (GABHS) were recovered from 91 children (41%) and GGBHS from 56 children (25%) . One patient had both GABHS and GGBHS isolated . This isolation rate of GGBHS was dramatically greater than in previous and subsequent years, and 67% of the GGBHS isolates occurred during an 8-week period . Results of DNA fingerprinting of the 57 isolates of GGBHS demonstrated that 43 (75%) appeared to be the same strain . The patients with GGBHS were comparable to those with GABHS with respect to clinical findings, antistreptolysin-O titer response, and clinical response to antibiotic therapy . However, patients with GGBHS were significantly older (P less than .05) . This is the first well-documented, community-wide outbreak of GGBHS pharyngitis and the first respiratory outbreak of GGBHS pharyngitis in a pediatric population . GGBHS may be a more important cause of acute, treatable pharyngitis than had been previously recognized.

J Lab Clin Med, 1991 May, 117(5), 402 - 9
Evaluation of the immune response in protection against experimental Streptococcus defectivus endocarditis; Sieling PA et al.; Immune protection from endocarditis caused by Streptococcus defectivus was examined by using a rabbit model . Previously we had demonstrated that immunization with nutritionally variant streptococci (NVS, now referred to as Streptococcus, species defectivus and adjacens) protected rabbits against endocarditis when they were challenged with the homologous strain . However, when high-titer immune globulin was transferred to nonimmunized rabbits, no protection was achieved . In the present study, immunosuppressive treatments were given to previously immunized rabbits, and alterations in the level of protection were determined by using the rabbit endocarditis model . Control-immunized rabbits as well as immunized rabbits receiving cyclosporin A or methylprednisolone treatments were protected from S . defectivus endocarditis at levels between 50% and 67% . Rabbits in each of these groups cleared S . defectivus organisms from the circulation by 3 hours after infection . Nitrogen mustard-treated rabbits (immunized or nonimmunized), however, were unable to clear S . defectivus organisms as efficiently (almost 100 times as many organisms in the blood when compared with other groups) by 3 hours, and all were susceptible to endocarditis . These data suggest that circulating phagocytes such as monocytes and granulocytes function to a certain extent in protection against S . defectivus endocarditis . Moreover, when neutrophils were transfused into granulocytopenic and monocytopenic rabbits, efficient clearance was prolonged, indicating that polymorphonuclear leukocytes were involved in the later (greater than 1 hour after infection) phase of protection.

J Infect Dis, 1991 May, 163(5), 1141 - 5
Pooled human IgG hyperimmune for type III group B streptococci: evaluation against multiple strains in vitro and in experimental disease; Givner LB et al.; Because rates of morbidity and mortality due to newborn sepsis are unacceptably high, adjunctive therapies must be investigated . In the current studies, after healthy adults were immunized with type III group B streptococcal (III-GBS) capsular polysaccharide vaccine, serum was obtained from "vaccine-responders" from which a pooled human IgG preparation hyperimmune for III-GBS was prepared by ion-exchange column chromatography . This preparation, containing 549 micrograms/ml III-GBS antibody was very active functionally when evaluated against multiple III-GBS strains both in vitro in an opsonophagocytic assay using newborn sera and in a newborn rat model of III-GBS disease . The level of functional activity was dramatically higher than that of commercially available human IgG preparations for intravenous use demonstrated previously in identical assays . Human IgG preparations hyperimmune for GBS offer promise for use as adjunctive therapy of sepsis in newborns.

Infect Immun, 1991 May, 59(5), 1811 - 7
Role of M protein in adherence of group A streptococci; Caparon MG et al.; The role of the M protein in adherence of group A streptococci to human epithelial cells was directly tested by using an isogenic pair of M+ and M- strains . There was no difference between these strains in the number of streptococcal units that adhered to buccal or tonsillar epithelial cells, indicating the following: (i) that adhesins that are not dependent upon M protein expression are present on the surface of group A streptococci and (ii) that the M protein is not the primary streptococcal adherence ligand . However, the M+ strain adhered to tonsillar epithelial cells as aggregates . This aggregation was dependent on the presence of the M protein, since the isogenic M- strain did not clump . The coaggregation of streptococci suggests that the M protein plays an important role in promoting the formation of microcolonies after initial attachment . Binding to fibronectin, a potential epithelial cell receptor for group A streptococci, was also the same for the isogenic M+ and M- strains as well as for an isogenic strain with a regulatory mutation that decreases the expression of M protein . In summary, the M protein is not the primary streptococcal adhesin, nor is it required to orient the streptococcal adhesin and/or fibronectin receptor.

Infect Immun, 1991 May, 59(5), 1661 - 6
Aggregation of group A streptococci by human saliva and effect of saliva on streptococcal adherence to host cells; Courtney HS et al.; The aggregation of group A streptococci by whole, stimulated human saliva (WHS) and the effect of saliva on streptococcal adherence to host cells was investigated . WHS samples from 11 individuals were found to aggregate both M+ and M- group A streptococci to various degrees . The aggregating activity was sensitive to heat, EDTA, EGTA {ethylene glycol-bis(beta-aminoethyl ether)-N,N,N',N'-tetraacetic acid}, sodium dodecyl sulfate, and lipoteichoic acid . None of the simple sugars tested, mercaptoethanol, albumin, or nonionic detergents had any effect on aggregation . The aggregating activity of EDTA-treated saliva was restored by 0.1 mM Ca2+ and 1.0 mM Mn2+ but not by up to 5 mM Mg2+ . Only streptococci from the stationary phase were aggregated . Hyaluronidase treatment of streptococci from the exponential phase of growth restored their ability to be aggregated, suggesting that the hyaluronic acid capsule interferes with agglutination . Adsorption of WHS by one strain of Streptococcus pyogenes removed aggregating activity for other strains of S . pyogenes and Streptococcus sanguis but not agglutinins for Escherichia coli, suggesting that the agglutinin is specific for certain gram-positive bacteria . Molecular sieve chromatography of WHS and identification of streptococcus-binding components of saliva suggest that either a glycoprotein of approximately 360 kDa or a mucin of saliva of greater than 1,000 kDa mediates aggregation of streptococci . WHS also inhibited adherence of S . pyogenes to buccal epithelial cells.

J Infect, 1991 May, 22(3), 233 - 9
Microbial aetiology of otitis externa; Dibb WL; Microbiological samples were collected from the ears of patients with otitis externa for a period of 1 year . Altogether, 226 evaluable samples from 104 males and 122 females were received . The age range of the patients was similar to that of the Norwegian population . A wide variety of bacteria and fungi was isolated . The commonest isolates, excluding normal flora, were Staphylococcus aureus (34.1%), Pseudomonas aeruginosa (22.1%) and Streptococcus pyogenes (8.8%); 9.3% samples contained fungi . Of all samples, 15% showed a mixture of Gram-positive and Gram-negative, potentially pathogenic, bacteria . Infection due to Gram-negative organisms alone was commoner in males, while the lack of any obvious microbial aetiology was more frequent in females . Isolation of S . aureus together with S . pyogenes was common but that of S . aureus together with S . pyogenes was common but that of S . aureus together with P . aeruginosa was unusual . In treated patients, the finding of streptococci and S . aureus was rare whereas that of P . aeruginosa or absence of growth was common . Otitis externa involving Gram-positive bacteria seems to be more prevalent in our area than in that of other reported studies.

Arch Otolaryngol Head Neck Surg, 1991 May, 117(5), 538 - 41
Tracheal granulation tissue . A study of bacteriology; Matt BH et al.; We prospectively examined 19 patients (21 laryngotracheal reconstructions) over a 6-month period to evaluate the bacteriology of granulation tissue present at the time of Teflon stent removal and at the first laryngoscopy several weeks later . The most frequently recovered isolates were viridans streptococci, Pseudomonas aeruginosa, nonhemolytic Streptococcus, and Staphylococcus aureus . All but one positive culture were polymicrobial . The amount of tissue did not correlate with the duration of stenting and the amount of granulation tissue and number of organisms decreased after stent removal . Further prospective study of the most appropriate antimicrobial therapy is needed.

Zh Mikrobiol Epidemiol Immunobiol, 1991 May, (5), 12 - 4
{The biochemical and immunological properties of group A type M 29 streptococci cultured in the presence of a bovine blood serum preparation}; Bitko SA et al.; The influence of the preparation of cattle blood serum on group A streptococcus, type M 29, has been studied . The study has revealed that the addition of 17% of dialysis water obtained from a fraction of cattle blood serum to the standard culture medium (3% Todd-Hewitt broth) produces changes in the amino acid composition of the cell walls of M+ variant without altering the antiphagocytic resistance of the mutant thus obtained . The dialysate of the pepsin digest of the cell walls of the mutant contains Fc-receptors and receptors to fibrinogen, while the initial strain contains only receptors to fibrinogen which are, in this case, the pepsin fragments of M protein . The study has revealed similarity in the amino acid compositions of these proteins (receptors to fibrinogens) of phenotypes M+ and M2+ . Thus, our data confirm that the initial strain and the mutant belong to different phenotypes of group A streptococcus, type M 29.

Pathol Biol (Paris), 1991 May, 39(5), 489 - 90
{Epidemiology of aminoglycoside resistance in Streptococcus except in group D Streptococcus and Enterococcus}; Le Pennec MP et al.; During a ten month period (march-december 1989), all streptococcal strains isolated from clinical specimens sent to our laboratory were routinely tested for high-level resistance to aminoglycosides . High-level resistance was detected in 16 out of 475 streptococci: streptomycin (two strains), kanamycin (four strains), streptomycin and kanamycin (ten strains).

Pathol Biol (Paris), 1991 May, 39(5), 466 - 70
Rapid antimicrobial susceptibility testing of gram-positive cocci using Baxter MicroScan rapid fluorogenic panels and autoSCAN-W/A; Bascomb S et al.; The Microscan Rapid Pos MIC/Combo panels and autoSCAN-W/A (Walk Away) system utilize automated fluorescence technology for rapid antimicrobial susceptibility testing of staphylococci, streptococci, and Listeria . In a three site clinical study, panels containing 26 antimicrobial agents were evaluated by comparing results obtained with 605 clinically significant isolates, using rapid fluorogenic expanded dilution MIC panels and corresponding frozen microdilution reference panels . Results for 16%, 40%, 13%, 9%, 8%, 11% and 1% of the isolates were available within 3.5, 4.5, 5.5, 7.0, 8, 11 and 15 h respectively . Results for 2% were not available within that time period . Overall agreement (+/- 1 dilution) for the 14,609 efficacy comparisons was 96%, with 1% each for very major, major and minor errors . Interlaboratory reproducibility testing of 25 isolates in triplicate in each site, showed an overall essential agreement of 97% . The MicroScan Rapid Pos MIC System is an accurate, reproducible and rapid method for same-day determination of susceptibility of Gram-positive cocci.

Kansenshogaku Zasshi, 1991 May, 65(5), 559 - 63
{T-serotype distribution of group A hemolytic streptococci in a rapidly expanding residential area in Sanda City, Hyogo Prefecture, with reference to an outbreak of serotype T-28 in autumn, 1988}; Morikawa Y et al.; In the fall of 1988, an outbreak of streptococcal infections was observed at 2 pediatric clinics in Sanda City, Hyogo prefecture . The 2 clinics were independent of each other; one (clinic A) was located in the down town area, in the older part of the city, where there is little population turn over, while the other (clinic B) was in a newly developed-fast growing residential district . The strains and the distribution of T-serotypes isolated at each location are as follows: clinic A; 58 strains (34.5% serotype T-4, 31.0% serotype T-12, 10.3% serotype T-1, and 23.3% serotype T-28), clinic B; 43 strains (48.8% serotype T-28, 23.3% serotype T-12, 11.6% serotype T-4 and 7.0% serotype T-1) . According to the data from Kobe City infectious disease surveillance center, there were a total of 102 group A hemolytic streptococci strains isolated in 1988, the T-serotypes distribution of which was as follows: 47.0% serotype T-4, 15.7% serotype the T-12, 10.8% serotype T-1 and 9.8% serotype T-28 . Serotype T-4 was dominant here, as it was in location A of Sanda City . The epidemic proportion of serotype T-28 found at location B is considered to be due to the fact that location B has very little social interaction with location A and other areas . No difference was observed among the different serotypes on the drug susceptibility test: all strains showed a sensitivity to ampicillin and penicillin G, but were resistant to tetracycline and chloramphenicol.

J Dairy Sci, 1991 May, 74(5), 1550 - 2
Mastitis prevalence in primigravid heifers at parturition; Pankey JW et al.; Prevalence of intramammary infection was determined for 382 primigravid heifers within 3 d postpartum on 11 Vermont dairy farms . Data collected during a 5-yr period are summarized . Duplicate quarter milk samples were cultured on tryptose-blood agar plates containing .1% esculin . Intramammary infections were diagnosed in 45.5% of the heifers and 18.7% of quarters . Staphylococcus species were the most prevalent bacteria isolated: they appeared in 25.4% of the heifers and 12.1% of quarters . Only 2.6% of the heifers were diagnosed with Staphylococcus aureus; 22.8% had udder infection caused by other staphylococcal species . Environmental mastitis pathogens, coliforms, and streptococci other than Streptococcus agalactiae were isolated from 14.9% of the heifers and 4.8% of quarters . The prevalence of mastitis among these primigravid heifers at parturition indicates a need to improve methods of diagnosis and control programs.

Iowa Med, 1991 May, 81(5), 218 - 21
Infective endocarditis in Iowa; Olds J; This review of 43 cases of infective endocarditis (IE) treated at a large Iowa community hospital reveals an incidence of 9 cases per 22,000 annual admission . IE is most likely to occur in an elderly male with non-specific symptoms and signs and involvement of the mitral valve infected with streptococci.

J Dairy Res, 1991 May, 58(2), 179 - 85
Bacteriological investigations of clinical mastitis in heifers in Sweden; Jonsson P et al.; Bacterial analyses were carried out of 2069 udder secretions, isolated from 1481 heifers with mastitis in eight veterinary districts in Sweden . Streptococci, e.g . Streptococcus dysgalactiae and Str . uberis, dominated the bacterial flora, being isolated from 34.4 and 19.5% respectively of heifers with clinical mastitis occurring from puberty up to 14 d post partum . Bacterial species generally regarded as important pathogens in the summer mastitis complex, e.g . Actinomyces pyogenes, Stuart-Schwan coccus and strictly anaerobic bacteria such as Peptostreptococcus indolicus, Fusobacterium necrophorum and Bacteroides melaninogenicus were isolated at low frequencies (13.2, 6.3, 9.4, 3.8 and 1.3% respectively) . When the cases of mastitis studied were restricted to those appearing in heifers pre partum, May 15 to October 14 (summer mastitis), these bacterial species were isolated at higher percentages (27.1, 14.4, 21.4, 13.5 and 5.2% respectively) . These figures were, nevertheless, still lower than those published in reports from other countries . Whether considered up to 14 d post partum or only pre partum, there were no significant differences in the frequencies of A . pyogenes isolated at different seasons . There were geographical differences in bacterial incidence, e.g . Staphylococcus aureus was isolated significantly more often in northern regions whereas Str . dysgalactiae was more common in the south . This and other Swedish investigations support the theory that A . pyogenes and strictly anaerobic bacteria are 'secondary invaders' that depend on Str . dysgalactiae to cause a primary infection . It is stressed that the udders of all heifers should be examined daily so that cases of mastitis can be treated immediately.

Infection, 1991 May-Jun, 19(3), 190 - 4
Teicoplanin in the treatment of skin and soft tissue infections: results of a multicentre study; Lang E et al.; The clinical efficacy and safety of teicoplanin was studied in hospitalized patients with skin and soft tissue infections . In an open multicentre study 64 patients were treated with teicoplanin i.v . and/or i.m . Predisposing or complicating factors for infection were present in almost 80% of the patients . Teicoplanin was usually given as an initial loading dose of 400 mg (87.1%), or 800 mg (6.5%) or various doses (6.5%) . During the course of the study, the mean daily dose of teicoplanin was 261.3 mg . Sixty of the 62 evaluable patients responded to treatment . 58 gram-positive pathogens were isolated, consisting of Staphylococcus aureus (n = 41), coagulase-negative staphylococci (n = 6) and streptococci (n = 11) . Elimination of pathogens was seen in 37/47 of all microbiologically evaluable cases . Persistence, recurrence or reinfection occurred in 7/47, 2/47 and 1/47, respectively . Adverse reactions were reported in only three patients with allergic reaction, local reaction and rise in transaminases in one case each . Therapy failed only in two patients.

Jpn Circ J, 1991 May, 55(5), 437 - 42
Native valve infective endocarditis in adults--analysis of 32 consecutive cases over a ten-year period from 1980 to 1989; Iga K et al.; Thirty-two patients with native valve infective endocarditis who presented over a 10-year period at our hospital were analyzed retrospectively . The presenting symptom was a persistent fever in 22 patients . In 30 patients, the New York Heart Association functional class was less than II before the development of endocarditis . Blood cultures were positive on all occasions in 24 out of 29 culture-positive patients . All of the viridans streptococci, accounting for 79% of the isolated pathogens, were highly susceptible to ampicillin . Treatment consisted of a 6 week course of antibiotics, usually ampicillin, at a dose of 12 grams/day . In 9 cases, we had to change or stop the antibiotics because of severe side effects . The longer the period before making a diagnosis, the more severe were the symptoms of congestive heart failure and the more frequent was the incidence of cerebral hemorrhage . To initiate treatment as early as possible, in order to minimize valve destruction and to reduce the risk of cerebral hemorrhage, serial blood cultures are recommended in patients with valvular heart disease or congenital heart disease and a persistent fever, with minimal cardiac symptoms.

Zh Mikrobiol Epidemiol Immunobiol, 1991 May, (5), 41 - 4
{Antibodies to the rhamnose determinants of the polysaccharide of streptococci group A in the sera of rheumatism patients and donors}; Borodiiuk N et al.; In the sera of patients with recurrent rheumocarditis, and especially in cases of primary rheumatism, the level of antibodies to group A streptococcal polysaccharide (A-PS) has been found, according to the results of the enzyme immunoassay, to be considerably higher than in the sera of healthy donors . The level of antibodies to rhamnose determinants (RD) of A-PS has been determined by the inhibition of the immunoenzyme reaction with A-PS under the influence of a variant of group A streptococcus and rhamnose disaccharides with the bonds alpha 1-2 and alpha 1-3 . In patients with recurrent rheumocarditis the level of antibodies to A-PS has been shown to be considerably higher than in healthy donors having these antibodies . In acute primary rheumatism a high level of antibodies to A-PS has been detected only in a few cases, and at the same time the prevalence of antibodies to the specific RD of A-PS, bound with beta-N-acetylglucosamine, is observed . In the sera of patients with recurrent rheumocarditis and donors having a high content of antibodies to the rhamnose site of A-PS antibodies, seemingly active against at least two RD, have been detected . In acute primary rheumatism an insignificant amount of antibodies to the rhamnose site of A-PS may probably cause the autoimmune process accompanying rheumatism . This suggestion is substantiated by the previously established capacity of these antibodies for inducing the suppression of cytotoxic cell reactions to microbial antigens.

Infect Immun, 1991 May, 59(5), 1690 - 6
The alpha-L-(1----2)-trirhamnopyranoside epitope on the group-specific polysaccharide of group B streptococci; Michon F et al.; A number of epitope specificities associated with the group antigen (group B polysaccharide) of group B streptococci have been identified in a polyclonal antiserum induced in rabbits by a nonencapsulated variant strain of group B streptococci . This was achieved by using a series of oligosaccharide inhibitors, obtained by both synthetic and degradative procedures, to inhibit the binding of the group B polysaccharide to the polyclonal antiserum . While the dominant epitope expressed in the antiserum was alpha-L-Rhap(1----2)alpha-L-Rhap(1----2)alpha-L-Rhap, specificities associated with alpha-L-Rhap and alpha-L-Rhap(1----3)alpha-D-Galp(1----3)beta-D-Glcp-NAc(1----4)alp ha-L-Rhap were also identified . The dominant expression of the former epitope is consistent with its terminal location on the group antigen and also with highly branched multiantennary structure of this antigen . Antibodies specific for the alpha-L-trirhamnopyranoside epitope were purified by affinity chromatography, using the synthetic trisaccharide glucitol as the hapten . Oligosaccharide inhibition studies indicate that the specificity of these antibodies is identical to that of a murine monoclonal antibody induced by the same nonencapsulated strain of group B streptococci.

Tidsskr Nor Laegeforen, 1991 Apr 30, 111(11), 1366 - 8
{Recurrent herpes labialis and secondary bacterial infection . A study among the employees at the Ulleval hospital}; Laerum E et al.; Recurrent herpes labialis is a prevalent infection . We have investigated the annual incidence and some clinical aspects of the condition, and the frequency of probable superinfection among the staff at the largest hospital in Norway . Over a period of 12 months a total of 83 (67 females and 16 males) out of 3,565 persons with a mean age of 34.3 years experienced clinical recurrence of herpes labialis, giving an annual incidence of 23 persons with one or more eruptions per 1,000 employed . The mean recurrence rate was 4.8 episodes per year . UV-light was reported as a precipitating factor by 60% and psychological stress by 30% . Seven persons reported sick leave of one to three days' duration because of the most recent eruption . In 6/83 patients the probable pathogenic bacteriae (i.e . beta-hemolytic streptococci group A in one and Staphylococcus aureus in five cases) were isolated within the first 48 h after the skin lesions occurred . After 7-9 days S aureus was found in eight persons . The mean duration in days until all skin lesions had healed was the same in patients with or without probable superinfection . Recurrent herpes labialis does not seem to be a significant health problem among the staff of Ulleval Hospital . Probable superinfections appear to occur rarely and without significantly increasing morbidity.

Ugeskr Laeger, 1991 Apr 29, 153(18), 1268 - 71
{Bacterial genesis of preterm delivery}; Helmig R et al.; From a review of the literature it is concluded that one forth of preterm deliveries are associated with infections . The presence of Group B Streptococci (GBS), Ureaplasma urealyticum, Chlamydia specific IgM antibodies, and bacterial vaginosis may be of importance, but the odds-ratio is seldom more than two, and the studies do not include confounder control . Treatment with penicillin may be indicated in pregnant women (1) with GBS-uri (2) who have given birth to at child with neonatal GBS meningitis, or (3) with preterm labour and/or rupture of fetal membranes.

Proc Natl Acad Sci U S A, 1991 Apr 15, 88(8), 3190 - 4
Assembly and analysis of a functional vaccinia virus "amplicon" containing the C-repeat region from the M protein of Streptococcus pyogenes; Hruby DE et al.; Previous studies have shown that when inoculated intranasally into mice, vaccinia virus (VV) recombinants expressing the carboxyl half of the Streptococcus pyogenes M protein {which contains the C-repeat region (CRR)} could elicit a protective immune response against subsequent challenge by both homologous and heterologous serotypes of pathogenic group A streptococci . In the present study, an insertion plasmid was constructed that contained three tandem in-frame repeats of a 310-base-pair DNA sequence encoding the CRR from streptococcal M6 protein under control of a constitutive viral promoter . The plasmid was used to introduce the bacterial sequences into the VV genome by homologous recombination . Surprisingly, the recombinant VV:CRR3X virus that was isolated appeared to represent not an individual recombinant virus but a complex mixture of variants that contained from 1 to greater than 20 tandem copies of the CRR region at the insertion site . This genomic complexity was mirrored at the transcriptional level in that a nested set of coterminal transcripts was detected in VV:CRR3X-infected cells, which increased in size from 1400 to 6600 bases by increments of approximately 300 bases . All transcripts containing two or more CRR inserts appeared functional, as Western (immuno) blot analyses of VV:CRR3X-infected cell extracts revealed a family of CRR-related proteins with apparent molecular masses that increased from 30 kDa upward in increments of 10 kDa . All data are consistent with the hypothesis that variation in the VV:CRR3X recombinants is from random crossover events that occur within the CRR region during viral DNA replication . These results suggest that the genomic diversity generated by the "recombinogenic" properties of vaccinia recombinants containing tandem foreign inserts could be used to facilitate induction of a broadly protective immune response against antigenically diverse pathogenic agents.

J Immunol, 1991 Apr 15, 146(8), 2659 - 63
H chain C domains influence the strength of binding of IgG for streptococcal group A carbohydrate; Cooper LJ et al.; We have produced a panel of murine anti-streptococcal mAbs, expressing identical V domains and different H chain C domains, corresponding to the IgG3, IgG1, and IgG2b subclasses . We have used these mAb to evaluate the role of IgG subclass-specific C region determinants in modulating the interaction between antibody and the bacterial surface . We report, for the first time, that V region-identical murine IgG of different subclasses exhibit substantial differences in binding to specific Ag; IgG3 mAb binds more strongly to streptococci than the IgG1 and IgG2b mAb or IgG3-derived F(ab')2 fragments . Furthermore, the IgG3 mAB binds cooperatively to the bacteria, whereas the IgG1, IgG2b, and IgG3-derived F(ab')2 fragments do not exhibit significant cooperativity, which suggests that differences in Fc region structure can affect antibody binding to multivalent Ag by modulating the potential for cooperative binding . These results suggest a plausible mechanism by which murine IgG3 could be more effective, than other antibodies bearing identical V domains, but of different gamma-subclass, in mediating bacterial immunity.

Harefuah, 1991 Apr 15, 120(8), 451 - 3
{Vasculitis with cutaneous necrosis induced by oral contraceptive}; Mosovich B et al.; Multiple ulcerated and necrotic lesions developed in a 29-year-old woman . Response to treatment during the next few months was minimal . The most plausible explanation was drug-induced vasculitis caused by contraceptive pills (Microgynon: levonorgestrel 0.15 mg and ethinyl oestradiol 0.03 mg) . The diagnosis of vasculitis was confirmed by histopathological and immunofluorescent studies . Urticarial manifestations had developed into necrotizing inflammation and the lesions only began to heal after discontinuation of the pills . Contraceptive pills are not included among the drugs causing necrotizing vasculitis, and to the best of our knowledge, this is the first report . Although contraceptive pills are commonly implicated in the induction of erythema nodusom or vasculitis, such a severe reaction with necrosis is rarePIP: Oral contraceptives (OCs) have been implicated as a major cause of mostly mild vascular diseases; cutaneous necroses are rare . A 29-year old married female developed vasculitis following administration of (OCs) . The disease which developed her knees, progressed into cutaneous ulcerative necrosis that was impervious to therapy . She had stopped taking OCs a month before . The presence of staphylococci and streptococci were detected in the ulcer cultures . A slight improvement of the ulcers occurred following treatment with cephalosporins . 1 week after treatment ceased she returned with new ulcers . She had resumed taking OCs and had taken 5 pills at once to make up for 5 omitted days . 2 days later new ulcers appeared, and the existing ones became aggravated . Histology showed an inflammatory reaction rich in leukocytes, monocytes, and eosinophils, and endothelial edema of vessels with fibrin deposition . In some places, partial obstruction of the blood vessels was observed . Partial involvement of the subcutaneous fat was also observed . Improvement occurred 1 month later following discontinuation of OCs .

FEMS Microbiol Lett, 1991 Apr 15, 63(2-3), 153 - 7
Molecular basis for the association of glucosyltransferases with the cell surface of oral streptococci; Kato C et al.; The expression of Streptococcus mutans mutant glucosyltransferase-I enzymes in S . sanguis and S . milleri suggests that cell-associated glucosyltransferase activity is dependent upon both glucan synthesis and glucan binding by the carboxyl-terminal repeating units of the enzyme . Mutant enzymes lacking these repeating units were only present in the extracellular fluids of these transformed streptococcal strains.

Monatsschr Kinderheilkd, 1991 Apr, 139(4), 208 - 13
{Evaluation of a rapid test for direct detection of group A streptococcal antigen in throat swabs . Study of 4 commercial test systems}; Kaufhold A et al.; Four commercially prepared test reagent kits for the rapid screening of throat swabs for group A streptococci were examined in comparison to bacteriological cultures of 963 double throat swabs . The sensitivities of the test systems were 86.7% (Abbott Test Pack Strep A), 81.8% (Hybritech Tandem Icon Strep A), 79.6% (Pharmacia Phadirect Strep A), and 72.6% (Wellcome Reveal Colour Strep A) respectively . The specificity of the four tests was above 90% . Marked variations between different test reagent batches could be observed . The two tests based on the enzyme immunoassay principle proved to be superior to the agglutination tests investigated with respect to sensitivity and reading accuracy . Our results are evaluated in the light of the published literature on these tests.

Clin Microbiol Rev, 1991 Apr, 4(2), 184 - 90
Nutritionally variant streptococci; Ruoff KL; Streptococci requiring either pyridoxal or L-cysteine for growth were first observed 30 years ago as organisms forming satellite colonies adjacent to colonies of "helper" bacteria . Although they were previously considered nutritional mutants of viridans streptococcal species, the nutritionally variant streptococci (NVS) are currently thought to belong to distinct species of the genus Streptococcus . NVS strains may display pleomorphic cellular morphologies, depending on their growth conditions, and are distinguished from most other streptococci by enzymatic and serological characteristics and the presence of a cell wall chromophore . NVS are found as normal inhabitants of the oral cavity, and in addition to their participation in endocarditis, they have been isolated from a wide range of clinical specimens . Endocarditis caused by NVS is often difficult to eradicate; combinations of penicillin and an aminoglycoside are recommended for treatment . The unique physiological features of the NVS contribute to the difficulties encountered in their recovery from clinical specimens and may play a role in the problems associated with successful treatment of NVS endocarditis.

Mol Immunol, 1991 Apr-May, 28(4-5), 349 - 57
Binding properties of protein Arp, a bacterial IgA-receptor; Akerstrom B et al.; A cell surface receptor that binds to the Fc region of IgA is expressed by certain strains of group A streptococci . The physico-chemical properties and binding characteristics of this receptor, called protein Arp, were studied . Like bacterial receptors that bind IgG, protein Arp has an elongated shape and no disulfide bonds . The affinity constant of protein Arp for three different molecular forms of IgA was determined, and was found to be more than ten-fold higher for serum IgA than for two complexed forms of IgA: secretory IgA and IgA bound to alpha 1-microglobulin . Cleavage of protein Arp with CNBr resulted in a peptide corresponding to the region located outside the cell wall, except for the N-terminal 52 amino acids . This CNBr-fragment did not bind IgA, which strongly suggests that the IgA-binding region of protein Arp is located in the N-terminal part of the molecule . In addition to the binding of IgA, protein Arp also binds to IgG weakly . The pH-dependence of these two types of binding is different, with maximal binding of IgA at neutral pH (5-7) and maximal binding of IgG at acidic pH (3-5) . Both for IgA and IgG, protein Arp shows strong specificity for immunoglobulins of human origin.

J Appl Bacteriol, 1991 Apr, 70(4), 334 - 8
The microflora of soak water during tempeh production from various beans; Ashenafi M et al.; The microflora of soak water was studied during the soaking of horsebean, pea, chickpea and soybean for tempeh production . Lactic streptococci dominated the flora in both unacidified and acidified soak water . Coliforms and yeast were found only in unacidified soak water . Growth of micro-organisms in acidified and unacidified soak water resulted in a decrease in pH value of the cooked beans . Microbial acidification during soaking is considered to be important in tempeh production.

J Appl Bacteriol, 1991 Apr, 70(4), 294 - 301
In-vitro bacteriocin-mediated antagonism by oral streptococci against human carrier strains of staphylococci; Tzannetis SE et al.; All strains of oral streptococci tested and specially those of Streptococcus mutans, Strep . sanguis and Strep . mitior produced more than one distinct bacteriocin-like substance with variable inhibitory activity on 20 indicator staphylococci . Inhibitory activity was comparatively higher on nasal strains of Staph . aureus and Staph . epidermidis than on strains of both species isolated from the mouth . Nineteen of 20 staphylococcal indicators were inhibited by 1-12 of the 12 effector streptococci . Sensitivity of nasal staphylococci to bacteriocins (frequency of positive inhibitory tests and total inhibition zone diameters) was significantly higher (P less than 0.001, chi 2 test and P less than 0.05, t test respectively) than that of oral ones . The sensitivity of nasal over oral Staph . aureus (P less than 0.001 and P less than 0.01) and of oral Staph . epidermidis over oral Staph . aureus (P less than 0.01 and P less than 0.05) was also significantly higher . The evaluation of variability of inhibitory patterns of bacteriocins produced by streptococci (p-typing), of sensitivity patterns of staphylococci to bacteriocins (s-typing) and of the significantly higher sensitivity of nasal over oral staphylococci to bacteriocins from the epidemiological and ecological viewpoints are discussed.

Scand J Dent Res, 1991 Apr, 99(2), 113 - 6
Interference of oral hygiene products with an adhesion-based assay of salivary mutans streptococci; Soderling E et al.; The effect of several oral hygiene products on an adhesion-based assay for salivary mutans streptococci (Dentocult-SM Strip Mutans) was studied in three women . The mutans streptococci levels were recorded for up to 24 h after a 1-min rinse with the product . The chlorhexidine (0.05%) and stanno-amine fluoride solutions (corresponding 0.025% F) interfered selectively with the adhesion-based assay . No such effect was observed for a polyvidoneiodine solution (10 micrograms/ml) or two toothpastes containing either sodium lauryl sulfate or amine fluorides . The results indicate that antimicrobial agents showing retention in the oral cavity may interfere for several hours after their use with adhesion-based assays of salivary mutans streptococci.

Community Dent Oral Epidemiol, 1991 Apr, 19(2), 98 - 100
Dental caries and mutans streptococci in selected groups of urban and native Indian schoolchildren in Mexico; del Rio Gomez I; Two groups of Mexican children aged 12-14 yr were examined for dental caries and salivary mutans streptococci counts . One hundred lived in Mexico City and 100 belonged to a native Mazahua Indian population . The prevalence of caries, diagnosed according to WHO, was 90% in Mexico City and 82% in the Indian community . Mean DMFT was 5.98 and 3.57 respectively . Saliva samples were analyzed for mutans streptococci by the "Strip mutans" method . Further identification of the biotype/serotype was done . Mutans streptococci were found in 95% of the urban children and 75% of the Indians . There was a statistically significant difference in the prevalence of mutans streptococci between the city and the rural samples . Streptococcus mutans was more frequently found than Streptococcus sobrinus.

Genitourin Med, 1991 Apr, 67(2), 133 - 6
Prevalence of sexually transmitted pathogens among women attending a methadone clinic in Israel; Samra Z et al.; OBJECTIVE--To assess the prevalence of sexually transmitted pathogens in drug-addicted women in Tel Aviv, Israel . DESIGN--A prospective study conducted between March and July 1987 . SETTING--A methadone clinic in Tel Aviv, Israel . SUBJECTS--Sixty four asymptomatic female drug addicts were studied; 38 of them were declared practising prostitutes . METHODS--Cervical specimens were obtained for cultures, and blood samples were drawn for serological tests . Demographic data and sexual histories were obtained using a standard questionnaire . RESULTS--Chlamydia trachomatis was detected in the cervix of 25% of women; 98% had antibody titres (greater than 1:64) . Mycoplasma hominis and Ureaplasma urealyticum were isolated in 57% and 65% respectively . Gardnerella vaginalis was detected in 17% of women, and herpes simplex virus was cultured from two prostitutes . Five per cent of women were carriers of HBsAg, while 57% had HBSs and/or HBc antibodies . Only one prostitute had specific treponemal antibodies . In no case were gonococci or group B streptococci isolated, and HIV serology was invariably negative . CONCLUSION--Chlamydia and genital mycoplasmas appear to be the prevailing pathogens in Israeli drug-addicted women, while gonococci and Treponema pallidum occur only rarely.

J Clin Pathol, 1991 Apr, 44(4), 329 - 33
Use of rapid carbohydrate utilisation test for identifying "Streptococcus milleri group"; Whitworth JM et al.; A short series of biochemical and serological tests were developed for the rapid presumptive identification of "Streptococcus milleri group" isolates . One hundred and seventy seven streptococcal isolates were recovered from the mouths of 10 out of 12 healthy adult volunteers by use of a simple sampling procedure and a single selective medium . In all, 127 oral "S milleri group" isolates were identified by biochemical and serological tests, confirming the indigenous nature of these streptococci in the mouth . Most (70.1%) of "S milleri group" isolates were non-haemolytic, 26% were alpha-haemolytic, and 3.9% beta-haemolytic . Fifty four (42.5%) were serologically typable, of which 46 were Lancefield group F, suggesting that the mouth is an important source of Lancefield group F streptococci . A collection of group F streptococci from a range of sources was indistinguishable from a collection of oral "S milleri group" isolates on the basis of the tests used, supporting the general synonymity of group F streptococcus with the broader "S milleri group" . The battery of tests was cheap and simple to perform, and was capable of identifying "S milleri group" isolates from a range of sources, including variants with wide sugar fermentation patterns.

J Trauma, 1991 Apr, 31(4), 531 - 6; discussion 536-7
Role of gastric colonization in the development of pneumonia in critically ill trauma patients: results of a prospective randomized trial; Simms HH et al.; Critically ill trauma patients were entered in a prospective, randomized trial to determine the role of gastric colonization in the development of pneumonia . Trauma patients admitted to the SICU were randomized to receive antacids (n = 27), continuous IV cimetidine (n = 32), or sucralfate (n = 30) . Quantitative nasogastric tube (NGT) cultures were obtained biweekly and correlated with gastric pH, the incidence of pneumonia, and the incidence of pneumonia caused by an organism previously isolated from the stomach (percentage of gastric source of pneumonia--% GSP) . Patients receiving antacids had a significantly greater pH than those receiving cimetidine (5.6 +/- 1.03 vs . 4.7 +/- 1.03; p = 0.006) . However, there was no significant difference between the overall incidence of pneumonia, the percentage of NGT isolates greater than 10(6)/ml, or the % GSP . The gastric bacteriology of the three subgroups was nearly identical, with Candida albicans, Enterococci, and beta-hemolytic Streptococci being the most frequently isolated organisms . Gastric growth of organisms preceding their appearance in the blood occurred in 5 of 89 (5.6%) patients . These results suggest that 1) in trauma patients, the incidence of pneumonia is not increased by the use of stress ulcer prophylactic agents that elevate gastric pH; 2) increases in gastric pH progressively increased the number of intragastric bacteria but this did not correlate with an increased incidence of % GSP; and 3) while organisms in the upper intestinal tract may be pathogens for pneumonia, they are uncommonly a source of bacteremia in seriously injured patients.

J Infect Dis, 1991 Apr, 163(4), 792 - 8
Comparative protective activity of human monoclonal and hyperimmune polyclonal antibody against group B streptococci; Hill HR et al.; Group B streptococcal (GBS) infections cause significant morbidity and mortality in neonates and compromised hosts, who usually lack opsonic antibody to their infecting strain . Unfortunately, most conventional immunoglobulin preparations possess little GBS antibody . The protective activity of a human monoclonal antibody (HuMAb) and a human hyperimmune intravenous immunoglobulin (HivIg) were evaluated against these organisms and compared with a conventional intravenous immunoglobulin (ivIg) . The HuMAb and the HivIg possessed significant protective activity (50%-95%) against extremely virulent strains of types I, II, and III GBS in doses as low as 4-20 mg/kg . In contrast, the conventional ivIg had little protective activity against some of these strains in doses as high as 500 mg/kg . The opsonic activity of the HuMAb and HivIg also usually exceeded that of the conventional ivIg . These studies suggest HivIg or HuMAb with markedly enhanced specific activity may provide optimal immunotherapy for GBS infections.

J Infect Dis, 1991 Apr, 163(4), 786 - 91
Group B streptococcal C protein-associated antigens: association with neonatal sepsis; Chun CS et al.; The c protein (Ibc) of group B streptococci (GBS) is associated with at least four antigens (alpha, beta, gamma, delta) . To assess the virulence potential of these antigens, 255 GBS isolates recovered from septic neonates, healthy neonates, and pregnant women were serotyped and surveyed for reactivity with sera to c protein and the four associated antigens . A radioimmunoassay using intact bacteria was used to detect the GBS antigens . In contrast to earlier reports, most (66%) of the type III strains expressed the c protein . Except for the gamma antigen, none of the other c protein-associated antigens showed an increased association with pathogenic strains independent of the polysaccharide antigens . The gamma antigen was expressed by 15 of 41 c protein-positive early-onset strains and by 4 of 38 c protein-positive late-onset strains (P = .007) . This association was independent of the type-specific antigen, suggesting a potential role for the gamma antigen as a virulence factor in GBS strains causing early-onset sepsis.

Infect Immun, 1991 Apr, 59(4), 1434 - 41
Association between the 65-kilodalton heat shock protein, Streptococcus sanguis, and the corresponding antibodies in Behçet's syndrome; Lehner T et al.; The etiology of Behcet's syndrome (BS) is unknown, but a number of streptococcal species have been implicated . A hypothesis was postulated that a shared antigen, such as a stress protein, might account for some of these findings . Indeed, a rabbit antiserum against a 65-kDa heat shock protein of Mycobacterium tuberculosis revealed a corresponding 65-kDa band with all six Streptococcus sanguis strains examined and S . pyogenes but not with S . salivarius . By applying a panel of nine monoclonal antibodies to the mycobacterial 65-kDa heat shock protein, an approximately 65-kDa antigen was identified in the uncommon serotypes of S . sanguis ST3 and H.83 and one with a different Mr was identified in KTH-1 and S . pyogenes . Monoclonal antibodies Y1.2, C1.1, II H9, and ML30, which reacted with these streptococci, recognize residues 11 to 27, 88 to 123, 107 to 122, and 276 to 297 of the 65-kDa heat shock protein, respectively, suggesting that these residues are conserved among some uncommon serotypes of S . sanguis and S . pyogenes . Immunoblot analyses of sera from patients with BS for immunoglobulin A (IgA) and IgG antibodies revealed bands of 65 to 70 kDa with the mycobacterial heat shock protein, S . sanguis strains, and S . pyogenes, although these reactivities were also found to a lesser extent in controls . A 65- to 70-kDa band was found more frequently with S . sanguis KTH-2 or KTH-3 and IgA in serum from patients with BS than with serum from controls (P less than 0.02) . Antibodies in serum were then studied by a radioimmunoassay, and in patients with BS this revealed significantly raised IgA antibodies to the recombinant 65-kDa mycobacterial heat shock protein and to soluble protein extracts of S . sanguis ST3, KTH-1, KTH-2, and KTH-3 . Whereas significant anti-65-kDa heat shock protein and anti-S . sanguis ST3 antibodies were also found in sera from patients with rheumatoid arthritis and recurrent oral ulcers, the anti-S . sanguis KTH-1, KTH-2, and KTH-3 antibodies were confined to BS . The results are consistent with the hypothesis that some of the streptococcal antigens are associated with heat shock or stress proteins, which will need to be formally established by isolating heat shock proteins from streptococci.

Acta Paediatr Jpn, 1991 Apr, 33(2), 166 - 71
Possible role of Streptococcus pyogenes in mucocutaneous lymph node syndrome XIII . No recovery of beta-hemolytic streptococci from pharynx of MCLS patients; Osawa N et al.; Lack of recovery of beta-hemolytic streptococci from the throat of 80 patients finally diagnosed as mucocutaneous lymph node syndrome was again confirmed, although alpha-hemolytic streptococci were consistently isolated from all patients but one . The implications of these findings were discussed, particularly in terms of the possible role of Streptococcus pyogenes in the pathogenesis of this disease.

Oral Microbiol Immunol, 1991 Apr, 6(2), 72 - 5
Factors affecting peptide catabolism by oral streptococci; Rogers AH et al.; The binding of a number of unsubstituted peptides to Streptococcus sanguis and Streptococcus mutans and their subsequent degradation by such cells were examined . Peptides were added to cell suspensions prepared from glucose-limited growth in a chemostat and, at appropriate time intervals, cell-free filtrates were analyzed for peptides and their constituent amino acid residues by high-pressure liquid chromatography techniques . The results indicated that peptide hydrophobicity plays a limited role in peptide binding, but that charge and chain-length are probably important . In S . sanguis, carboxypeptidase activity rapidly released C-terminal arginine (Arg); this amino acid was less rapidly released from the N-terminus but a number of other residues were also released by aminopeptidase activity . When Arg is buried in the peptide, the rate of its release depends upon the number and type of residues between it and the N-terminus . In contrast, S . mutans possessed only weak peptidase activities . The nature of its peptidase activities indicates that S . sanguis can obtain the metabolically important Arg from a variety of peptides.

Ann Pediatr (Paris), 1991 Apr, 38(4), 289 - 95
{Cefaclor versus penicillin V in staphylococcal infections in children}; Cohen R et al.; Although rheumatic fever virtually no longer occurs in France, pharyngitis due to group A beta-hemolytic streptococci (ABHS) remains a common pediatric problem . American studies have underscored the high rate of bacteriologic treatment failures and recurrences of ABHS pharyngitis . Furthermore, several comparative studies have demonstrated that cephalosporins provide better results on these two parameters . This prospective randomized study compared the effectiveness of penicillin V (50,000 to 100,000 IU/kg/day in three divided doses) and Cefaclor (20 to 40 mg/kg/day in three divided doses), each given for ten consecutive days . From September 1989 through October 1990, 117 children (mean age 5.7 years) were entered into the study . All study subjects were seen as outpatients and found to have ABHS pharyngitis on the basis of a rapid screening test and confirmatory bacteriologic studies . Cefaclor was given to 56 patients and penicillin V to 61 . Reevaluation with a repeat bacteriologic study was performed in all patients at the end of the treatment period, or earlier in the event of new clinical manifestations, and towards D40 . Among patients given penicillin V, bacteriologic failure rate at completion of therapy was 19.6%, clinical failure rate on D10 was 8%, and recurrence rate on D40 was 16.5% . Cefaclor exhibited greater bacteriologic and clinical effectiveness, with 3.4% bacteriologic failures on D10 (p less than 0.01), 1.7% clinical failures on D10, 8.9% clinical recurrences between D10 and D40, and an overall 10.6% rate of failure or recurrence (p = 0.05).

Arch Ophthalmol, 1991 Apr, 109(4), 563 - 4
Streptococcus sanguis survival in K-Sol . Comparison of gentamicin and the fluoroquinolone antibiotics; Glaros DS et al.; Viridans streptococci are poorly covered by gentamicin sulfate in corneal storage medium . To evaluate possible antibiotic alternatives among the newer broad-spectrum fluoroquinolone antibiotics, we compared the survival of the viridans representative Streptococcus sanguis in K-Sol with gentamicin sulfate (100 mg/L), norfloxacin (250 mg/L), ciprofloxacin lactate (250 mg/L), ofloxacin (250 mg/L), or no antibiotic . At 23 degrees C, K-Sol with gentamicin produced a 2-log kill by 80 minutes . By comparison, only one of the others (norfloxacin) had achieved a 2-log kill by 4 hours . At 4 degrees C, all antibiotics differed little from the control, and none was superior to gentamicin.

J Pediatr, 1991 Apr, 118(4 ( Pt 1)), 606 - 14
Effect on neutrophil kinetics and serum opsonic capacity of intravenous administration of immune globulin to neonates with clinical signs of early-onset sepsis; Christensen RD et al.; This study was designed to test the hypothesis that administration of immune globulin to human neonates with early-onset bacterial sepsis would (1) facilitate neutrophil egress from the marrow, (2) improve serum opsonic capacity, and (3) facilitate recovery from the infectious illness . Twenty-two newborn infants with clinical signs of early-onset sepsis were given an intravenous infusion of either 750 mg of immune globulin (IVIG) per kilogram of body weight or the same volume of a vehicle control (albumin) . All 22 infants survived, but significant hematologic, immunologic, and respiratory differences were observed after the IVIG and not after the control infusion . Eleven of the patients had neutropenia; 24 hours after the infusions, the neutropenia had resolved in all six IVIG recipients but persisted in all five control recipients (p less than 0.001) . Ten patients had I/T neutrophil ratios (a measure of immature neutrophils to total neutrophils on the leukocyte differential count) of less than 0.2 . One hour after completion of the infusions, all five IVIG recipients had elevated I/T ratios (mean +/- SEM:0.10 +/- 0.05 before vs 0.43 +/- 0.03 after infusion; p less than 0.001), suggesting a prompt release of neutrophils from the marrow neutrophil storage pool into the circulation; no increase in the I/T ratio was observed in the control recipients . Six hours after the IVIG infusions, the ratio of arterial oxygen tension to fraction of inspired oxygen increased; no increase was observed after control infusions . Serum concentrations of IgG, IgG1, IgG2, IgG3, IgG4, and total hemolytic complement and the capacity of serum to support opsonophagocytosis of type II and type III group B streptococci increased markedly in the IVIG recipients but not in the control subjects . We conclude that administration of 750 mg IVIG per kilogram to neonates with clinical signs of early-onset sepsis was associated with immunologic, hematologic, and physiologic improvement.

Med Trop (Mars), 1991 Apr-Jun, 51(2), 181 - 4
{Non-groupable streptococci: identification, sensitivity to antibiotics (Charles Nicolle Hospital in Tunis)}; Kechrid A et al.; 50 strains of viridans streptococci isolated from human material are identified by biochemical tests (bile esculin, Cl Na 6,5%, acid production from lactose, mannitol, sorbitol, inulin, arginine, esculin and starch hydrolysis; production of levan and dextran in sucrose media) Streptococcus salivarius and Streptococcus mitis are predominant species . Susceptibility to antibiotics was studied: 70% of viridans streptococci were susceptible to all antibiotics tested, high level resistance to aminoglycoside was not present . The only resistance observed were to tetracycline, macrolides and related drugs.

J Clin Microbiol, 1991 Apr, 29(4), 848 - 9
Inverse correlation in nutritionally variant streptococci between the production of bacteriolytic activity and sensitivity to a Streptococcus pyogenes bacteriocinlike inhibitory substance; Tagg JR et al.; Nineteen strains of nutritionally variant streptococci (NVS) were tested for bacteriolytic activity and for their production of and sensitivity to streptococcal bacteriocinlike inhibitory substances (BLIS) . None appeared to produce BLIS . An inverse relationship was found between the sensitivity to BLIS and the production of bacteriolytic activity against Micrococcus luteus . All but one of the 14 Streptococcus defectivus isolates were sensitive to the BLIS of S . pyogenes P5, and these isolates were nonlytic . The five S . adjacens isolates were not sensitive to any BLIS tested, and all of these isolates displayed bacteriolytic activity . Sensitivity to the BLIS of S . agalactiae P3 separated the nonlytic S . defectivus strains into two categories.

Can J Vet Res, 1991 Apr, 55(2), 168 - 73
Endometrial biopsy in Holstein-Friesian dairy cows . III . Bacteriological analysis and correlations with histological findings; Bonnett BN et al.; This study examines the results of bacterial culture from 159 endometrial biopsy samples from 97 commercial dairy cows and correlations between bacteriological and histological findings . Bacteria were isolated from approximately 80% of biopsies taken at day 26 and day 40 postpartum . Eleven percent of biopsies were positive for both aerobic and anaerobic culture . Streptococci, Escherichia coli and Actinomyces pyogenes were the most common isolates . Isolation of A . pyogenes from a biopsy at day 26 was positively correlated with isolation of anaerobic bacteria and segmented cell inflammation in the same biopsy, and with subsequent isolation of A . pyogenes at day 40 . There was a strong association between isolation of A . pyogenes and anaerobes at day 26 with increased uterine lesions at day 40 . Isolation of alpha hemolytic streptococci (AHS) was negatively correlated with isolation of A . pyogenes and with inflammation . Actinomyces pyogenes and AHS showed opposite associations with mononuclear cell inflammation and lymphocytic foci.

Nihon Kyobu Shikkan Gakkai Zasshi, 1991 Apr, 29(4), 482 - 6
{A case of multiple pulmonary arteriovenous fistulae associated with splenic abscess}; Ishida T et al.; A 51-year-old female was admitted with high grade fever, cyanosis and hypoxemia . The chest X-ray showed nodular shadows on bilateral lung fields . Beta-streptococci were found on culture from the blood, and the fever fell after administration of both antibiotics and corticosteroid . Pulmonary angiography revealed four arteriovenous fistulae on bilateral lung fields . On abdominal ultrasonography and CT scan, a hypoechoic lesion with an irregular wall and varying internal echogenicity was detected within the spleen . This lesion changed in size and shape during the clinical course and diminished with improvement in the patient's condition . These findings were compatible with splenic abscess . Splenic abscess with pulmonary arteriovenous fistulae is rare.

Eur J Clin Microbiol Infect Dis, 1991 Apr, 10(4), 355 - 60
Use of quinolones in pediatrics; Schaad UB; Compared to nalidixic acid, the new quinolones possess an enlarged antimicrobial spectrum, greatly enhanced bactericidal activity, and substantial pharmacokinetic advantages . Because their activity against streptococci is limited the quinolones presently available will never be included in routine regimens for children . Moreover, adequate pharmacokinetic studies are still lacking in pediatrics, and potential drug toxicity warrants further long-term monitoring . Nevertheless, various studies strongly suggest that there is no quinolone-induced cartilage toxicity in humans, and the results of published clinical trials with fluoroquinolones in pediatric patients show promising efficacy and safety . From a review of the available data it is concluded that use of the quinolones in children should be limited to specific infections which are usually caused by Pseudomonas aeruginosa, Staphylococcus aureus or Staphylococcus epidermidis, and are complicated by underlying pathologic or special conditions such as cystic fibrosis or urologic abnormality . In each case, careful monitoring to determine efficacy, potential adverse effects including drug-drug interaction and toxicity, and any emergence of bacterial resistance is mandatory.

Eur J Clin Microbiol Infect Dis, 1991 Apr, 10(4), 330 - 3
Treatment of intra-abdominal infections with quinolones; Smith JA; Intra-abdominal sepsis may be caused by intestinal bacteria or by skin bacteria . In the largest series of patients studied in trials of quinolones, anti-anaerobic drugs were included in the therapeutic regimen . Several small series have reported success without the concomitant use of anti-anaerobic drugs . The balance of evidence at present suggests that the quinolones referred to in this report should be supplemented with anti-anaerobic drugs in the treatment of peritonitis related to bowel disease . Quinolones alone have been highly effective in the treatment of peritonitis associated with chronic ambulatory peritoneal dialysis, spontaneous bacterial peritonitis and biliary sepsis . Notwithstanding this success, the potential for an anaerobic aetiology in biliary sepsis and bacteremia must be borne in mind . Lack of clinical efficacy may be associated with resistant bacteria including streptococci . Quinolones offer a relatively non-toxic alternative in the management of intra-abdominal sepsis as well as being cost-saving since early discharge from hospital on oral medication is possible.

Ther Umsch, 1991 Apr, 48(4), 225 - 31
{Antibiotic prevention of bacterial endocarditis}; Fluckiger U et al.; Infective endocarditis is a serious disease and should be, if possible, prevented . Two risk groups are classified in relation to the patient's underlying cardiac lesions . At high risk are patients with prosthetic valves or with a previous infective endocarditis . Patients with congenital and acquired heart disease, mitral valve prolapse with regurgitation and hypertrophic obstructive cardiomyopathy are at moderate risk . Patients of these two groups should receive antibiotic prophylaxis before dental or surgical procedures that cause bacteremia . For patients at moderate risk a single dose of an orally administered antibiotic should be given one hour before the procedure (e.g . amoxicillin 3 g for procedures of the oropharyngeal, gastrointestinal or genitourinary tract, where the causitive agents of endocarditis are Viridans streptococci or enterococci) . Multiple doses are recommended for patients at high risk . The combination of amoxicillin and gentamicin (vancomycin and gentamicin in penicillin-allergic patients) offers the widest margin of safety in high-risk patients.

Mol Microbiol, 1991 Apr, 5(4), 843 - 9
The IgA-binding beta antigen of the c protein complex of Group B streptococci: sequence determination of its gene and detection of two binding regions; Jerlstrom PG et al.; The beta antigen of the lbc protein complex of Group B streptococci is a cell-surface receptor which binds the Fc region of human immunoglobulin A (IgA) . Determination of the nucleotide sequence of the beta antigen gene shows that it encodes a preprotein having a molecular weight of 130,963 daltons and a polypeptide of 1164 amino acid residues that is typical of other Gram-positive cell-wall proteins . There is a long signal sequence of 37 amino acids at the N-terminus . Four of the five C-terminal amino acid residues are basic and are preceded by a hydrophobic stretch that appears to anchor the C-terminus in the cell membrane . To the N-terminal side of this hydrophobic stretch is a putative cell-wall-spanning region containing proline-rich repeated sequences . An unusual feature of these repeated sequences is a three-residue periodicity, whereby every first residue is a proline, the second residue is alternating positively or negatively charged, and the third residue is uncharged . The IgA-binding activity was approximately localized by expressing subfragments of the beta antigen as fusion proteins . Two distinct but adjacent DNA segments specified peptides that bound IgA, which indicates that the IgA-binding activity is located in two distinct regions of the protein.

Immun Infekt, 1991 Apr, 19(2), 45 - 9
{Therapy and prophylaxis of infectious endocarditis}; Niebel J; Infective endocarditis remains even today a potential lethal disease . The most frequent bacterial agents are viridans streptococci, staphylococci and enterococci . Left-sided endocarditis predominates except for patients with drug addiction . Modern recommendations of treatment are based on in vitro studies, experimental data from the animal model and clinical studies . Antimicrobial therapy should be parenteral and bactericidal in character . Detailed recommendations for treatment are given . Progressive heart failure, persistent bacteremia and repeated embolism are the most important reasons for surgical intervention . Modern prevention is performed as single or short-term prophylaxis for about sixteen hours . Simple practicability as well as handing out of guidelines to the patient will contribute to improved acceptance.

Immun Infekt, 1991 Apr, 19(2), 38 - 41
{Microbial spectrum and microbiological diagnosis of infectious endocarditis}; Schubert S et al.; Still streptococci play the most important role as causatives of infective endocarditis . As change in composition of patient groups has taken place gradually pathogens like Staphylococcus epidermidis, enterococci, gram-negative rods and Candida species become more and more important now . Providing high-level accuracy if applied according to current rules blood culture is yet the basis for endocarditis caused by popular bacterial pathogens . If infection due to Candida species is suspected additional measuring of antibody response may be helpful in supporting the tentative diagnosis . Rare pathogens like Rickettsiae and Mycoplasma sp . must be considered for differential diagnosis, as infections caused by these organisms are to be identified by serological methods in first line.

Am J Clin Pathol, 1991 Apr, 95(4), 587 - 90
Comparative evaluation of selective and nonselective culture techniques for isolation of group A beta-hemolytic streptococci; Welch DF et al.; A new selective blood agar medium, Strep A Isolation Agar (SI) from Remel (Lenexa, KS), was compared with Becton Dickinson's Streptococcus Selective Agar (SA) (Becton Dickinson Microbiology Systems, Cockeysville, MD) and with a nonselective Columbia Blood Agar (CB) (Difco, Detroit, MI) . Throat swabs from patients with acute pharyngitis were cultured with the use of a single swab to inoculate each of the three plates in a specific order, rotating in three-week cycles . Plates were examined (each medium by a different technologist) after 24 and 48 hours of incubation at 35 degrees C in 5% carbon dioxide, and beta-hemolytic streptococci were serogrouped with the use of coagglutination . The positivity rate was significantly greater for SI (25%) and SA (26%) than for CB (18%) (P less than 0.001) . The respective rates of Group A streptococcal detection by SI, SA, and CB were 91%, 95%, and 67%, respectively . However, a feature associated with the use of SI or SA, in contrast to CB, was delayed identification of isolates by 24-48 hours because of small colony size, slower growth rate, and inability to serogroup colonies taken directly from primary culture plates . Recovery of non-Group A beta-hemolytic streptococci occurred with CB (12%) greater than SI (8%) greater than SA (6%) . SI is superior to a nonselective medium, such as CB, and is equal to SA for recovery of Group A streptococci from throat cultures.

Mikrobiyol Bul, 1991 Apr, 25(2), 144 - 50
{Comparison of two different media-atmosphere combinations on the isolation of group A beta-hemolytic streptococci from throat cultures}; Tunckanat F et al.; In this study effects of incubation of sheep blood agar medium in aerobic conditions and incubation of sulfamethoxazole-trimethoprim containing sheep blood agar medium in 5 to 10% CO2, of the isolation of group A beta hemolytic streptococci from throat cultures were compared . 608 throat swab specimens were studied . Each agar medium was evaluated after 24 and 48 hours of incubation period . The aerobic incubation of sheep blood agar plates for 24 hours yielded 108 (17.7%) strains of beta hemolytic streptococci, of these 96 (15.8%) strains being group A . 113 (18.5%) strains of beta hemolytic streptococci were isolated after 48 hours of incubation and 100 (16.4%) of these were group A . The number of beta hemolytic streptococci isolated in 5 to 10% CO2 atmosphere for 24 hours was 62 (10.2%), and 57 (9.3%) of these were group A . When the incubation period was prolonged to 48 hours, the total number of beta hemolytic streptococci isolated increased to 82 (13.5%) and 76 (12.5%) of these were determined as group A . The difference between these two combinations was significant for 24 hours of incubation, but not significant for 48 hours of incubation . The highest isolation rate for group A streptococci was achieved in aerobic incubation of sheep blood agar plates for 48 hours.

Carbohydr Res, 1991 Mar 20, 210, 199 - 219
Synthesis and n.m.r . analysis of branched trisaccharide and pentasaccharide haptens of the beta-hemolytic streptococci group A and the preparation of synthetic antigens; Pinto BM et al.; The synthesis of branched trisaccharide and pentasaccharide portions of the cell-wall polysaccharide of the beta-hemolytic Streptococci Group A is described . The key dissaccharide acceptors, allyl or 8-(methoxycarbonyl)ocytol 3-O-(3,4,6-tri-O-benzyl-2-deoxy-2-phthalimido-beta-D-glucopyranosyl)-4-O -benzyl - alpha-L-rhamnopyranoside, in conjunction with a selectively blocked alpha-L-rhamnopyranosyl chloride under Koenigs-Knorr conditions, afforded the branched trisaccharides in 81 and 62% yield, respectively . Analogously, glycosylation of the 8-(methoxycarbonyl)octyl disaccharide with a protected beta-D-GlcpNAc-(1----3)-alpha-L-Rhap-(1----3)-alpha-L-Rhap chloride gave the pentasaccharide in 43% yield . The key disaccharide acceptors were obtained, in turn, from the allyl or 8-(methoxycarbonyl)octyl rhamnoside acceptors and 3,4,6-tri-O-benzyl-2-deoxy-2-phthalimido-beta-D-glucopyranosyl chloride under Koenigs-Knorr conditions . The latter glycosyl donor has not been described previously . Removal of the protecting groups afforded the trisaccharide haptens as their 1-propyl and 8-(methoxycarbonyl)octyl glycosides and the pentasaccharide as its 8-(methoxycarbonyl)octyl glycoside . The compounds have been subjected to detailed analysis by two-dimensional n.m.r . methods . Preparation of the synthetic antigens followed coupling of the 8-(methoxycarbonyl)octyl glycosides to bovine serum albumin via the acyl azide intermediates.

FEMS Microbiol Lett, 1991 Mar 15, 63(1), 95 - 7
beta-N-acetyl-D-glucosaminidase activity of oral nutritionally variant streptococci; Lampis G et al.; The ability of nutritionally variant streptococci from the oral cavity to produce beta-N-acetyl-D-glucosaminidase (NAGase) activity was studied . Of the three biotypes analyzed, the strains belonging to biotype III were all shown to produce detectable amounts of both cell-associated and excreted NAGase activity; some strains, but not all of biotype II, were also good NAGase producers, whilst strains of biotype I were not . NVS may contribute to the production of NAGase activity found in human saliva.

Biochem J, 1991 Mar 15, 274 ( Pt 3), 699 - 705
Secondary and tertiary structures of hyaluronan in aqueous solution, investigated by rotary shadowing-electron microscopy and computer simulation . Hyaluronan is a very efficient network-forming polymer; Scott JE et al.; 1 . Hyaluronan from mesothelioma fluid, rooster comb and streptococci was examined by rotary shadowing and electron microscopy . All preparations showed extensive branched networks, but high-viscosity hyaluronan networks were essentially infinite, with no individual 'molecules' that were not integrated via multiple branched points into the meshwork . Low-viscosity hyaluronan, recovered after papain digestion of mesothelioma fluid, showed occasional single filaments that were independent of the main aggregates, some of which were themselves independent of other aggregates . 2 . Hyaluronan is a polymer with a very marked capability to form meshworks at very low dilution (less than 1 microgram/ml) . The longer the hyaluronan molecule, the more branching is potentially possible, and the more extensive and coherent is the network, with every hyaluronan molecule in contact with every other in the solution, via the network . This behaviour accounts for the mechanical properties of the soft tissues (e.g . vitreous humour) and fluids (e.g . synovial fluid) of which hyaluronan is a major component . 3 . The hyaluronan twofold helix, previously demonstrated to be present in solution {Heatley & Scott (1988) Biochem . J . 254, 489-493} was shown by computer simulation and energy calculations to be sterically capable of extensive duplex formation, probably driven by interactions between the large hydrophobic patches on alternate sides of the tape-like polymer, forming stable aggregates at biological temperatures in water . This 'stickiness' is postulated to be the basis of the network-forming and laterally aggregating behaviour of hyaluronan . 4 . The tertiary structures formed by hyaluronan may not be possible in the case of chondroitin 4-sulphate.

J Biol Chem, 1991 Mar 15, 266(8), 4922 - 8
Isolation of a prokaryotic plasmin receptor . Relationship to a plasminogen activator produced by the same micro-organism; Broder CC et al.; Plasminogen receptors have been identified on the surface of a number of prokaryotic and eukaryotic cells . A receptor demonstrating high affinity for plasmin with minimal reactivity with the native zymogen Glu-plasminogen has been identified on the surface of certain group A streptococci . In this study the group A streptococcal plasmin receptor has been solubilized and purified to homogeneity . The isolated protein was an Mr approximately 41,000 molecule which retained its ability to bind plasmin following solubilization and affinity purification on a column of enzymatically inactivated human plasmin . The isolated plasmin receptor was compared functionally, antigenically, and physicochemically to the secreted plasminogen activator, streptokinase, produced by the same organism . The Mr approximately 41,000 surface plasmin receptor was shown to be functionally and antigenically distinct from the Mr approximately 48,000 streptokinase molecule produced by the same strain and lacked any plasminogen activator activity . The streptokinase molecule produced by this strain was shown to be closely related to the plasminogen activator protein secreted by other group A and C streptococci . This study represents the first report of the isolation of a plasmin receptor, either prokaryotic or eukaryotic, with functional activity.

Rev Infect Dis, 1991 Mar-Apr, 13(2), 270 - 80
Group C streptococcal bacteremia: analysis of 88 cases; Bradley SF et al.; Eighty-eight cases of group C streptococcal bacteremia were reviewed retrospectively . Most patients had underlying diseases (72.7%), predominantly cardiovascular disease (20.5%) or malignancy (20.5%) . The infection originated most often from the upper respiratory tract (20.5%), the gastrointestinal tract (18.2%), or the skin (17.1%) . Prior exposure to animals or animal products was reported in 23.9% of cases . The most common clinical manifestations of group C streptococcal bacteremia were endocarditis (27.3%), primary bacteremia (22.7%), and meningitis (10.2%) . Of streptococcal isolates, 61.4% were not speciated, 19.3% were Streptococcus equisimilis, 17.1% were Streptococcus zooepidemicus, and two (2.3%) were Streptococcus equi . The isolates were sensitive to most antibiotics, and most patients were treated with beta-lactam agents . Mortality was high (25.0%), especially among older patients and patients with endocarditis, meningitis, and disseminated infection . Group C streptococcal bacteremia does not differ from bloodstream infection caused by other beta-hemolytic streptococci with regard to clinical presentation, treatment, or outcome.

Pediatr Res, 1991 Mar, 29(3), 310 - 4
Pharmacokinetic and pharmacodynamic analysis of a human immunoglobulin M monoclonal antibody in neonatal Macaca fascicularis; Raff HV et al.; We have developed a human MAb that opsonizes group B streptococci, the major cause of gram-positive bacterial sepsis in newborns . It is an IgM class human MAb that possess unique protective activity against experimental infections caused by the predominant group B capsule serotypes III and I . Preliminary preclinical studies with the IgM human MAb were designed to provide initial information useful for predicting its safety and pharmacokinetic properties . Two neonatal Macaca fascicularis monkeys were infused with the human MAb at either 17.8 or 230 mg/kg . Safety was evaluated by visually monitoring postinfusion clinical status and by standard clinical chemistry analyses and quantitative hematology on blood samples collected for 30 d . The serum antibody levels were determined by ELISA and antibody functional activity in serum samples by opsonophagocytic assays . The IgM human MAb appeared safe (normal laboratory values and clinical status) with a half-life of 2.5 d, a period compatible with the 5-d half-life reported for human IgM in adult serum . In addition, the human MAb retained functional opsonic activity for at least 30 d . Human MAb may offer a safe alternative for treating severe bacterial infections.

Pediatr Res, 1991 Mar, 29(3), 282 - 7
Effects of hyperventilation on prostacyclin formation and on pulmonary vasodilation after group B beta-hemolytic streptococci-induced pulmonary hypertension; Hammerman C et al.; Prostacyclin is released during hyperventilation (HV); however, its role as mediator of HV-induced pulmonary vasodilation remains controversial . We have investigated this by studying the effects of HV on pulmonary artery pressure (PAP) in otherwise normal lungs versus lungs vasoconstricted with group B streptococci (GBS), with and without prior prostacyclin synthesis inhibition . Two- to 3-wk-old piglets were given tranylcypromine, a prostacyclin synthetase inhibitor (n = 6), or placebo (n = 6) . Animals were mechanically ventilated normally, then hyperventilated (PCO2 1.5 +/- 0.2 kPa) and then returned to normal ventilation . After each 30-min segment, plasma 6-keto-prostaglandin F1 alpha (6-keto-PGF1 alpha) (prostacyclin hydrolysis product) levels and PAP were measured . Then GBS infusions were administered to both groups to induce pulmonary hypertension . With GBS, the normal ventilation/hyperventilation/normal ventilation protocol was repeated as above.(ABSTRACT TRUNCATED AT 250 WORDS)

J Am Board Fam Pract, 1991 Mar-Apr, 4(2), 79 - 82
Experience with rapid latex agglutination testing for group A streptococcal pharyngitis in a pediatric group office laboratory; Wiedermann BL et al.; We evaluated 2401 patients with suspected streptococcal pharyngitis with the Culturette 10-minute Group A Strep ID test during a 6-month period in order to determine its suitability for rapid diagnosis in a busy private office practice . Duplicate throat swabs were obtained for each child, and latex agglutination was performed within 15 minutes . In children with negative latex agglutination results, the second swab was cultured . All latex agglutination results were available within 20 minutes of collection, while the patients waited in the office . Seven hundred thirty-eight specimens were positive by latex agglutination . Seventy-eight of the 1663 latex negative specimens contained group A streptococci on culture (sensitivity 90 percent) . Approximately 60 percent of these latex-negative, culture-positive specimens demonstrated 3(+)-4+ growth in culture, unlike previous studies ascribing false-negative latex results to low colony count specimens . Fifty percent of bacitracin-susceptible streptococci tested were not group A, indicating a relatively high occurrence of nongroup A beta-hemolytic streptococcal carriage in this patient population . The use of latex agglutination for detection of group A streptococcal pharyngitis was well-suited to our office practice, even during an extremely busy winter season . Although this assay appears to have a relatively high sensitivity, it is still prudent to culture latex-negative swabs to exclude group A streptococcal infection . The significance of nongroup A beta-hemolytic streptococci in our patient population was unclear . Further refinements are necessary.

Postgrad Med, 1991 Mar, 89(4), 109 - 12
Managing skin infections in children; Wooldridge WE; Because neonates and very young children have little or no immunity to common streptococci and staphylococci, skin infections caused by these organisms must be regarded warily . Prompt and proper treatment may be critical in preventing progression of the lesions and averting systemic complications.

J Pediatr, 1991 Mar, 118(3), 341 - 6
Apparent increase in the incidence of invasive group A beta-hemolytic streptococcal disease in children; Givner LB et al.; Recently, among adults, an increase in the incidence of invasive disease caused by group A beta-hemolytic streptococci (GABS) has been noted, as has the appearance of a severe illness called "toxic shock-like syndrome," also caused by GABS . We now report an apparent increase beginning in 1987 in the incidence of invasive disease caused by GABS in children . Among these patients the manifestations were varied . One child had signs and symptoms compatible with the streptococcal toxic shock-like syndrome . Among the GABS isolates from our patients, 8 (80%) of 10 evaluated for M-protein antigens were nontypeable . Further studies will be necessary to determine the relationship between serotypes and virulence of GABS . Physicians should be aware of the possibility of an increasing incidence of invasive GABS disease in children, as well as its manifestations, which may include toxic shock-like syndrome.

Microb Pathog, 1991 Mar, 10(3), 209 - 20
Identification of Streptococcus pyogenes proteins that bind to rabbit kidney in vitro and in vivo; Glurich I et al.; Proteins were extracted from the surface of a nephritogenic strain of Streptococcus pyogenes M12 and tested for binding to rabbit kidney using indirect immunofluorescence and enzyme-linked immunoassays . Streptococcal antigens bound in vitro in a fine linear pattern to basal laminae of glomeruli, Bowman's capsule, and tubules . Perfusion of rabbit kidney in vivo with streptococcal components resulted in focal and segmental fine granular staining of glomerular capillaries . Three streptococcal proteins (43, 31 and 9 kDa) were recovered from renal tissue that was pretreated in vitro with S . pyogenes extract . Streptococcal components bound in vitro to heparan sulfate, heparin, laminin and collagen IV but only weakly or not at all to fibronectin, bovine serum albumin or dextran sulfate . Affinity chromatography of bacterial extracts on heparin-agarose produced a 9 kDa streptococcal protein (pI 9.5) which bound to kidney basement membranes in vitro and in isolated perfused kidneys . Several additional strains of group A streptococci were found to contain the 9 kDa cationic protein . This bacterial protein, when released into the blood by the bacterium during infection, may contribute to the pathogenesis of streptococcus-associated nephritides in man.

Zh Mikrobiol Epidemiol Immunobiol, 1991 Mar, (3), 26 - 9
{Streptococcus group B in a maternity home with a decentralized system of newborn infant care (of the mother-child type)}; Shevchuk MS et al.; In a maternity hospital with the decentralized system of infant care the presence of the group B streptococcal colonization of puerperants (13.0 +/- 4.5%), newborn infants (25.0 +/- 4.4%) and medical staff (16.9 +/- 3.2%) was established . The strains isolated in this hospital belonged to 13 different serotypes and antigenic combinations with type 1 a/c dominating among them (28.7 +/- 4.8%) . Group B streptococci were found to be transmitted by the vertical way in one out of two colonized mother-child pairs, in all other cases the nosocomial spread of streptococci occurred.

J Med Assoc Thai, 1991 Mar, 74(3), 159 - 61
Causative organisms in puerperal infection; Chaisilwatana P et al.; Ninety-two postpartum women who had been admitted to Siriraj Hospital from April 1, 1980 to March 1, 1983 were studied for the causative organisms of puerperal infection . Cervical and intrauterine swab & smear-gram stain as well as cultures were performed . Hemocultures were done in some cases . Only 50 per cent of all cases had positive cervical and intrauterine swab smears which showed different kinds of micro-organisms, 78 per cent were gram-positive cocci, gram-negative rod was found in 4 specimens, 2 specimens of gonococcal smears, one for trichomonads . Cervical and intrauterine swab cultures were positive in only 31.5 per cent . E . Coli was the most common and Staphylococci & Streptococci were the second most common.

J Indian Soc Pedod Prev Dent, 1991 Mar, 9(1), 4 - 12
Mutans streptococci -dental, oral and global aspects; Bratthall D; The evaluation of the levels of mutans streptococci have been used for many years in some countries, in clinical work to monitor patients during treatment of dental caries, based on the observations that teeth, and patients, with elevated levels of mutans streptococci are at higher risk for caries . Other studies have focussed on attempts to select high caries risk groups based on salivary levels . Several methods to estimate the bacteria have been developed, among them being the "Spatula method" and the more recent "Strip mutans" method . Both methods are based on observations made in studies aimed at determining factors of importance for the transfer of these bacteria between persons . This paper gives a background to saliva sampling for mutans streptococci and describes some studies that have evaluated the role of these bacteria for caries . Such background information is important for the correct use of bacterial tests in the clinic and for interpretation of the results.

Aust J Adv Nurs, 1991 Mar-May, 8(3), 15 - 8
Bacterial contamination of three-way taps--one Australian hospital's experience; Chew S et al.; The incidence and types of organisms present in the vacant ports of 424 three-way taps were studied . The taps were used in 50 children in ICU . Twenty-five (6%) of the taps showed organism growth of one to three colonies from swabs taken of one or more vacant ports . The organisms cultured were staphylococci, klebsiella, streptococci, bacilli and fungi . While there was no marked difference in the growth rate of organisms in three-way taps used in intravenous, intra-arterial and central venous lines, growth rate increased with duration of use.

Clin Orthop, 1991 Mar, (264), 302 - 8
Elution of vancomycin, daptomycin, and amikacin from acrylic bone cement; Kuechle DK et al.; Increasing antibiotic resistance of bacteria that infect prosthetic joints has stimulated interest in the incorporation of more effective antimicrobial agents into polymethylmethacrylate (PMMA) . Vancomycin and daptomycin are effective against nearly all staphylococci and streptococci, and amikacin has a broader spectrum against gram-negative bacilli than do other aminoglycosides such as gentamicin . These three antibiotics maintained bioactivity after incorporation into several commonly used preparations of PMMA and eluted readily into the surrounding medium . Preparing PMMA under negative atmospheric pressure, which decreases porosity, caused a 50% reduction in antibiotic release; the addition of 25% dextran, which increases porosity, greatly facilitated elution of these antibiotics . Based on their broad antibacterial effect against gram-positive and gram-negative bacteria, inclusion of vancomycin and amikacin in PMMA merits clinical study . The addition of these antibiotics to PMMA, together with dextran, may be applicable when structural integrity is unimportant but a substantial local antimicrobial effect is desired, such as in the use of antibiotic-containing beads to treat osteomyelitis.

Eur J Obstet Gynecol Reprod Biol, 1991 Feb 25, 38(3), 203 - 7
Maternal colonization by group B streptococci and puerperal infection; analysis of intrapartum chemoprophylaxis; Matorras R et al.; In a population of 1011 puerperal women, the significance of rectovaginal colonization by group B streptococci during pregnancy with respect to infective puerperal morbidity was analyzed . Patients who were found to be carriers during pregnancy (121) were randomly divided into two groups: women who received ampicillin during delivery (500 mg i.v./6 h) and patients without chemoprophylaxis . Compared with the non-carriers, the carrier patients without prophylaxis had a significant increase in the mild puerperal infective morbidity, when defined as the proportion of women with an index fever greater than or equal to 10 (10.6% vs . 25%) . However, the increased incidence among the carrier women of premature rupture of the membranes and of other possible morbidity factors made it impossible to identify the role of group B streptococci . Mild puerperal infective morbidity in the carrier women who received prophylaxis was lower than in those without prophylaxis and very similar to that of non-carrier women . It is concluded that the use of chemoprophylaxis to prevent neonatal sepsis would probably be followed by a reduction in infectious puerperal morbidity.

J Immunol, 1991 Feb 15, 146(4), 1247 - 53
Evidence for functional heterogeneity in IgG Fc-binding proteins associated with group A streptococci; Raeder R et al.; A number of group A streptococcal isolates have been compared for their nonimmune reactivity with each human IgG subclass, and rabbit, pig, or horse IgG . The results obtained demonstrate considerable heterogeneity in the expression of type II IgG-binding proteins among and within group A isolates . Extraction and analysis of type II IgG-binding proteins from selected strains demonstrate the existence of five functionally distinct IgG-binding proteins . The type IIo IgG binding protein displayed the greatest range of reactivities, binding to all four human IgG subclasses, and rabbit, pig, and horse IgG . A variant of this protein, designated type II'o, bound all four human subclasses and rabbit IgG, but failed to react with pig or horse IgG . A type IIa protein was recovered from certain group A strains which bound human IgG1, IgG2, IgG4, as well as reacting with rabbit, pig, and horse IgG . A functionally related type IIc activity that displayed all of the reactivities of the type IIa protein but did not bind with human IgG2 was also identified . The final functional form of group A IgG-binding protein, the type IIb protein, bound exclusively to human IgG3 . Comparison of these functionally different type II IgG-binding proteins demonstrated no simple structure-function relationship . These studies underscore the heterogeneity of type II Ig-binding proteins expressed by different group A streptococci and document that a single strain can change its pattern of expression of type II IgG-binding protein both quantitatively and qualitatively.

Cent Afr J Med, 1991 Feb, 37(2), 56 - 60
Community acquired staphylococcal skin infections in rural areas of Zimbabwe; Mason PR et al.; Swabs from superficial skin or wound infection in 254 outpatients at rural clinics and hospitals in the Eastern Districts of Zimbabwe were examined for microorganisms . The most common site of infection was on the limbs, with infected wounds or abscesses being the most common complaint . Staphylococcus aureus was by far the most common pathogen being isolated from almost half the specimens . Coliforms were obtained from 36pc and streptococci from 18pc of swabs . Over two-thirds of the staphylococcal isolates showed in-vitro resistance to penicillin and there was an indication that penicillin resistant strains occurred more frequently in specimens from the Mozambique border areas . Resistance to other antibiotics occurred only rarely in these isolates, and in particular we found only three strains showing methicillin resistance, with one of these also showing resistance to gentamicin . The value of penicillinase sensitive penicillins in treating superficial wound infections is questioned.

Scand J Dent Res, 1991 Feb, 99(1), 8 - 12
Intraindividual variations in counts of mutans streptococci measured by "Strip mutans" method; el-Nadeef MA et al.; Intraindividual variations in the mutans streptococci measured by Strip mutans, in a 1-day and a 5-day period, as well as the effect of toothbrushing, were investigated . 30 subjects participated, and their levels of salivary mutans were estimated by a scale containing four steps . With the exception of three comparisons, time intervals of different lengths did not cause a deviation of more than one step . Comparisons made before and after toothbrushing yielded the same score in 22 cases, whereas two subjects showed a discrepancy of two steps . Clearly, in a short-term perspective, variations can certainly be found, but more pronounced discrepancies are rare.

Nippon Hoigaku Zasshi, 1991 Feb, 45(1), 33 - 43
{Personal identification from antibodies to oral streptococci using ELISA}; Yamashita M; Serum antibodies to oral streptococci were titrated by ELISA for the purpose of personal identification . The bacteria concerned comprised 9 strains of Streptococcus mutans, which are known to cause dental caries, and one strain of Streptococcus sanguis commonly found in the oral cavity and harmless to the teeth . The quantities of IgM antibodies to these streptococci were more or less dependent on the total levels of serum IgM . However, no relation was found between the IgG antibodies and the total serum levels of IgG . IgA antibodies showed a degree of correlation that was intermediate between those of the IgM and IgG antibodies . Two antibodies, anti-Streptococcus mutans PS14 (anti-SM) and anti-Streptococcus sanguis 10556 (anti-SS), were selected, because the cross-reactivities of the IgG antibodies with these streptococci were slight . The quantity ratios of IgG anti-SM antibodies and IgG anti-SS antibodies differed from person to person, ranging from about 1:1 to 1:6 in 129 healthy Japanese adults . ELISA was considered to be appropriate for assaying these antibodies because of its good intra-assay reproducibility . The IgG anti-SM/anti-SS quantity ratio was not related to sex, age or ABO blood group, and appeared to be unrelated to the "decayed, missing and filled teeth index" (DMF index) . The anti-SM/anti-SS ratios were investigated for 12 months after the preparation of bloodstains . They remained almost unchanged for 8 months, although the reactivities of individual IgG antibodies began to decrease 3 to 5 months after preparation . These results indicate that the ratio of IgG anti-streptococcal antibodies in bloodstains is a very useful parameter in personal identification.

Curr Opin Rheumatol, 1991 Feb, 3(1), 32 - 5
Behçet's disease; Mizushima Y; Recent studies have revealed the important role of streptococci in the etiology of Behcet's disease . Among patients with Behcet's disease, there is a high incidence of a history of streptococcal infections . Certain antigens of streptococci induced not only cutaneous, delayed-type hypersensitivity, but also systemic attacks of Behcet's disease when skin tests were performed . Neutrophil-activating lymphokines are produced when streptococcal antigen reacted with lymphocytes from patients with Behcet's disease . The first international diagnostic criteria for Behcet's disease were prepared by multicenter studies and published recently . With recent progress in diagnostic imaging techniques, magnetic resonance imaging and position emission tomography are particularly important for the diagnosis of neuro-Behcet's disease . In Japan, cyclosporin was also proved to be effective for eye lesions of Behcet's disease in a double-blind clinical trial comparing this drug with colchicine.

J Am Vet Med Assoc, 1991 Feb 1, 198(3), 450 - 2
Conjunctivitis associated with a Mycoplasma-like organism in swine; Rogers DG et al.; A midwestern producer reported high incidence of conjunctivitis and keratoconjunctivitis in a herd of crossbred finishing swine . Complete necropsy was performed on 3 pigs with bilateral mucopurulent conjunctivitis and chemosis; other gross lesions were not seen . Mycoplasma sp was isolated from conjunctival swab specimens obtained from 1 pig; small numbers of streptococci and coagulase-negative staphylococci were isolated from conjunctival swab specimens from all 3 pigs . Neither swine influenza virus nor pseudorabies virus was isolated from conjunctival swab specimens . Histologically, the 3 pigs had chronic lymphoplasmacytic conjunctivitis with lymphofollicular hyperplasia and foci of epithelial and goblet cell hyperplasia . Ultrastructural examination of conjunctival specimens from the 3 pigs revealed large numbers of Mycoplasma-like organisms adhered to superficial conjunctival cells . Mycoplasma-like organisms also were seen in membrane-bound vacuoles in superficial conjunctival cells . Bacteria (including chlamydiae) or viruses were not seen ultrastructurally . The lymphoproliferative nature of the conjunctival lesion and the evidence of adhered and intracellular organisms suggested an etiologic role for a Mycoplasma-like organism in the disease in these pigs.

Ophthalmology, 1991 Feb, 98(2), 159 - 69
Infectious crystalline keratopathy . Role of nutritionally variant streptococci and other bacterial factors; Ormerod LD et al.; Infectious crystalline keratopathy (ICK) is a chronic corneal infection characterized by interlamellar plaques of gram-positive coccal bacteria in the absence of inflammatory cells . It generally occurs within a corneal graft . Viridans streptococci are usually isolated, but the clinical response to antibiotics is poor and disparate with the in vitro antimicrobial sensitivities . These features suggest the possibility of unusual bacterial factors in pathogenesis . Four cases caused by nutritionally variant viridans streptococci are described . The organisms were fully characterized . They have a rare nutritional requirement for pyridoxal and require defined culture conditions and specific identification . Nutritional variant streptococci (NVS) are principally described as causing endocarditis, another infection involving an avascular collagenous tissue, and exhibiting similar biologic behavior . Electronmicrographic evidence is also adduced that suggests the possible importance of intracorneal glycocalyx deposition . Such factors might explain the anomalous clinical characteristics of this condition.

J Am Acad Dermatol, 1991 Feb, 24(2 Pt 2), 363 - 5
Group A streptococcal cellulitis-adenitis in a patient with acquired immunodeficiency syndrome; Janssen F et al.; A rapidly enlarging left inguinal adenitis, with positive groove sign, and fever, chills, malaise, hypotension, headache, scarlatiniform rash, choleroid diarrhea, and proteinuria developed in an homosexual man who was positive for human immunodeficiency virus . The needle aspiration of the inguinal mass showed group A beta-hemolytic streptococci and the blood cultures were negative, suggesting group A streptococcal cellulitis-adenitis with toxic strep syndrome . Treatment with penicillin and surgical drainage was successful . Bacterial infections associated with defective humoral immunity appear to be common in patients with acquired immunodeficiency syndrome (AIDS), and some of these infections have a remarkable extensive and lethal evolution . Therefore streptococcal adenitis should be considered in any patient with AIDS or AIDS-related syndrome in whom rapidly enlarging inguinal nodes develop.

Biochem J, 1991 Feb 1, 273 ( Pt 3), 635 - 40
Group B streptococci inactivate complement component C5a by enzymic cleavage at the C-terminus; Bohnsack JF et al.; Incubation of recombinant human C5a (rC5a) with the 7360 strain of group B streptococci (GBS) destroyed the ability of rC5a to stimulate chemotaxis or adherence of purified human polymorphonuclear leucocytes (PMNs) . Treatment of 125I-labelled rC5a with GBS 7360 correspondingly decreased rC5a binding to human PMNs . This also resulted in an approx . 600 Da decrease in the molecular mass of rC5a as determined by SDS/PAGE . Incubation of rC5a with the GBS strain GW, which only minimally altered the ability of rC5a to activate human PMNs, did not affect rC5a binding to PMNs and did not alter the molecular mass of rC5a on SDS/PAGE . Plasma-desorption m.s . of rC5a inactivated by GBS 7360 showed that the GBS cleaved the rC5a between histidine-67 and lysine-68 near the C-terminus of rC5a . This mechanism of inactivation of C5a by proteolytic cleavage at the C-terminus of C5a is consistent with the known critical role of the C-terminus in C5a activation of human PMNs . This C5a-cleaving proteinase activity may contribute to the pathophysiology of GBS infections.

Am J Kidney Dis, 1991 Feb, 17(2), 231 - 2
Group B streptococcus: an unusual cause of severe peritonitis in young children treated with continuous ambulatory peritoneal dialysis; Schroder CH et al.; Peritonitis in continuous ambulatory peritoneal dialysis (CAPD) patients is only rarely caused by beta-hemolytical streptococci species . We describe two young children, aged 15 months and 5 years, respectively, who presented an unusually severe course of peritonitis due to group B beta-hemolytical streptococci . This course of the disease showed a strong similarity with neonatal streptococcal septicemia . In neonates, IgG2 deficiency is thought to be partly responsible for the severity of this condition . This may also be true for young children treated with CAPD, since IgG2 deficiency has been established for children.

J Dent Res, 1991 Feb, 70(2), 150 - 3
Effects of fluoride and chlorhexidine on the microflora of dental root surfaces and progression of root-surface caries; Schaeken MJ et al.; The effects of fluoride and chlorhexidine varnishes on the microflora of dental root surfaces and on the progression of root-surface caries were studied . Forty-four patients, surgically treated for advanced periodontal disease, were distributed at random among three groups . All patients received a standardized preventive treatment . Furthermore, the dentition of the patients in the two experimental groups was treated, at three-month intervals, with chlorhexidine and fluoride varnish, respectively . Patients in the control group received no additional treatment . In the experimental groups, plaque samples were collected from selected sound and carious root surfaces at baseline and at three, six, and nine months after the onset of the study . The presence of root-surface caries was scored at baseline and after one year . In addition, the texture, depth, and color of the root-surface lesions were monitored . Mutans streptococci on root surfaces were suppressed significantly (p less than 0.05) during the whole experimental period in the chlorhexidine varnish group, but not in the fluoride varnish group . A non-significant increase in the number of Actinomyces viscosus/naeslundii was noted after treatment with chlorhexidine and fluoride varnish . The increase in the number of decayed and filled root surfaces after one year was significantly lower in the experimental groups than in the control group . After treatment with chlorhexidine varnish, significantly more initial root-surface lesions had hardened than in the other groups.

Blood, 1991 Feb 1, 77(3), 579 - 86
Expression of a heat-inducible gene of the HSP70 family in human myelomonocytic cells: regulation by bacterial products and cytokines; Fincato G et al.; In this study we have examined the expression of a heat-shock protein (HSP) 70 gene in normal human peripheral blood leukocytes . Northern blot analysis showed that appreciable levels of hsp70 mRNA are present in monocytes and granulocytes, whereas transcript levels were barely detectable or absent in lymphocytes . Monocytes functionally activated by bacterial lipopolysaccharide (LPS) showed an early (15 minutes) increase of hsp70 transcripts that was shown, by actinomycin D blocking and nuclear run-off experiments, to be dependent on transcriptional activation of the gene . LPS did not appreciably affect the hsp70 mRNA half-life . Monocytes exposed to inactivated streptococci, phorbol-12-myristate-13-acetate, and tumor necrosis factor showed augmented levels of hsp70 transcripts, whereas interferon-gamma and monocyte, granulocyte, and granulocyte-monocyte colony-stimulating factors had no effect . Adherence to plastic augmented hsp70 expression in monocytes . S1 protection analysis indicated that the gene expressed in monocytes is indeed a heat-inducible member of the hsp70 gene family rather than a constitutively expressed heat-shock cognate gene . Western blot analysis showed that a heat-inducible HSP72 was present in monocytes and, at augmented levels, in LPS-treated monocytes . LPS-activated monocytes were more resistant to heat shock than unstimulated cells . These data indicate that a heat-inducible hsp70 gene can be efficiently expressed in myelomonocytic cells at physiologic temperatures . Expression of hsp70 genes in monocytes suggests a possible role of heat-inducible genes in the differentiation and/or functional activation of terminally differentiated nonproliferating elements of the myelomonocytic lineage.

Am Fam Physician, 1991 Feb, 43(2), 487 - 92
Preventing group B streptococcal infection in newborns; Hueston WJ; Group B streptococci, commonly found in the maternal gastrointestinal and genitourinary tracts, can be transmitted to the neonate at the time of rupture of membranes and during delivery . Current management strategies include early detection of group B streptococcal carriers and the administration of intrapartum prophylactic antibiotics to prevent maternal fetal transmission . Several tests are now available to rapidly identify group B streptococcal carriers . Physicians should be able to recognize patients at high risk for colonization and the situations in which prophylactic antibiotics should be employed . Proper use of antibiotics during labor can eliminate group B streptococcal sepsis in neonates . Early group B streptococcal meningitis carries a mortality rate of almost 50 percent, despite medical support from neonatal intensive care units.

J Med Microbiol, 1991 Feb, 34(2), 119 - 24
Antibodies to streptococcal opacity factor in a selected Indian population; Prakash K et al.; Antibody to at least one type of streptococcal opacity factor (OF) was present in 39.0% of 235 selected subjects and, in 47.8% of these, to more than one type . Only 21.6% of children less than 4 years old had antibody to OF; these were to one type in 62.5% or to more than one in 37.5% . In the study group as a whole, the commonest antibodies were those to OF from M-serotype 25 followed, in descending order, by serotypes 4, 22, 2, 9, 48, 49, 28, 61 and 75 . Patients with rheumatic fever or rheumatic heart disease most often had antibodies to OF from M-types 25, 22, 4 and 9, whereas in patients with acute glomerulonephritis, antibodies to OF from M-types 48, 49 and 61 were commonest . The limitations of the OF-inhibition test as an epidemiological marker for prevalent M-types of group A streptococci are discussed.

J Infect Dis, 1991 Feb, 163(2), 346 - 54
Comparison of functional activities between IgG1 and IgM class-switched human monoclonal antibodies reactive with group B streptococci or Escherichia coli K1; Raff HV et al.; The influence of valence and heavy chain on antibody activity was investigated using transfectoma-derived, class-switched IgG1 and IgM human monoclonal antibodies (MAbs) reactive with the bacterial pathogens Escherichia coli K1 and group B Streptococcus species . IgG-IgM pairs were compared in vitro for antigen binding and opsonic activities and in vivo for protective efficacy in neonatal rats . For the anti-E . coli pair, the IgM MAb was 1000-fold more potent in all assay formats . Importantly, the 50% protection dose (PD50) of the IgM MAb was 10-20 ng/rat, while 100 micrograms of the IgG MAb was only minimally protective . For the group B streptococcal MAbs, the IgM was 100- and 4500-fold more potent in binding and opsonization assays, respectively . However, while 20 micrograms of IgM protected neonatal rats, 100 micrograms of IgG MAb was partly protective . These experiments demonstrate the utility of recombinant DNA technology for creating a panel of antibodies that may aid in selecting potential immunotherapeutic candidates.

Infect Immun, 1991 Feb, 59(2), 592 - 9
Purification and characterization of Streptococcus adjacens (nutritionally variant Streptococcus serotype II) group antigen; Sieling PA et al.; Nutritionally variant streptococci (NVS) possess amphiphiles which are serologically distinct from lipoteichoic acid and which serve as group-specific antigens for NVS . The objective of this study was to purify and characterize the NVS serotype II (Streptococcus adjacens) amphiphile . Amphiphile was isolated from stationary-phase culture supernatants of NVS strain 81 (NVS serotype II) . Phenol-water extracts of culture supernatants were subjected to hydrophobic interaction chromatography and gel filtration chromatography . A homogeneous preparation of amphiphile (22 mg; 8.5 x 10(6) hemagglutination units) was recovered, and its approximate molecular size (23,000 to 24,000 Da) and chemical composition were determined . Purified S . adjacens amphiphile contained phosphorus, ribitol, galactose, galactosamine, alanine, and fatty acids in molar ratios of 1.00:0.88:1.39:1.10:0.08:0.24 . Since ribitol, galactose, and galactosamine were the primary carbohydrate components, the amphiphile may exist as a polyribitol phosphate with galactose and galactosamine substituents . Preliminary structural analysis demonstrated the presence of phosphodiester bonds within the amphiphile structure . Finally, the amphiphile serves as the S . adjacens group antigen.

Infect Immun, 1991 Feb, 59(2), 563 - 9
Detection of immunoglobulin A1 protease-induced Fab alpha fragments on dental plaque bacteria; Ahl T et al.; The mechanisms by which immunoglobulin A1 (IgA1) protease activity may enable bacteria to evade the effect of specific secretory IgA (S-IgA) antibodies are not clear . A possibility which has received indirect experimental support is that bacteria, as a consequence of the protease activity, become coated with incompetent Fab alpha fragments instead of with intact antibody molecules . Using a combination of nonreducing sodium dodecyl sulfate-polyacrylamide gel electrophoresis and immunoblotting, we detected Fab alpha fragments not only on oral streptococci (Streptococcus sanguis and Streptococcus gordonii) incubated in saliva but also on the bacteria in incipient dental plaque . These results are of relevance to our previous observation that IgA1 protease activity may neutralize the ability of S-IgA antibodies to inhibit the adherence of oral streptococci to saliva-coated hydroxyapatite.

Infect Immun, 1991 Feb, 59(2), 555 - 62
Evidence for peptidoglycan absorption in rats with experimental small bowel bacterial overgrowth; Lichtman SN et al.; Surgical creation of jejunal self-filling blind loops (SFBL) causes small bowel bacterial overgrowth which is associated with hepatobiliary inflammation in the susceptible Lewis and Wistar rat strains . Since hepatic injury occurs when small bowel anaerobic bacterial concentrations are increased 4 to 6 log10 units per ml and hepatic bacterial cultures are negative, we postulate that the inflammation is caused by absorption of phlogistic cell wall polymers originating from bacteria within the loop . To demonstrate absorption of bacterial cell wall polymers, we measured plasma and hepatic levels of immunoreactive peptidoglycan-polysaccharide (PG-PS) following intraluminal injection as well as anti-PG antibodies as an indirect measure of absorption and/or accumulation of endogenous PG . PG-PS purified from group A streptococci was detected in plasma by enzyme-linked immunosorbent assay after intraluminal injection; rats with SFBL showed significantly more uptake into plasma and the liver than sham-operated rats or SFBL rats which were treated with metronidazole (P less than 0.025) . Total plasma immunoglobulin A (IgA), IgG, and IgM levels did not differ among sham-operated rats and those with self-emptying blind loops or SFBL, but plasma anti-PG IgA (P less than 0.05), IgG, and IgM (P less than 0.01) levels were increased in rats with SFBL . Metronidazole and tetracycline prevented the elevation of anti-PG antibody, but gentamicin and polymyxin B did not . Anti-lipid A, anti-soy protein, and anti-chow antibodies in plasma were not consistently increased in rats with SFBL indicating the lack of a generalized antibody response to luminal antigens . These data suggest that PG from normal flora bacteria is absorbed from the intestinal lumen and that mucosal injury and/or increased luminal concentrations of PG, such as those induced by small bowel bacterial overgrowth, lead to enhanced absorption of potentially inflammatory bacterial polymers.

Infect Immun, 1991 Feb, 59(2), 537 - 43
Binding of a Streptococcus mutans cationic protein to kidney in vitro; Choi SH et al.; An 8-kDa protein, with binding activity for heparin and heparan sulfate of basal laminae of animal tissues, was isolated from Streptococcus mutans MT703 and purified to homogeneity . Binding of radioiodinated 8-kDa protein to rabbit kidney tissue in vitro showed a high degree of specificity, as indicated by saturation kinetics, time dependence, and competitive inhibition by unlabeled protein . Binding activity for kidney tissue was competitively inhibited by selected glycosaminoglycans and polyanions in the following order: heparin greater than dextran sulfate greater than heparan sulfate greater than chondroitin sulfate greater than lipoteichoic acid greater than keratan sulfate greater than hyaluronic acid . Binding of the streptococcal protein to rabbit kidney tissue was also strongly inhibited by protamine sulfate, polylysine, and a random copolymer of lysine and alanine . Among the monosaccharides tested at 50 mM, glucosamine 2,3- or 2,6-disulfate, glucuronic acid, glucose 6-phosphate, and glucose 6-sulfate inhibited 50% or more of the binding activity, whereas N-acetylglucosamine 3-sulfate, glucosamine 6-sulfate, N-acetyl-glucosamine, N-acetylgalactosamine, N-acetylneuraminic acid, and a selection of neutral sugars were not inhibitory . The heparin-binding protein was detected on the cell wall of S . mutans and in the culture medium following growth . Several other species of streptococci produce an immunologically related protein of similar size.

Mycopathologia, 1991 Feb, 113(2), 117 - 9
Decrease of aflatoxin B1 in yoghurt and acidified milks; Rasic JL et al.; Fermentation of yoghurt and acidified milks containing aflatoxin B1 (AB1) were studied . AB1 added to milk before fermentation at concentrations of 600, 1000 and 1400 micrograms/kg was reduced in yoghurts (pH 4.0) by 97, 91 and 90%, respectively . Coagulation time was approximately the same as in the controls . Streptococci had longer chains than those in the controls . The main decrease of AB1 occurred during the milk fermentation . A decrease of AB1 (conc . 1000 micrograms/kg) in milks acidified with citric, lactic and acetic acids (pH 4.0) was 90, 84 and 73%, respectively.

J Pak Med Assoc, 1991 Feb, 41(2), 42 - 4
Carriage of group B streptococci in rectum and urogenital tract of pregnant women; Kirmani N et al.; One hundred pregnant women in third trimester were screened for the carriage of group B streptococci (GBS) in a prospective study . Rectal and urogenital samples were collected, 25% women were positive for non group B beta haemolytic streptococci . Twelve (48%) were positive at single site and 13 (52%) at more than one site . Beta haemolytic streptococci isolated were non-groupables in 19 (76%) and groupables in 6 (24%) . Among groupables, Group D streptococci (GDS) were the commonest 3 (12%) followed by Group G2 (8%) and Group F1 (4%) . Group B streptococci were not isolated in our study population.

Zh Mikrobiol Epidemiol Immunobiol, 1991 Feb, (2), 4 - 7
{The modification of the cell wall proteins in group A streptococci type M 29 under the influence of spermidine contained in the culture medium}; Bitko SA et al.; The addition of spermidine into growth medium used for the cultivation of group A streptococci, type M 29, leads to changes in the amino acid composition of cell walls and surface proteins isolated by the method of E . H . Beachey et al . The separation of surface proteins into fibrinogen-binding proteins and fibrinogen receptors by affinity chromatography techniques on cellulose with covalently bound fibrinogen indicates that the proportion of these proteins in pepsin extracts obtained from different strains varies . Both spermidine and avirulent strains have similar content of fibrinogen-binding proteins, although these proteins are absent in virulent strains . Different amounts of fibrinogen receptors are extracted from all strains . As shown in the enzyme immunoassay, fibrinogen receptors contain no group-specific polysaccharide A, Fc-receptors and interact with total antiserum to group A streptococci, type M 29 {correction of 28} . Fibrinogen receptors isolated from the strains under study have been found to have similar amino acid composition . On the basis of these results we believe that neither receptor capacity to fibrinogen nor amino acid composition is indicative of the protective properties of protein M.

J Clin Pathol, 1991 Feb, 44(2), 160 - 3
Incidence of penicillin tolerance among blood culture isolates of Streptococcus sanguis, 1987-88; James PA et al.; Laboratories that reported isolations of Streptococcus sanguis from blood cultures to the Communicable Disease Surveillance Centre (CDSC) Colindale were requested to submit strains to Bath Public Health Laboratory to allow the prevalence of penicillin tolerance within different biotypes of this species to be studied . One hundred and fifty one Streptococcus spp were received from 78 United Kingdom laboratories in one year . Strains were identified using the API 20 Strep, and minimum inhibitory concentrations (MICs) of penicillin were determined using the spiral gradient plate method . Penicillin tolerance was detected by spraying beta-lactamase over inoculated gradient plates, reincubating for 48 hours and counting the number of surviving organisms represented by colonies . There were 57 different API identification profiles encountered in the survey . Most S sanguis I/1 strains were penicillin tolerant, most S sanguis II strains were non-tolerant . The overall geometric mean MIC of penicillin was considerably lower for S sanguis I/1 than for all other biotypes . The distribution of biotypes and the geometric mean MIC of penicillin for each biotype were not significantly different for infective endocarditis strains than for all strains tested, suggesting little or no association between penicillin tolerance and the seeding of endocardium . When the reactions obtained using API 20 Strep were compared with a recent taxonomic study of viridans streptococci, 22 of 38 S sanguis I/1 strains could be reclassified as S gordonii; all these strains were penicillin tolerant . Such reclassification would allow likely penicillin tolerant strains to be predicted.

Acta Paediatr Jpn, 1991 Feb, 33(1), 20 - 6
Possible role of Streptococcus pyogenes in mucocutaneous lymph node syndrome . XII . Variable responses of platelets in MCLS seem to be explainable by streptococcal pyrogenic exotoxin; Akiyama T et al.; As a model system for mucocutaneous lymph node syndrome (MCLS), we have advocated and used mice which had been rendered tolerant to Streptococcus pyogenes-associated antigens by neonatal infection with group A beta-hemolytic streptococci, because these mice have shown a variety of peculiar bioimmunological characteristics bearing a striking resemblance to those of MCLS patients . The results of our current investigations reaffirmed the reliability of the animal model by indicating that mice subjected to neonatal infection with S . pyogenes, or inoculation with streptococcal pyrogenic exotoxin (SPE) in Freund's adjuvant, were perfect counterparts of patients with MCLS on account of their platelet activation and hyperaggregability in response to provocative treatment, which are familiar findings in this disease.

Infect Immun, 1991 Feb, 59(2), 609 - 16
Comparison of albumin receptors expressed on bovine and human group G streptococci; Raeder R et al.; The albumin receptor expressed by bovine group G streptococci was extracted and affinity purified . The protein was characterized for species reactivity, and monospecific antibodies were prepared to the purified receptor . The bovine group G albumin receptor was compared functionally, antigenically, and for DNA homology with the albumin-binding protein expressed by human group G streptococci . In agreement with previous reports, the albumin-binding activity of human strains was mediated by a unique domain of the type III immunoglobulin G-Fc-binding molecule, protein G . The albumin receptor expressed by bovine group G strains was found to lack any immunoglobulin G-binding potential but displayed a wider profile of species albumin reactivity than protein G . Both albumin receptors could inhibit the binding of the other to immobilized human serum albumin, and each displayed similar binding properties . Antigenic comparison of the two albumin receptors demonstrated a low level of cross-reactivity; however comparison at the DNA level, using an oligonucleotide probe specific for the albumin-binding region of protein G, demonstrated that the two albumin receptors expressed by human and bovine group G streptococcal strains do not display significant homology.

Zh Mikrobiol Epidemiol Immunobiol, 1991 Feb, (2), 16 - 20
{The low-molecular protein of the cell wall in streptococci group A devoid of serological type specificity}; Molchanova TO et al.; The scheme for the isolation and purification of low-molecular cell-wall protein without type specificity, including the extraction of the cell walls of group A streptococci, type M 29, with 1% solution of Triton X-100, the separation of the extract by ion-exchange chromatography in DEAE-trisacryl M with the subsequent two-stage gel filtration in superfine Sephadex G-50, is described . The isolated protein had a molecular weight of 4,000 daltons and contained no admixtures of group-specific polysaccharide A, phosphorus, nucleic acids and Fc receptors and interacted with antisera to group A streptococcal cells of heterologous type M in the enzyme immunoassay (EIA) . Purified protein was characterized by a high content of glycine . The antigenic determinants of immobilized protein, recognized by antibodies in EIA, were sensitive to the action of trypsin and resistant to the action of pepsin, papain, pronase E and sodium periodate.

Am J Pathol, 1991 Feb, 138(2), 285 - 301
Immunoreactivity of anti-streptococcal monoclonal antibodies to human heart valves . Evidence for multiple cross-reactive epitopes; Gulizia JM et al.; Association of group A streptococci with acute rheumatic fever and valvular heart disease is well established; however the basis of valve injury remains unclear . In this study, anti-streptococcal monoclonal antibodies (MAbs) cross-reactive with myocardium were reacted with sections from 22 rheumatic valves, nine normal, five endocarditic, one 'floppy,' and one Marfan valve . In immunohistochemical studies, MAb reactivity was observed with cardiac myocytes, smooth muscle cells, cell surface and cytoplasm of endothelial cells lining valves, and valvular interstitial cells . Endothelial basement membrane and elastin fibrils reacted with the MAbs, whereas collagen was unreactive . Similar reactivity was seen with sera from acute rheumatic fever patients . The anti-streptococcal MAbs reacted with intravalvular myosin and vimentin in Western blots, and purified elastin competitively inhibited the binding of the anti-streptococcal MAbs to whole group A streptococci . The data show that human heart valves have numerous sites of immunoreactivity with anti-streptococcal MAbs and acute rheumatic fever sera of potential importance in the pathogenesis of rheumatic valvular injury.

Bull Tokyo Dent Coll, 1991 Feb, 32(1), 9 - 17
Inhibition of adsorption of oral streptococci to saliva treated hydroxyapatite by chitin derivatives; Sano H et al.; This study estimated the effects of five chitin derivatives low molecular chitosan (LMCS), ethyleneglycol chitin (PEGT), carboxymethyl chitin (PCMT), sulphated chitosan (PSSS), and phosphorylated chitin (PPPT) on the adsorption of three oral streptococci to saliva-treated hydroxyapatite (S-HA) . The adsorption was evaluated by measuring the optical density of the bacterial cell suspensions released from saliva-treated hydroxyapatite by 0.5 N HCl . The adsorption of test strains to S-HA progressively decreased in proportion to each additional volume of PEGT, PPPT, or PSSS . PPPT and PSSS quite effectively inhibited the adsorption of S . mutans onto S-HA, but were less effective against S . sanguis and S . mitis . PPPT, PSSS, and PCMT all markedly promoted the desorption of S . mutans cells pre-adsorbed onto S-HA . Pretreatment of S-HA with PPPT, PSSS, or PCMT significantly decreased the subsequent adsorption of S . mutans and S . mitis . Pretreatment of these cells with PEGT also decreased their adsorption to S-HA . These findings suggest that these chitin derivatives may change the ionic natures of the S-HA and the bacterial cell surface, resulting in a less favorable interaction.

Oral Microbiol Immunol, 1991 Feb, 6(1), 41 - 50
Intracellular xylitol-phosphate hydrolysis and efflux of xylitol in Streptococcus sobrinus; Trahan L et al.; The parental strain Streptococcus sobrinus (Streptococcus mutans ATCC 27352), which is known to transport, phosphorylate and accumulate xylitol intracellularly as nonmetabolizable xylitol-phosphate (xylitol-sensitive (XS) strain) and its xylitol-resistant (XR) spontaneous mutant were used to further investigate the inhibitory action of xylitol on oral streptococci . Fructose-grown XR cells did not accumulate xylitol-phosphate, indicating that the inducible fructose PTS is incapable of transporting the pentitol . The intracellularly accumulated pentitol-phosphate by the XS cells did not prevent the subsequent uptake and degradation of glucose or fructose, despite a drop in the PEP pool and a 50% inhibition of the glucose but not the fructose catabolism . Intracellular dephosphorylation of the pentitol-phosphate and release of xylitol in the extracellular medium resulted in a rapid decrease of the intracellular level of this nonmetabolizable product . A Mg(++)- or Mn(++)-independent sugar-phosphate hydrolysing activity capable of splitting xylitol-phosphate was demonstrated in both XS and XR strains . Preincubation in the presence of N1-ethylmaleimide (NEM) and xylitol or NEM and fructose resulted in the subsequent inhibition of both xylitol uptake and efflux . The efflux kinetic at various temperatures is compatible with a facilitated diffusion by the phosphotransferase system EIIfru without, however, excluding the existence of an additional exit route, but it excludes a simple diffusion exit process . The results are consistent with the existence of a xylitol futile cycle contributing to the growth inhibition of S . sobrinus by the pentitol without excluding a toxic effect of xylitol-phosphate . Discrepancies in the literature on the action of xylitol on S . mutans could be explained in the light of the evidence presented.

Gene, 1991 Jan 2, 97(1), 63 - 8
Polymerase chain reaction amplification, cloning, sequence determination and homologies of streptococcal ATPase-encoding DNAs; Quivey RG Jr et al.; The highly conserved portion of the catalytic subunit (beta-subunit) of the membrane-bound, proton-translocating ATPase from three strains of oral streptococci has been amplified via the polymerase chain reaction . Hybridization studies demonstrated the existence of homology between Escherichia coli and Bacillus megaterium beta-subunit probes at the streptococcal DNA level . Highly degenerate primers, based on the E . coli and B . megaterium amino acid (aa) sequences, were used to amplify the homologues in Streptococcus mutans, S . sanguis and S . sobrinus . The 600 bp fragment from S . sobrinus has been cloned and its nucleotide (nt) sequence determined . Comparison of its nt and deduced aa sequence to that of E . coli and B . megaterium reveals a high degree of homology at the aa level.

Ned Tijdschr Geneeskd, 1991 Jan 12, 135(2), 74 - 6
{2 newborn infants with septicemia caused by multiresistant Streptococcus mitis}; Veringa EM et al.; Multiresistant viridans streptococci had not yet been encountered in the Netherlands . In the spring of 1990 we isolated multiresistant S . mitis from blood of two Dutch neonates (minimal inhibitory concentration of penicillin 64 mg/l) . In both patients septicaemia developed while they were being treated with beta-lactam antibiotics . Although viridans streptococci usually are extremely sensitive to penicillin and other beta-lactams, the possibility of development of (multi-)resistance in these microorganisms during antibiotic treatment should be kept in mind.

J Biol Chem, 1991 Jan 5, 266(1), 399 - 405
Streptococcal protein G . Gene structure and protein binding properties; Sjobring U et al.; Protein G was solubilized from 31 human group C and G streptococcal strains with the muralytic enzyme mutanolysin . As judged by the mobility in sodium dodecyl sulfate-polyacrylamide gel electrophoresis and the binding patterns of the solubilized protein G molecules in Western blot experiments, the strains could be divided into three groups, represented by the group G streptococcal strains G148 and G43 and the group C streptococcal strain C40 . The 65-kDa G148 protein G and the 58-kDa C40 protein G showed affinity for both immunoglobulin G (IgG) and human serum albumin (HSA), whereas the 40-kDa G43 protein G bound only IgG . Despite the different molecular patterns, the three protein G species had identical NH2-terminal amino acid sequences . Apart from the 65-kDa peptide, digestion of G148 streptococci with mutanolysin also produced a 52-kDa IgG- and HSA-binding peptide and a 14-kDa HSA-binding peptide . It was demonstrated that these peptides resulted from cleavage of 65-kDa protein G by proteolytic components in the mutanolysin preparation . The protein G genes of the C40 and G43 strains were cloned and sequenced, and their structure was compared to the previously published sequence of the G148 protein G gene . As compared to G148, both the C40 and G43 genes lacked a 210-base pair fragment in the IgG-binding region, accounting for the 10-fold lower affinity of these proteins for IgG . The G43 gene also lacked a 450-base pair fragment in the 5'-end of the gene, explaining why the G43 protein G did not bind HSA . The differences in protein G structure did not correlate with the clinical origin of the strains used in this study . The IgG-binding region of protein G was further mapped . Thus, a peptide corresponding to a single IgG-binding unit was obtained by the cloning and expression of a 303-base pair polymerase chain reaction-generated DNA fragment . The affinity of this 11.5-kDa peptide for human IgG was 8.0 x 10(7) M-1, as determined by Scatchard plots . Finally, a 55-amino acid-long synthetic peptide, corresponding to one of the three repeated domains in the COOH-terminal half of strain G148 protein G, effectively blocked binding of protein G to IgG.

Gene, 1991 Jan 2, 97(1), 49 - 54
The subtilisin Carlsberg pro-region is a membrane anchorage for two fusion proteins produced in Bacillus subtilis; Egnell P et al.; The extracellular serylprotease subtilisin Carlsberg (SubC) of Bacillus licheniformis is produced in a precursor form which includes a signal peptide (sp) and a pro-region . We have constructed a fusion protein in which the sp, pro-region and 38 amino acids (aa) at the N terminus of SubC were joined to the immunoglobulin (Ig) G-binding protein G produced by group G streptococci . The fused SubC::protein G was purified on IgG-Sepharose . IgG-binding material derived from membrane or supernatant fractions had different N termini, indicating that release from the membrane occurred only after removal of the pro-region . The proteolytic pattern was identical when SubC::protein G was produced in Bacillus subtilis 168 wild type or in a protease-deficient strain . The sp cleavage point was also defined in the membrane-derived material.

Cardiology, 1991, 78(2), 156 - 60
Acute nonrheumatic perimyocarditis complicating streptococcal tonsillitis; Putterman C et al.; Streptococcal infection is a rarely recognized cause of nonrheumatic perimyocarditis . We report a case of a young patient who developed acute perimyocarditis as manifested by diffuse electrocardiogram changes, and markedly elevated cardiac enzymes, concurrently with streptococcal tonsillitis . Despite the dramatic presentation, the patient recovered uneventfully . We conclude that streptococci can involve the heart also directly by a bacterial component or toxin, and not only through a delayed immunologic mechanism as in rheumatic fever . Further studies are necessary to accurately determine the incidence of myocardial involvement during early stages of streptococcal infection.

Biol Neonate, 1991, 59(4), 244 - 52
Hemodynamic effects of conventional and high frequency oscillatory ventilation in normal and septic piglets; Osiovich HC et al.; The cardiovascular effects of high frequency oscillation (HFO) and conventional ventilation (CMV) were evaluated in 10 piglets prior to and during an infusion of group B streptococci (GBS) . Animals were randomized to begin ventilation with either HFO or CMV . Arterial blood gases, cardiac output (CO), and pulmonary artery (Ppa), pulmonary wedge (Ppw) and arterial blood pressures were measured . These values were recorded at a mean airway pressure (MAP) of 2 cm H2O for both modes of ventilation after which a continuous infusion of GBS (4 X 10(7) CFU/kg/min) was begun . MAP was increased in both ventilators in the following sequence: 4, 8 and 12 cm H2O . Prior to GBS infusion, HFO was associated with small but significant changes in hemodynamic parameters when compared to CMV for the following: Ppa (15 +/- 4 vs . 13 +/- 4.0 mm Hg; p less than 0.03), Ppw (3 +/- 1 vs . 2 +/- 1 mm Hg; p less than 0.02), and CO (0.24 +/- 0.08 vs . 0.25 +/- 0.09 l/min/kg; p less than 0.05) . Similar statistically significant increases in Ppa (p less than 0.005) and Ppw (p less than 0.0001), and decrease in CO (p less than 0.007) were present during GBS infusion when animals were ventilated with HFO, irrespective of the MAP used . Our results suggest that the use of HFO in both normal piglets and those receiving an infusion of GBS results in mild but consistent impairment in cardiovascular function compared to CMV . In summary, these data demonstrate that HFO has no beneficial effect compared to CMV at similar MAP in the management of the septic piglet model and may in fact further compromise the animal's hemodynamic status.

Kansenshogaku Zasshi, 1991 Jan, 65(1), 124 - 8
{A case of Kawasaki's disease combined with septicemia--isolation of Streptococcus sanguis (MCLS-1) and Streptococcus pyogenes from blood at the acute stage}; Tsurumizu T et al.; The patient was diagnosed as having Kawasaki's disease . Streptococci were isolated from cultures of all blood samples collected during the acute stage (the third, fifth and seventh day of the disease) . The streptococci were subsequently identified as Streptococcus sanguis (MCLS-1) and Streptococcus pyogenes . This finding may suggest induction of Kawasaki's disease by S . sanguis MCLS-1, and in this case, the complication of septicemia by S . pyogenes.

Arch Oral Biol, 1991, 36(4), 251 - 5
Mutacin activity of strains isolated from children with varying levels of mutants streptococci and caries; Alaluusua S et al.; A total of 157 isolates of mutants streptococci from plaque and saliva of 94 children were studied for their serotypes, mutacin production, frequency and spectrum of activity . Of these isolates 71% were identified as serotype c and 22% as serotype e . Serotypes f, d and g, and one untypable strain made up about 7% of the isolates . More than one serotype was found in 13% of the children . Mutacin was produced by 83% of the isolates against one or more of the 14 indicator strains representing mutants streptococci . Streptococcus sanguis, Strep . oralis, Strep . gordonii, Strep . salivarius and Strep . pyogenes . Isolates that had a broad inhibitory spectrum also produced larger inhibition zones than isolates that inhibited fewer strains . When evaluating the effect of mutacin in vivo on plaque ecology, it was found that the counts of mutans streptococci or the proportion of mutans streptococci in the total streptococcal count of plaque did not differ between plaques containing strains that produced much mutacin and those with little production . The findings also failed to reveal an association between caries experience and mutacin activity.

Caries Res, 1991, 25(2), 153 - 7
Long-term xylitol consumption and mutans streptococci in plaque and saliva; Soderling E et al.; The effect of 4 to 6 years of habitual use of xylitol gum (greater than or equal to 2 times per day) on the viable counts of mutans streptococci in both plaque and saliva was evaluated in a cross-sectional study of participants of the Ylivieska xylitol study (Finland, 1982-1984) . Paraffin-stimulated saliva was collected first, whereafter the remaining plaque was collected from all available tooth surfaces and pooled . The habitual xylitol consumers (n = 15) had less plaque than the controls (n = 21) . The total viable counts of mutans streptococci in the plaque collected from the habitual xylitol users were about 10% of those determined in controls (p less than 0.01) . The salivary mutans streptococci levels were relatively high in both habitual xylitol consumers and controls, as determined using a plate count and with an adhesion-based assay; no significant differences were detected between these groups . Thus, habitual xylitol consumption appeared not to be associated with a reduction in the total numbers of mutans streptococci in saliva . The plaque and the mutans streptococci were, however, more loosely bound to the tooth surfaces of the habitual xylitol users . The results of the plate count and the adhesion-based assay for salivary mutans streptococci were in good agreement for both habitual xylitol consumers and the controls . This suggests that it was the accumulation of plaque rather than the adhesiveness of mutans streptococci that was affected by the habitual consumption of xylitol.

Caries Res, 1991, 25(2), 146 - 52
Dental location of Streptococcus mutans and Streptococcus sobrinus in humans harboring both species; Lindquist B et al.; The distribution and prevalence of Streptococcus mutans and Streptococcus sobrinus were determined in plaque samples from the cervical areas of all buccal, lingual and approximal tooth surfaces and from the fissures of all occlusal sites in 40 subjects harboring both species . S . mutans was detected more often and in higher numbers than S . sobrinus . There were more teeth detected with S . mutans only than with S . sobrinus only . Most teeth harbored both of these mutans streptococci species, indicating a positive association . The highest numbers of CFU for both species were detected on the molars, with the lowest incidence on the anterior teeth . The presence of S . mutans was relatively similar on all teeth tested, while the presence of S . sobrinus was relatively higher on the molars compared to the anterior teeth . S . mutans and S . sobrinus were found to colonize the buccal surfaces in almost equal numbers . On all other surfaces, S . mutans was detected more frequently or in higher numbers compared to S . sobrinus . No significant differences could be found in the relative proportions of S . mutans and S . sobrinus between sound, decayed or filled tooth surfaces.

Perit Dial Int, 1991, 11(1), 48, 53 - 8
CAPD peritonitis and fluoroquinolones: a review; Janknegt R; Fluoroquinolones are potentially useful agents in the treatment of CAPD peritonitis, due to their wide spectrum of antimicrobial activity, favourable pharmacokinetics, oral availability and their relatively low toxicity . The microbiological, pharmacokinetic, and clinical aspects of these drugs in CAPD are reviewed . Ciprofloxacin showed superior in-vitro activity in comparison with various beta lactam agents; gentamicin and vancomycin against staphylococci and particularly against Gram-negative bacteria . Its activity against streptococci is low . The in vitro activity of fluoroquinolones is reduced in peritoneal dialysis fluid . A limited rise in serum levels is observed with daily administration of fluoroquinolones in CAPD patients during 5-15 days . Effective dialysate levels are reached in most patients after oral dosing, but these levels are highly variable and low levels are often observed during the first day, and with short dwell times . Concurrent administration with phosphate binding antacids should be avoided . Initial clinical experience shows that ciprofloxacin and ofloxacin may be effective agents to treat CAPD peritonitis via the oral route . They are usually well tolerated, although convulsions have been observed . The relative efficacy in comparison with "standard therapies" will have to be shown in comparative studies.

Pharmacotherapy, 1991, 11(1), 38 - 49
Respiratory tract penetration of quinolone antimicrobials: a case in study; Ritrovato CA et al.; Antimicrobial lung penetration is thought to be predictive of efficacy in the treatment of lower respiratory tract infections . Lung penetration studies are commonly conducted with new antimicrobial agents to elucidate their potential utility in treating such infections . Although some very useful information may emerge, these studies are complicated by technical difficulties, theoretical assumptions, and numerous intricacies . Many studies describing quinolone penetration into saliva, sputum, bronchial secretions, and lung tissue have been published . In general, quinolone concentrations in lung tissue are 1.5-4 times the serum levels, whereas those in sputum and bronchial secretion are equal to or less than serum, and penetration into saliva is even less . The failure rate predicted from saliva, sputum, and bronchial secretion penetration and marginal in vitro activity of quinolones against streptococci does not consistently correlate with clinical efficacy data . In light of such conflicting data and the high lung tissue penetration of quinolones, the relevance of saliva, sputum, and bronchial secretion studies should be reevaluated . The utility of investigational quinolones in the treatment of lower respiratory tract infections can be determined only by well-designed clinical trials.

Rev Infect Dis, 1991 Jan-Feb, 13 Suppl 2, S160 - 3
Antibiotic management of outpatients with endocarditis due to penicillin-susceptible streptococci; Stamboulian D et al.; Thirty patients with endocarditis caused by penicillin-susceptible streptococci were enrolled in one of two groups in this study . Fifteen patients received ceftriaxone (2 g once daily) for 4 weeks; the other 15 received the same dosage of ceftriaxone for 2 weeks and then received oral amoxicillin (1 g four times a day) for 2 weeks . For the 27 patients treated predominantly as outpatients, 380 days of hospitalization were avoided . Clinical cure was achieved for all patients in both groups . We conclude that ceftriaxone, alone or followed by a course of amoxicillin, is an efficacious mode of treatment for infective endocarditis caused by penicillin-susceptible streptococci . Treatment with these agents can be administered predominantly on an outpatient basis.

Chemotherapy, 1991, 37(1), 70 - 6
Therapy of serious skin and soft tissue infections with ofloxacin administered by intravenous and oral route; Lentino JR et al.; We evaluated the safety and efficacy of ofloxacin administered both by the intravenous route and orally in 26 men with serious skin and soft tissue infection . Twenty-one patients completed antimicrobial therapy and were fully evaluable . Of these, 18 were judged to be cured, while 3 failed therapy either during or within 2 weeks after completion of therapy . Overall, Staphylococcus aureus was the most commonly isolated pathogen and was found to be susceptible to ofloxacin in 12 of 14 patients . Two patients, 1 with a tolerant isolate of S . aureus, the other patient with a resistant isolate of S . aureus, responded clinically to ofloxacin therapy; a third patient with an initially ofloxacin-sensitive isolate failed therapy, and on subsequent culture an ofloxacin-resistant S . aureus was isolated . Ofloxacin was well tolerated and efficacious in the treatment of skin and soft tissue infections including those caused by staphylococci and streptococci.

Ann Clin Lab Sci, 1991 Jan-Feb, 21(1), 56 - 61
Streptococcus milleri group (Streptococcus anginosus): recovery from intra-abdominal and soft tissue sites; Edmiston CE Jr et al.; One hundred thirty-three Streptococcus milleri group (S . anginosus) isolates were recovered from 487 surgical patients . The streptococci were recovered from 33 percent of intra-abdominal infection cultures (84/257) . 22 percent of samples from penetrating visceral trauma (19/86), 52 percent of perirectal abscess specimens (13/25), 13 percent of nonpuerperal breast abscess cultures (8/60), and 15 percent of diabetic foot lesions (9/59) . Ninety-eight percent of the S . milleri (131/133) were recovered as companion flora in polymicrobial cultures . The organisms were highly susceptible to the beta-lactam antibiotics . The precise pathogenic role of the S . milleri group (S . anginosus) is unknown . However, intrinsic virulence may be expressed in patients with severe infection or other predisposing factors.

J R Soc Med, 1991 Jan, 84(1), 49 - 50
Fournier's gangrene of the scrotum following day case vasectomy; Patel A et al.; PIP: A case of Fournier's gangrene of the scrotum is reported in a 31-year old man who had outpatient vasectomy during an intercurrent diarrheal illness . The surgery was done through a midline incision, under local anesthesia of plain 2% lignocaine, with a preoperative chlorhexidine scrub . Although his scrotum was red and swollen within 3 hours, he did not have medical care until admission to hospital 48 hours later . At admission he had Fournier's gangrene of the scrotum and penis, Gram-negative septic shock, and acute renal failure . In the intensive care unit he was treated with continuous dialysis, parenteral metronidazole, benzylpenicillin, Ceftazidime and inotropes . He had a cardiorespiratory arrest after emergency radical debridement . After resuscitation he developed adult respiratory distress syndrome and disseminated intravascular coagulation . Pathological exam showed necrosis of the dermis and subcutaneous layers, thrombosis and beta-hemolytic streptococci . After adding gentamicin and vancomycin, 2 weeks of ventilator care, 4 more surgical debridements, a left orchidectomy, and a despite a grossly abnormal EEG recording, the man regained consciousness and recovered . His scrotal and penile skin re-epithelialized over 3 months . Patients requesting vasectomy should be assessed for local and systemic illness before performing the procedure .

J Med Microbiol, 1991 Jan, 34(1), 33 - 7
Antibiotic-resistant oral streptococci in dental patients susceptible to infective endocarditis; Longman LP et al.; The aim of this study was to determine the incidence of amoxycillin and erythromycin resistance in oral streptococci in patients at risk from infective endocarditis . Samples of gingival crevicular flora were taken from 65 patients at the site of dental treatment, prior to the prophylactic administration of amoxycillin (54 patients) or erythromycin (11 patients) . Samples were also taken from 65 dental patients who were not considered to be at risk from infective endocarditis . No isolate had a minimum inhibitory concentration (MIC) of amoxycillin greater than 24 mg/L . However, erythromycin-resistant oral streptococci with MIC values greater than 3.5 mg/L were isolated from 22% of patients receiving amoxycillin prophylaxis, 9% of patients receiving amoxycillin prophylaxis, 9% of patients given erythromycin prophylaxis and 9% of patients not at risk from infective endocarditis . The antibiotic-resistant streptococci comprised mainly Streptococcus sanguis biotype II, although S . sanguis biotype I, S . mitis and S . salivarius were also frequently recovered.

J Bacteriol, 1991 Jan, 173(2), 487 - 94
Molecular analysis of lipoteichoic acid from Streptococcus agalactiae; Maurer JJ et al.; A method for the analysis of lipoteichoic acid (LTA) by polyacrylamide gel electrophoresis (PAGE) is described . Purified LTA from Streptococcus agalactiae tended to smear in the upper two-thirds of a 30 to 40% linear polyacrylamide gel, while the chemically deacylated form (cdLTA) migrated as a ladder of discrete bands, reminiscent of lipopolysaccharides . The deacylated polymer appeared to separate in this system on the basis of size, as evident from results obtained from PAGE analysis of cdLTA subjected to limited acid hydrolysis and LTA that had been fractionated by gel filtration . A survey of cdLTA from other streptococci revealed similarities in molecular weight ranges . The polymer from Enterococcus hirae was of a higher molecular weight . This procedure was used to examine the effect of penicillin and chloramphenicol on the synthesis, turnover, and heterogeneity of LTA in S . agalactiae . Penicillin appeared to enhance LTA synthesis while causing the release of this polymer into the supernatant fluid . In contrast, chloramphenicol inhibited the synthesis of this molecule and resulted in its depletion from the cell surface . Penicillin did not alter the heterogeneity of this polymer, but chloramphenicol caused an apparent shift to a lower-molecular-weight from of the LTA, as determined by PAGE . This shift in the heterogeneity of LTA did not appear to be due to increased carbohydrate substitution, since chloramphenicol did not alter the electrophoretic migration profile of LTA from E . hirae . From a pulse-chase study, it was determined that LTA was released as a consequence of deacylation.

Infect Immun, 1991 Jan, 59(1), 211 - 5
Frequency of the erythrogenic toxin B and C genes (speB and speC) among clinical isolates of group A streptococci; Yu CE et al.; DNA probes corresponding to the internal region of the erythrogenic toxin B and C genes, speB and speC, were used in hybridization studies with clinical isolates of Streptococcus pyogenes to determine the frequency of occurrence of these genes in a large population of group A streptococci . More than 500 strains from different geographical locations throughout the world were used in this study . The results from colony-lift hybridization experiments indicated that the frequency of occurrence of each toxin gene among all of these strains was 100% for speB and 50% for speC . Division of these strains into subgroups of general group A strains and strains associated with scarlet fever or rheumatic fever resulted in a frequency of occurrence of speC of about 50% for all subgroups . The speC gene was found to be more frequently associated with serotype M2, M4, and M6 strains and less frequently associated with serotype M1, M3, and M49 strains . The results from a similar study with the speA gene have been previously reported (C.-E . Yu and J.J . Ferretti, Infect . Immun . 57:3715-3719, 1989).

Arkh Patol, 1991, 53(8), 44 - 8
{The dynamic morphological changes in the joints of rats with experimental infection caused by Streptococcus group B}; Vartazarian ND et al.; A single intraperitoneal administration of the group B streptococci results, within one year, in the development of degenerative changes of the joint cartilage with its destruction and moderate inflammation of the synovial membranes . Local immune responses supported by persistent streptococci in the synovial and joint connective tissue are followed by strengthening of the interaction between the cells the manifestation of which are the intercellular cytoplasmatic "bridges" in the synovial membrane and cell pairs of lymphocytes with connective tissue cells of the joint capsule . The changes described resemble those observed in chronic infectious arthritis.

J Clin Lab Anal, 1991, 5(5), 367 - 71
Detection of group A streptococci by aerobic culture and a new simplified immunoassay in three pediatric practices and a hospital laboratory; Kellogg JA et al.; Duplicate throat swabs for detection of group A streptococci were collected in three pediatric offices from 1,035 patients with symptoms of pharyngitis . In the collecting office and in the hospital laboratory, one swab from each patient was first inoculated to sheep blood agar (incubated at 35 degrees C aerobically for 2 days) and then tested for group A streptococcal antigen by using the SMART enzyme immunoassay technique (New Horizons Diagnostics Corp) incubated for up to 24 hours . Group A streptococci were recovered in culture (from one or both swabs) and serologically identified from 444 (42.9%) of the patients . Pediatric offices numbers 1, 2, and 3 detected 84.4%, 84.6%, and 82.2%, respectively, of their patients who had positive cultures (in the office and/or laboratory) by using their own culture system and 82.6%, 71.1%, and 84.9%, respectively, of these same patients by using the SMART technique . In the laboratory, SMART test sensitivity and specificity were 71.4% and 98.7%, respectively, after 5 minutes of test incubation . However, SMART test sensitivity improved to 86.5% after overnight incubation of the immunoassay and to 91.3% if the data from one defective lot of seven SMART production lots studied were excluded . SMART test results which are negative after 5 minutes of incubation should therefore be confirmed both by reincubation of the antigen test up to 24 hours and by culture.

Padiatr Grenzgeb, 1991, 30(4), 305 - 9
{Microbiological studies on nursery children susceptible to infections}; Passauer I et al.; In a microbiological paper from 1986 to 1988 dealing with 76 children aged from 13 to 36 months in 8 creches of a large town, it could be found that 24 of these children were susceptible to infections and it is established that there were 3-9 bacteria per child . The most important bacteria were: Staphylococcus aureus, Streptococcus pneumoniae, haemolytic streptococci . But bacteria of the catarrhal group played a certain role, too . In 8 of these children dispositional factors and factors caused by exterior conditions of life (risk factors) could be shown, in 50% out of them a prolonged convalescence and in 50% after 4 weeks a reinfection after acute respiratory disease (ARD) . The course of phases of ARD (initial phase, 2 . and 4 . week of convalescence) is introduced from microbiological view at all children . We point out the meaning of microbiological diagnostics with subsequent aiming sanitation by children susceptible to infections with risk factors.

Neuroepidemiology, 1991, 10(3), 122 - 31
Incidence and prognosis of brain abscess in a defined population: Olmsted County, Minnesota, 1935-1981; Nicolosi A et al.; The incidence of brain abscess was studied on all cases occurring in residents of Olmsted County, Minn., from 1935 through 1981 . Thirty-eight cases (9 cases first diagnosed at autopsy) were identified and followed through the Rochester Olmsted County medical record-linkage system at the Mayo Clinic . The incidence rate was 1.3/100,000 person-years (PY), 1.9 in males and 0.6 in females . Incidence decreased from 2.7 in 1935-44 to 0.9 in 1965-81 . Rates were higher in children 5-9 years old (2.4) and after age 60 (2.6 PY) . An etiologic agent was identified in 29 cases (76%) with streptococci being the most frequently isolated . Case-fatality ratio was 38% (11/29), stable over time . Concurrent bacterial meningitis was the strongest predictor of death . Neurologic sequelae were observed in 8 (44%) of the 18 surviving patients including epilepsy (5 cases), deafness and motor impairment.

Hosp Pract (Off Ed), 1991, 26 Suppl 4, 6 - 10; discussion 46-8
Use of third-generation cephalosporins . Streptococci; Durack D; The third-generation cephalosporins are highly active against nonenterococcal streptococci . The subgroup of ceftizoxime, ceftriaxone, and cefotaxime are similar to penicillin in their activities by weight; and the drug with the longest half-life, ceftriaxone, offers the potential for home therapy for selected patients with endocarditis.

Caries Res, 1991, 25(4), 292 - 5
Influence of contact time and concentration of chlorhexidine varnish on mutans streptococci in interproximal dental plaque; Schaeken MJ et al.; This study describes the effects of varnishes containing 0, 25, 33 and 40% chlorhexidine diacetate on mutans streptococci in human approximal dental plaque . The chlorhexidine release from the varnishes was determined in vitro . Eleven subjects participated in the clinical experiment, each with at least five approximal areas harboring high levels of mutans streptococci . The approximal areas in each of the individuals were randomly assigned to five experimental groups, in each of which one of the varnishes was tested; 40% chlorhexidine varnish was tested in two experimental groups . The varnish treatment consisted of a single application of a small amount of varnish onto the selected approximal areas . From one of the sites receiving the 40% chlorhexidine varnish, all visible varnish was removed 15 min after application . The volunteers were asked to leave the varnish on the remaining treated sites and not to brush their teeth for 8 h . All chlorhexidine varnishes strongly suppressed mutans streptococci until 4 months after the varnish application . The extent of the suppression depended upon the concentration of chlorhexidine in the varnish, 40% chlorhexidine varnish giving the greatest suppression of mutans streptococci . No significant difference was found between the numbers of mutans streptococci from sites where the 40% varnish was removed after 15 min and sites where the 40% chlorhexidine varnish was left . The results suggested that 40% chlorhexidine varnish can be used successfully for the long-term suppression of mutans streptococci . A contact time of the varnish with the tooth surface of only 15 min is sufficient to achieve this long-term suppression.

Caries Res, 1991, 25(4), 277 - 82
Trehalulose does not induce dental caries in rats infected with mutans streptococci; Ooshima T et al.; The effects of trehalulose, a structural isomer of sucrose, and a syrup (TP syrup) rich in trehalulose and palatinose on caries development were examined in specific pathogen-free Sprague-Dawley rats . Streptococcus mutans MT8148R and Streptococcus sobrinus 6715 fermented the syrup which resulted in acid production, while both strains were found not to utilize trehalulose . Furthermore, trehalulose did not serve as a substrate for glucosyltransferases of these mutans streptococci to synthesize water-insoluble glucan, and it inhibited the sucrose-dependent adherence of mutans streptococci to a glass surface . Although trehalulose induced no significant dental caries in specific pathogen-free rats infected with either MT8148R or 6715, TP syrup was found to induce significant but low dental caries . Furthermore, replacement of the dietary sucrose content with trehalulose resulted in a significant reduction of caries development in rats infected with strain 6715.

Acta Otolaryngol, 1991, 111(3), 562 - 8
In vivo attachment of beta-haemolytic streptococci to tonsillar epithelial cells in health and disease; Stenfors LE et al.; In vivo attachment of beta-haemolytic streptococci Group A (GABHS) to the epithelial cells of the palatine tonsils was determined in 10 patients with current acute tonsillitis (AT-group) and in 10 healthy carriers of GABHS (C-group) according to a method described . Standard bacterial culture revealed growth of GABHS in both groups . In the AT-group, massive attachment of streptococcal chains to the tonsillar epithelium was noted . These chains proved positive for FITC-labelled antibodies against beta-haemolytic streptococci, and were only occasionally found in the C-group . The overall bacterial attachment was significantly greater in the AT-group than in the C-group (p less than 0.001) . Phenoxymethylpenicillin treatment caused a dramatic decrease in the number of the attached GABHS bacteria within 24 h . Two weeks after completion of the penicillin treatment one individual in each group was still culture-positive for GABHS.

Scand J Infect Dis, 1991, 23(3), 309 - 13
In vivo attachment of group A streptococci to tonsillar epithelium during acute tonsillitis; Stenfors LE et al.; The attachment of group A beta-hemolytic streptococci (GABHS) to the tonsillar epithelium during current acute tonsillitis (AT) was studied by means of fluorescence microscopy and electron microscopy in 5 patients . Conventional cultures from the tonsils showed massive growth of GABHS and tonsillar epithelial cells were heavily infested with GABHS, which proved positive for FITC-labelled antibodies against beta-hemolytic streptococci . The bacteria were firmly attached to the epithelial cell membranes by cell projections, which grasped the microorganisms from various directions . A 24 h course of oral treatment with phenoxymethylpenicillin radically affected bacterial adherence to the epithelial cells.

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