Thromb Res, 1990 May 1, 58(3), 283 - 91 Inhibition of platelet aggregation by a whole cell extract from strains of group B streptococcus; Usui Y et al.; A whole cell extract (HCl-Ext) from strains of group B streptococci (GBS) possessing fibrinogen binding activity prevented the platelet aggregation induced with adenosine 5'-diphosphate (ADP), collagen and thrombin, while aggregation by epinephrine and ristocetin was slightly inhibited and arachidonic acid-induced platelet aggregation was not affected whatsoever . When the HCl-Ext was added after commencement of the aggregation, deaggregation was observed in cases induced by ADP, collagen, and thrombin . By precoating the washed platelets with HCl-Ext, both of ADP- and collagen-induced platelet aggregation were suppressed . The active factor in the HCl-Ext seemed to be undialyzable, trypsin-susceptible, and proteinaceous substance, unlike GBS polysaccharide type antigen. DNA Cell Biol, 1990 May, 9(4), 287 - 92 Rapid colorimetric detection of in vitro amplified DNA sequences; Lundeberg J et al.; A colorimetric assay to detect immobilized amplified nucleic acids has been designed . This approach provides a rapid assay, suitable for clinical diagnosis, to analyze DNA sequences amplified by the polymerase chain reaction . The specific DNA sequences are captured on a solid support by the use of a recombinant fusion protein consisting of the Escherichia coli lac repressor and staphylococcal protein A . The biotin streptavidin system is used to detect the immobilized material . Positive samples can be analyzed by direct solid-phase sequencing . Here, we show that this nonradioactive concept can be used for analysis of Staphylococci and Streptococci and for specific detection of the protozoa Plasmodium falciparum in clinical samples. Am Rev Respir Dis, 1990 May, 141(5 Pt 1), 1209 - 13 Regional pulmonary blood flow in piglets during group B streptococcal bacteremia; Redding GJ et al.; Shunt fraction (QS/QT) and perfusion to hypoxic lung regions increase when pulmonary vascular driving pressure (PVDP) is raised by increasing pulmonary blood flow or enlarging the size of the hypoxic region . We hypothesized that perfusion to collapsed areas would similarly increase when PVDP was increased by a circulating pulmonary vasoconstrictor . Group B streptococci (GBS) were infused into 10 young piglets with left lung atelectasis to produce pulmonary vasoconstriction and determine if perfusion to collapsed regions (QL/QT) and intrapulmonary QS/QT increased as pulmonary vascular resistance (PVR) increased . Left lung collapse alone increased PVR from 11 +/- 3 to 18 +/- 10 mm Hg/L/min and QS/QT from 1.9 +/- 1.4% to 8.3 +/- 6.4%; QL/QT decreased from 44 +/- 1% to 10 +/- 7% of total pulmonary blood flow (p less than 0.02) . Intravenous GBS increased PVDP from 11 +/- 3 to 27 +/- 4 mm Hg and further increased PVR from 18 +/- 10 to 33 +/- 12 mm Hg/L/min (p less than 0.02) but did not change cardiac output, QS/QT, or QL/QT . Changes in QL/QT and QS/QT are not predicted by changes in PVDP alone but also depend upon the site and nature of pulmonary vasoconstriction in infants with regional lung disease. Am J Dis Child, 1990 May, 144(5), 587 - 9 Penicillin tolerance and erythromycin resistance of group A beta-hemolytic streptococci in Hawaii and the Philippines; Wittler RR et al.; Penicillin remains the drug of choice for the treatment of streptococcal pharyngitis, with erythromycin as an alternative drug for individuals who cannot take penicillin . Two areas of concern in the management of streptococcal pharyngitis are (1) the prevalence of penicillin-tolerant group A beta-hemolytic streptococci reported in recent studies and (2) the high prevalence of erythromycin resistance in some geographic areas . We tested 305 isolates of group A beta-hemolytic streptococci from Hawaii and the Philippines for penicillin minimum inhibitory concentrations and minimum bactericidal concentrations and erythromycin minimum inhibitory concentrations . There was no evidence of penicillin resistance or tolerance . The prevalence of erythromycin-resistant and moderately susceptible isolates was 3.6% and 2.3%, respectively . There was a trend toward greater erythromycin resistance levels among Hawaiian isolates, but this was not statistically significant. Infect Immun, 1990 May, 58(5), 1186 - 94 Molecular aspects of immunoglobulin A1 degradation by oral streptococci; Reinholdt J et al.; Using a panel of 143 strains classified according to a novel taxonomic system for oral viridans-type streptococci, we reexamined the ability of oral streptococci to attack human immunoglobulin A1 (IgA1) molecules with IgA1 protease or glycosidases . IgA1 protease production was an exclusive property of all strains belonging to Streptococcus sanguis and Streptococcus oralis (previously S . mitior) and of some strains of Streptococcus mitis biovar 1 . These are all dominant initiators of dental plaque formation . Degradation of the carbohydrate moiety of IgA1 molecules accompanied IgA1 protease activity in S . oralis and protease-producing strains of S . mitis biovar 1 . Neuraminidase and beta-galactosidase were identified as extracellular enzymes in organisms of these taxa . By examination with enzyme-neutralizing antisera, four distinct IgA1 proteases were detected in S . sanguis biovars 1 to 3, S . sanguis biovar 4, S . oralis, and strains of S . mitis, respectively . The cleavage of IgA1 molecules by streptococcal IgA proteases was found to be influenced by their state of glycosylation . Treatment of IgA1 with bacterial (including streptococcal) neuraminidase increased susceptibility to protease, suggesting a cooperative activity of streptococcal IgA1 protease and neuraminidase . In contrast, a decrease in susceptibility was observed after extensive deglycosylation of the hinge region with endo-alpha-N acetylgalactosaminidase . The effector functions of IgA antibodies depend on the carbohydrate-containing Fc portion . Hence, the observation that oral streptococci may cleave not only the alpha 1 chains but also the carbohydrate moiety of IgA1 molecules suggests that the ability to evade secretory immune mechanisms may contribute to the successful establishment of these bacteria in the oral cavity. J Emerg Med, 1990 May-Jun, 8(3), 291 - 4 Streptococcus viridans osteomyelitis with endocarditis presenting as acute onset lower back pain; Buchman AL; An elderly male with a history of diabetes mellitus and a recent dental procedure presented to the emergency department with acute lumbosacral pain and low grade fever . Computerized tomography (CT scan) and magnetic resonance imaging (MRI) yielded a presumptive diagnosis of pyogenic vertebral osteomyelitis . A diagnosis of viridans Streptococcus vertebral osteomyelitis was confirmed by gallium scanning and blood culture . The literature has emphasized the occurrence of pyogenic vertebral osteomyelitis as a chronic process . A review suggests that viridans Streptococci, although an uncommon cause of this disorder, is usually associated with back pain of more acute onset . It is therefore recommended that pyogenic vertebral osteomyelitis be considered in any patient presenting to the emergency department with the acute onset of lower back pain, fever, leukocytosis and an elevated erythrocyte sedimentation rate. J Periodontal Res, 1990 May, 25(3), 172 - 8 Selective modulation of bacterial attachment to oral epithelial cells by enzyme activities associated with poor oral hygiene; Childs WC 3rd et al.; The present investigation explored the hypothesis that elevated levels of certain enzymes in the gingival crevicular environment of individuals with poor oral hygiene and/or gingival inflammation may modify the surfaces of epithelial cells and thereby modulate the types of bacteria which attach and colonize . Buccal epithelial cells treated with neuraminidase and certain proteases were used as a model for study . Bacteria studied included Streptococcus sanguis and Streptococcus mitis which have been associated with gingival health, Actinomyces species which are increased in plaque associated with developing gingivitis, and Bacteroides gingivalis, Bacteroides intermedius, and Actinobacillus actinomycetemcomitans which are associated with destructive periodontal diseases . Treatment of epithelial cells with the enzymes studied produced selective effects on their receptivity for bacteria . Neuraminidase treatment of epithelial cells greatly reduced the attachment of all strains of S . sanguis and S . mitis studied . In contrast, the number of Actinomyces viscosus, A . naeslundii and A . israelii cells which attached was significantly increased . Neuraminidase treatment also appeared to enhance attachment of B . intermedius and B . gingivalis . Treatment of buccal cells with trypsin, chymotrypsin or papain also selectively affected bacterial attachment . Such protease treatment greatly reduced the numbers of streptococci and A . viscosus cells which attached, while the numbers of B . gingivalis and B . intermedius were significantly increased . Treatment of epithelial cells with preparations of lysosomal enzymes derived from human PMNs produced similar selective effects . The changes in bacterial adhesion observed by the enzyme treatments studied are consistent with the shifts in the composition of the gingival crevice flora which occur when oral hygiene is terminated and gingivitis develops. J Am Acad Dermatol, 1990 May, 22(5 Pt 1), 873 - 9 The clinical development of mupirocin; Pappa KA; Mupirocin is a novel antibiotic totally unrelated in chemical structure and mode of action to any other clinically useful class of antibiotics . It has greatest antibacterial activity against aerobic gram-positive cocci, namely, Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus pyogenes, and other beta-hemolytic streptococci . Bactroban ointment is formulated as 2% mupirocin in polyethylene glycol ointment . No systemic absorption of mupirocin or its major metabolite, monic acid, has been detected in short courses of topical administration to healthy volunteers or to patients with epidermolysis bullosa after prolonged courses of therapy with Bactroban ointment . Randomized, multicenter, double-blind, vehicle-controlled clinical trials have shown that mupirocin is safe and effective for the treatment of impetigo. J Bacteriol, 1990 May, 172(5), 2527 - 34 Purification and characterization of a Bacteroides loeschei adhesin that interacts with procaryotic and eucaryotic cells; London J et al.; The adhesin of Bacteroides loeschei PK1295 that mediates coaggregation with Streptococcus sanguis 34 and hemagglutination of erythrocytes was purified to electrophoretic homogeneity . The lectinlike protein has an estimated native Mr of 450,000 and consists of six subunits of identical molecular weight (Mr 75,000) . The purified adhesin appears to be a basic protein with a pI between 7.4 and 8.0 . Amino acid and N-terminal sequence analyses were carried out with the purified protein . These indicated that the protein contains a large number of Asx and Glx residues as well as basic amino acid residues . The binding site of the pure adhesin retained its native configuration during purification . When preincubated with streptococcal partner cells at pH 4.6, the adhesin prevented B . loeschei cells from coaggregating with the streptococci . An adhesin preparation adjusted to a pH of 6.8 rapidly agglutinated both streptococci and neuraminidase-treated erythrocytes . Galactosides inhibited the agglutination reactions. Eur J Clin Microbiol Infect Dis, 1990 Apr, 9(4), 251 - 6 Septicemia and endocarditis caused by group G streptococci in a Norwegian hospital; Bucher A et al.; The clinical and bacteriological features of septicemia caused by group G streptococci were analyzed in nine patients seen during a period of 28 months . Four of these patients had acute endocarditis with a high rate of serious neurological complications . The clinical response to antibiotic treatment was slow in the endocarditis patients despite sensitivity of the organism in vitro . Group G streptococcal septicemia can be a very serious condition associated with endocarditis of a destructive nature . Comparison with previous reports suggests that group G streptococcal infections are of increasing importance . The virulence of group G streptococci may be changing, resulting in more serious infections and complications . This series stresses the importance of prompt recognition of this infection and the need for aggressive management of these patients. Tierarztl Prax, 1990 Apr, 18(2), 145 - 9 {Enzootic streptococcal infection in a piglet production plant}; Kofer J et al.; Within a herd a syndrome affecting mainly sows occurred, with signs of apathy, anorexia or inappetence, subclinical to slight increase of body temperature and--as the prime symptom--skin hemorrhages appeared 2 to 3 days before parturition, during the lactation peak and in hot weather . By means of autopsy, histological investigations of affected skin areas, antibody and antigen evidence of Streptococcus (Sc.) MG and Sc . sanguis in blood cultures, streptococci could be found to be partly responsible for the disease mentioned above . Nearly all sows with clinical symptoms showed a significant neutrophilia and eosinophilia . Severely affected animals exhibited marked thrombocytopenia which could be due to the high levels of deoxynivalenol in the feed . A herd-specific vaccine of streptococci only temporarily succeeded. Arch Intern Med, 1990 Apr, 150(4), 825 - 9 Clinical and microbiological evidence for endemic pharyngitis among adults due to group C streptococci; Meier FA et al.; Group C beta-hemolytic streptococci cause rare epidemic outbreaks of pharyngitis, but their role in sporadic endemic pharyngitis has been uncertain . We addressed the question of whether non-group A beta-hemolytic streptococci are associated with endemic pharyngitis in two ways . First, we compared rates of isolation from throat swabs of group A, B, C, and G and ungrouped beta-hemolytic streptococci ("culture negative") in adult patients vs those rates in controls . Second, we collected in standardized form clinical indexes of patients with pharyngitis: signs and symptoms graded for severity, the examining physician's subjective estimate of the probability of streptococcal pharyngitis, a logistic regression score predicting streptococcal pharyngitis, and whether antibiotic therapy was prescribed . After collecting data and cultures on 1425 patients with sore throats and cultures on 284 controls, we found the following: group C streptococci were isolated significantly more frequently in patients with sore throats than in controls (6% vs 1.4%); four clinical signs and two symptoms distinguished group C-associated pharyngitis as more severe than culture-negative pharyngitis; and six clinical signs and one symptom distinguished group C-associated pharyngitis as less severe than group A pharyngitis . Physicians' subjective estimates, logistic regression scores, and antibiotic treatment all characterized group C-associated pharyngitis as more severe than culture-negative sore throats but less severe than group A pharyngitis . From these data we present the first definitive evidence that group C streptococci are associated with endemic pharyngitis, show that clinical presentation distinguishes a group of patients with group C-associated pharyngitis from populations with culture-negative sore throats and from those with group A pharyngitis . Physicians' response to that presentation merits consideration in the context of rapid group-specific diagnosis of streptococcal pharyngitis by group A antigen tests. Oral Surg Oral Med Oral Pathol, 1990 Apr, 69(4), 444 - 9 Chlorhexidine inactivation by saliva; Spijkervet FK et al.; Chlorhexidine mouth rinsing is commonly used for oral flora reduction . Indigenous microorganisms (viridans streptococci) are significantly suppressed, while "hospital-acquired" gram-negative bacilli are not affected in vivo . To explain the discrepancies between good in vitro and poor in vivo activity of chlorhexidine, minimum bactericidal concentration values for 120 isolates were studied by means of a standard dilution method in fresh whole saliva, broth, and glucose 5% . Both saliva and broth significantly reduced the bactericidal activity of chlorhexidine against all microorganisms tested as compared to glucose 5% (p less than 0.01) . Minimum bactericidal concentrations for indigenous flora were significantly lower than the values obtained for the "hospital-acquired" microorganisms (p less than 0.05) . These observations of chlorhexidine inactivation by saliva may explain why chlorhexidine mouth rinsing is of limited value in decontaminating the oral cavity. Ann Thorac Surg, 1990 Apr, 49(4), 619 - 24 Results of homograft aortic valve replacement for active endocarditis; Tuna IC et al.; Since July 1985, cryopreserved homograft prostheses have been used for aortic valve replacement in 10 patients, aged 2 to 77 years, with active endocarditis . Five patients had positive bacterial cultures from excised valves, and all had clinical findings of uncontrolled infection while receiving appropriate antibiotics . Homograft valves (four) or valved conduits (six) were implanted for treatment of sepsis (6 patients), congestive heart failure (3) or recurrent emboli (1 patient), and complicating native (5 patients) or prosthetic valve (5) endocarditis . Staphylococci (6 patients), streptococci (3), and Candida (1) were infecting organisms . Preoperatively, Doppler echocardiography showed aortic regurgitation in all patients . At operation, 9 patients had gross vegetations, 9 had single or multiple abscess cavities, and 5 had pericarditis . Complex reconstruction of the aortic valve and annulus with homograft conduits was necessary in 6 patients (3 with previous aortoventriculoplasty) . Two early deaths (ventricular failure, perioperative stroke) occurred . Mean follow-up of all operative survivors was 2.1 years (range, 0.6 to 3.6 years), and one late death resulted from arrhythmia . Homograft valve regurgitation increased in 1 patient, and 7 late survivors are asymptomatic . No patient has had recurrence of endocarditis . We conclude that cryopreserved homograft aortic valve/root replacement is an effective method for management of active endocarditis complicated by annular destruction. Antonie Van Leeuwenhoek, 1990 Apr, 57(3), 165 - 72 Utilization of mucin by oral Streptococcus species; van der Hoeven JS et al.; The ability of oral Streptococcus strains to utilize oligosaccharide chains in mucin as a source of carbohydrate was studied in batch cultures . Pig gastric mucin, as a substitute of human salivary mucin, was added to chemically defined medium containing no other carbohydrates . Strains of S . mitior attained the highest cell density, while mutans streptococci: S . mutans, S . sobrinus, S . rattus, grew very little in the medium with mucin . S . mitis, S . sanguis, and S . milleri in decreasing order, showed intermediate growth . Mucin breakdown as measured by sugar analyses indicated that oligosaccharide chains were only partially degraded . Every strain produced one or more exoglycosidases potentially involved in hydrolysis of oligosaccharide . The enzyme activities occurred mainly associated with the cells, and very little activity was found in the culture fluids . The relationships between glycosidase activities and growth, or mucin degradation were not always clear. Kitasato Arch Exp Med, 1990 Apr, 63(1), 7 - 10 {The haptoglobin-streptococcus relationship}; Nagai T; In many experiments beginning in 1977 Prof . O . Prokop and Prof . W . Kohler discovered that the human haptoglobins are able to agglutinate group G-streptococci, but the reaction depends on the haptoglobin type . Haptoglobins of the types Hp 2-2 and Hp 2-1 are complete agglutinins and haptoglobin of the Hp 1-1 type is incomplete ("blocking") antibody . Later it was found that streptococci with the T4--antigen (from Lancefield types A, C and G) are suitable for the test. Kansenshogaku Zasshi, 1990 Apr, 64(4), 467 - 73 {Isolation of group A streptococci from pharyngitis patients of all ages--studies from the clinical and epidemiological standpoint}; Nakamura S et al.; During the period from June 1981 through Dec . 1985, isolation of group A streptococci was attempted from throat swabs of pharyngitis patients of all ages, who visited a clinic in the central area of Yokohama-city . The data were analysed clinically and epidemiologically . The results were summarized as follows . 1) Group A streptococci were isolated from 85 (30.5%) out of 279 patients with pharyngitis . This is almost within the range of other reports . 2) During one year in the study period, no isolates of group A streptococci were obtained from throat swabs of 32 controls (healthy persons working in the clinic or patients without pharyngitis) . 3) The isolation rate correlated with the presence of pharyngeal purulent exudate and also with high maximum body temperature after onset of the illness . The isolation rate was significantly higher in patients with these two signs than those without them . Therefore, these two signs are useful to predict group A streptococcal pharyngitis prior to laboratory examinations . 4) The isolation rate was high in the age groups under 10 and from 30 to 39 . 5) The isolation rate was high in winter and low in summer . 6) The typing test revealed T types 13, 28 and 4 to be relatively frequent isolates. J Clin Periodontol, 1990 Apr, 17(4), 233 - 42 Improved metabolic control, clinical periodontal status and subgingival microbiology in insulin-dependent diabetes mellitus . A prospective study; Sastrowijoto SH et al.; The effect of improved metabolic control on the clinical periodontal condition and the subgingival microflora of diseased and healthy periodontal pockets in 6 ambulatory insulin-dependent diabetes mellitus (IDDM) patients was prospectively studied . Duplicate measurements with a time-interval of 3 days were made every 4 moths for assessment of the metabolic status, the clinical periodontal condition and the subgingival microflora . During the study, patients maintained personal oral hygiene measures as they usually did before the study . Neither supplementary dental prophylaxis nor oral hygiene measures were applied during the investigation . Long-term metabolic control (HbAlc) improved significantly with intensive conventional insulin treatment . Gingival redness decreased significantly whereas gingival swelling showed a not significant trend to decrease . It is suggested that microvascular changes associated with improved metabolic control in diabetes mellitus may mediate the observed change in gingival redness . No effect could be demonstrated for probing pocket depth, probing attachment level, bleeding on probing and the plaque index . Statistical analysis of the effect of improved metabolic control on the subgingival microflora revealed that only the % of streptococci increased significantly in diseased periodontal pockets . In general, no significant changes were found in either healthy or diseased pockets with regard to the bacterial flora associated with periodontal disease . The results of the present study indicate that improved metabolic control in IDDM patients may have no potential impetus for an improved clinical periodontal condition nor on the subgingival bacterial flora . It is concluded that the periodontal condition in IDDM patients may only ameliorate when local oral hygiene measures are applied. Scand J Dent Res, 1990 Apr, 98(2), 106 - 11 Sample, count, identify, and store the mutans streptococci; del Rio Gomez I et al.; According to a new method for sampling mutans streptococci, "Strip mutans", a plastic strip is contaminated by human saliva and incubated in a selective broth . After growth the strip with adherent colonies may be dried and stored . We wanted to know for how long a time bacteria in the colonies were viable if the strips were stored under different conditions . The survival time is important if the bacteria need to be subjected to further analyses . The results showed that the viability of the bacteria after the incubation period was at least 1 yr when the strips were stored frozen or frozen in glycerine . Stored dried in room temperature the survival was about 8 wk . A second part of the study aimed at identifying the colonies on strips obtained from different countries . Dried strips were sent air mail to our laboratory for biochemical and immunological analyses and the results showed that serotype/biotype c/e/f of S . mutans were most frequent but d/g S . sobrinus was also present in the samples, which came from Brazil, Greece, and Sweden . Three colonies of 213 on these strips did not grow, possibly indicating non-mutans bacteria. Pediatr Res, 1990 Apr, 27(4 Pt 1), 344 - 8 Organ-specific disposition of group B streptococci in piglets: evidence for a direct interaction with target cells in the pulmonary circulation; Bowdy BD et al.; Despite the serious pulmonary manifestations of early onset group B streptococcal (GBS) sepsis, it is not known whether the organism distributes into lung tissue and whether adverse pulmonary hemodynamic abnormalities relate to an interaction between the organism and target cells in the pulmonary vascular bed . Accordingly, this study evaluated the distribution and fate of GBS in the lung, liver, and spleen of anesthetized infant piglets and in isolated, salt solution-perfused piglet lung preparations . GBS were radiolabeled with 111Indium-oxine and infused at a dose of 10(8) organisms/kg/min for 15 min into anesthetized piglets ranging in age from 5-10 d . Forty-five min after termination of the infusion, animals were killed and specimens of lung, liver, spleen, and blood were excised and the relative deposition and viability of GBS were determined . Most of the recovered bacteria were detected in the lung (53.2 +/- 3.9%) followed by the liver (41.4 +/- 2.0%) and spleen (2.2 +/- 0.38%) . GBS detected in the blood was estimated to be only 3.2 +/- 1.0% of the infused dose . Viability of GBS was least in the lung (21.4 +/- 2.6%) relative to the liver (45.7 +/- 11.2%) and spleen (83.4 +/- 19.5%) . After a 60-min GBS infusion, transmission electron microscopy localized the organism within pulmonary intravascular macrophages in the lung; there was no evidence for bacterial interaction with either neutrophils or endothelial cells . In the liver, GBS was found exclusively in Kupffer cells . In isolated piglet lungs perfused at a constant flow rate with blood-free physiologic salt solution, GBS (10(6) to 10(8) organisms/mL) provoked concentration-dependent increases in pulmonary vascular resistance.(ABSTRACT TRUNCATED AT 250 WORDS) Berl Munch Tierarztl Wochenschr, 1990 Apr 1, 103(4), 121 - 5 {The possible pathogenic factors of Actinomyces pyogenes . A review}; Lammler C; Actinomyces pyogenes, an important pathogen of the bovine udder, was mainly characterized by production of the enzymes protease and neuraminidase . Both enzymes could be isolated and further analyzed . In addition A . pyogenes demonstrated lectin-like surface structures which caused hemagglutination reactions of neuraminidase treated erythrocytes . Further surface antigens of A . pyogenes which characteristically cross reacted with antisera against group polysaccharide antigens of streptococci of serological group G allowed an additional serological identification of this species . A . pyogenes further demonstrated binding properties for the plasma proteins alpha 2-macroglobulin, haptoglobin and fibrinogen and bacteriocin-like activities which caused growth inhibition of micrococci and staphylococci. Oral Microbiol Immunol, 1990 Apr, 5(2), 63 - 71 Glucosyltransferase production by Streptococcus sanguis Challis and comparison with other oral streptococci; Buchan RA et al.; Glucosyltransferase (GTF) activity in batch cultures of Streptococcus sanguis strain Challis in defined medium was maximum at peak growth and declined rapidly on further incubation into stationary phase . Activity was present in spent culture medium and was associated with 2 polypeptides of approximate Mrs 170 kDa (90% of activity) and 155 kDa (about 10% of activity) . Other S . sanguis strains produced similar antigenically-related polypeptides but with varying activities, and antibodies to the S . sanguis enzyme did not react with enzymes produced by other species of oral streptococci . Increasing the {Na+} reduced GTF production by S . sanguis strains Challis and NCTC 7865, and by Streptococcus sobrinus, but not by Streptococcus salivarius . Addition of Tween 80 to cultures caused a rapid inhibition of GTF synthesis by strain Challis, but not by strain NCTC 7865 . Benzyl alcohol had a slower and less inhibitory effect on GTF production by strain Challis . Tween 80 generally inhibited to varying degrees GTF production by other oral streptococci through in S . sobrinus it was stimulated . The results suggest controls operating on GTF synthesis and secretion by different strains of oral streptococci appear to be diverse. Zh Mikrobiol Epidemiol Immunobiol, 1990 Apr, (4), 26 - 31 {The OF characteristics of streptococci group A and immunity to streptococcal infection based on the results of OF and anti-OF tests}; Krasil'nikov IA et al.; The influence of the OF activity of group A streptococci on their specific pathogenic properties has been shown, which is manifested by increased virulence of these streptococci for children of younger age groups and by a two times higher isolation rate of OF+ strains in tonsillitis than in scarlet fever . The possibility of the indirect evaluation of the content of anti-M-antibodies by the results of the anti-OF test has been revealed, which permits using this test instead of the bactericidal test, more complicated, in the study of immunity to infection induced by group A OF+ streptococci . Among the main methods of laboratory support of epidemiological surveillance on streptococcal infection, the introduction of the highly discriminating OF typing and the anti-OF test into practical use is recommended. J Infect Dis, 1990 Apr, 161(4), 747 - 54 A human IgG receptor of group A streptococci is associated with tissue site of infection and streptococcal class; Bessen D et al.; The distribution of receptors for immunoglobulins of several different isotypes was examined for group A streptococcal isolates derived from skin and nasopharyngeal sites . Although human IgG-Fc receptor activity was a variable property of group A streptococci, found among 61% of all isolates tested, it was largely restricted to well-defined subpopulations . Human IgG-binding activity was observed among nearly all impetigo isolates examined . In addition, the expression of the class II M protein molecule (one of two broad antigenic classes of the major virulence factor) and opacity factor (a lipoproteinase) was almost invariably accompanied by human IgG binding, regardless of tissue site of infection . In contrast to class I impetigo isolates, class I nasopharyngeal isolates were relatively devoid of human IgG-binding activity . The data suggest that the presence or absence of human IgG-binding activity correlates with certain diseases caused by group A streptococci. Mikrobiyol Bul, 1990 Apr, 24(2), 164 - 76 {Functional properties of plasmids in lactic streptococci}; Akcelik M; For over half a century studies of the lactic Streptococci have reported instability of several metabolic properties vital successful dairy fermentation . Little has been done explain this instability, however, and only in the last 10 years or so, with the advent of techniques for studying genetic composition of lactic Streptococci, has it become possible to explanations for this phenomenon . It is now well established that diversity of plasmid sizes are found within strains of lactic Streptococci . Further it has been demonstrated that these organisms characteristically harbour many plasmid species. Biochem J, 1990 Apr 1, 267(1), 191 - 6 Shedding of hyaluronate synthase from streptococci; Mausolf A et al.; Hyaluronate synthase was shed into the culture medium from growing streptococci (group C) together with nascent hyaluronate . The mechanism of solubilization was analysed using isolated protoplast membranes . Solubilization increased when membranes were suspended in larger volumes, but it was temperature-independent and was not inhibited by protease inhibitors . Increased hyaluronate chain length enhanced solubilization . The soluble synthase could re-integrate into Streptococcal membranes in a saturable manner . The soluble synthase behaved like an integral membrane protein, although it was not integrated into phospholipid vesicles . In sucrose velocity centrifugation the synthase had a higher sedimentation rate in detergent-free solution, indicating that it existed in an aggregated state. Oral Microbiol Immunol, 1990 Apr, 5(2), 57 - 62 Salivary IgA antibody to oral streptococcal antigens in predentate infants; Smith DJ et al.; Salivary IgA antibodies to oral streptococci which colonize the infant oral cavity soon after birth were analyzed in 53 whole salivas of 17 infants who were between three and 27 weeks old . Antibody activities to Streptococcus mitis cells were detected by enzyme linked immunosorbent assay in 78% of the whole salivas by the twelfth week of age . This antibody activity was associated with polymeric IgA as determined after gel filtration of salivas on Superose 6, followed by ELISA . Western blot analyses were used to detect IgA antibodies to Streptococcus mitis and Streptococcus salivarius culture supernatants . Forty one, and 91% of saliva samples contained IgA antibody which reacted in Western blot analyses with S . salivarius and S . mitis culture supernatants, respectively . The youngest infant to show reactive IgA antibody with either oral streptococcal antigen preparation was five week old . Salivary IgA antibody to either bacterial culture supernatant was detected in Western blot only after the isolation of the respective streptococcal species from the oral cavity of these young infants . Some heterogeneity was observed among patterns developed with salivas from different infants . These results suggest that salivary IgA antibody responses may be induced by oral colonization (S . mitis, S . salivarius) by the end of the first month of life. Med J Aust, 1990 Mar 19, 152(6), 319 - 20 Group C streptococcal meningitis; Mollison LC et al.; Group C streptococci have been infrequently described as human pathogens . A case of meningitis caused by Streptococcus dysgalactiae, in a 73-year-old man with alcoholic liver disease, was treated successfully with penicillin and chloramphenicol. Cas Lek Cesk, 1990 Mar 16, 129(11), 343 - 9 {Urogenital chlamydial infection in men and their sexual contacts}; Strauss J et al.; Cultivation and serological tests for Chlamydia trachomatis were made in a total of 39 male patients (24 married, 11 single, 3 divorced, 1 widower) and their female partners (9 extra-marital, 12 wives) on average 35 years old in both groups . Apart from the clinical diagnosis of non-specific urethritis found in all male patients, 11 patients suffered from other infections (5 from balanitis, 4 from prostatitis, 1 from prepuce infection, 1 from herpetic infection) and subjective disorders . Side by side with clinical diagnosis of cervicitis or in combination with urethritis found in 16 female sexual partners, two of them suffered also from vulvovaginitis, 2 from adnexitis, 1 from candidosis, 1 had dysuric difficulties and 1 female patient was found sterile . 11 women had no subjective problems . The cultivation-tinction technique used in 25 men (14 married, 11 single) and 14 female sexual partners respectively (8 marital and 6 extramarital), positive Chlamydia trachomatics was isolated 21 times (84%) and 9 times (64.3%) respectively . The immunofluorescence technique using monoclonal antibodies applied to 39 men (24 married, 15 single) and 21 female sexual partners respectively, (i . e . 12 marital and 9 extramarital) gave positive results in 29 cases (74.4%) and 16 persons (76.2%) respectively . One patient was homosexual with a positive finding in the urethra and rectum, and, in addition, he was found to have BWR positive with Candida albicans and group B streptococci, however, his serological HIV was negative . The immunoenzymatic test (EIA) showed borderline titres as being positive in men in 28.2% cases and women in 26.3% and high levels (1:128+) in 41.0% in male patients and 21.1 percent in female patients respectively.(ABSTRACT TRUNCATED AT 250 WORDS) Indian Pediatr, 1990 Mar, 27(3), 241 - 6 The first attack of acute rheumatic fever in childhood--clinical and laboratory profile; Nair PM et al.; One hundred consecutive cases of 'first attack' of acute rheumatic fever were studied . There were 52 males and 48 females, constituting 1.12% of total hospital admissions . Nearly 10% of children were below the age of 5 years, stressing the early onset of rheumatic fever in tropics . Only 47% gave a definite history of overcrowding at home . Sore throat was present in 67%, overt arthritis in 66%, carditis in 57%, arthralgia alone in 22% of which 45.45% had carditis . Small joint involvement was noticed in 23% of cases of which 73.91% had carditis . Only 33.33% had congestive cardiac failure . Ten per cent of children had chorea, while subcutaneous nodules were seen in 4% of cases, all of whom had associated carditis . Erythrocyte sedimentation rate (ESR) showed good correlation with clinical profile . Throat cultures were positive for beta hemolytic streptococci only in 12% of cases . Anti-streptolysin 'O' (ASO) titre showed significant titres on 68% of cases, anti-deoxyribonuclease "B" (ADN-B) in 69.32%, antibody to group A carbohydrate (ACHO) in 70.65% . ASO, ADN-B, and ACHO titres together gave 87.5% positivity while estimations in paired sera showed ASO 79.54%, ADN-B 82.27% and ASO, ADN-B together 99.92% significant titres . Study of blood groups showed A group children to be more vulnerable to rheumatic fever (37.5%) and rheumatic carditis (47.37%) . Mortality in the present study was nil. J Dairy Sci, 1990 Mar, 73(3), 648 - 60 Clinical mastitis in two California dairy herds participating in contagious mastitis control programs; Gonzalez RN et al.; The occurrence of clinical mastitis in two large California dairy herds over a 3-yr period is described . Herds had been participating for 15 or 22 yr in mastitis control programs against Streptococcus agalactiae and Staphylococcus aureus, had low bulk tank SCC, and had maintained good standards of hygiene and husbandry, but clinical mastitis remained a serious problem . A total of 1654 clinical mastitis cases were detected; the annual incidence in each herd was 49% . Coliform bacteria and environmental streptococci were etiological agents in 60% of the total clinical mastitis cases; coliforms produced 1.6 times more clinical mastitis than environmental streptococci . A higher susceptibility to clinical mastitis, primarily from coliform bacteria and environmental streptococci, was found in the first months of lactation . Clinical mastitis incidence peaked for cows in lactations 4 and 5 and was lowest during the first lactation . Highest incidence of clinical mastitis due to coliform bacteria and environmental streptococci at each dairy occurred during the rainy season (late fall and winter). Ann R Coll Surg Engl, 1990 Mar, 72(2), 123 - 4 The significance of beta-haemolytic streptococci in chronic leg ulcers; Schraibman IG; beta-Haemolytic streptococci were identified in 18.8% of bacterial isolates from 91 legs of patients with leg ulcers swabbed routinely . This previously unreported high incidence is ascribed to selective culture methods . In view of its sensitivity to simple antibiotics and its reputed proclivity for skin destruction, the beta-haemolytic streptococcus should be sought and, if found, energetically treated. Zentralbl Bakteriol, 1990 Mar, 272(3), 283 - 9 Correlation between growth in antibiotic-medium and hemolytic activity of group C and G streptococci; de Castro AC et al.; The effect of a subminimal inhibitory concentration of penicillin on the production of bound and free hemolysins by streptococci was examined using sheep red blood cells . A marked decrease of a group C cell-free and bound activities was observed with penicillin at a concentration of 1/3 of the MIC whereas an increase was observed with those of a group G strain . Potassium ferricyanide and anti-streptolysin O (group A streptococcus) were strongly inhibitory for the free activities of both strains . The cell-bound activities were stimulated by addition of RNA during bacterial growth in control cultures and also in drug-containing media. J Antibiot (Tokyo), 1990 Mar, 43(3), 223 - 8 Altromycins, novel pluramycin-like antibiotics . I . Taxonomy of the producing organism, fermentation and antibacterial activity; Jackson M et al.; The altromycins are novel anthraquinone-derived antibiotics related to the pluramycins . They are produced by an actinomycete, AB 1246E-26, which was isolated from a South African bushveld soil . The altromycins have Gram-positive antibacterial activity with MICs of 0.2 to 3.12 micrograms/ml against Streptococci and Staphylococci. Oral Surg Oral Med Oral Pathol, 1990 Mar, 69(3), 366 - 71 Analysis of positive cultures from endodontically treated teeth: a retrospective study; Stern MH et al.; A study of 12,150 endodontically treated teeth from 11,797 patients in a private patient setup revealed an incidence of 10.2% positive cultures obtained just before obturation of the root canal . Streptococcal predominance was reflected by a presence of nearly 60% in the pure culture and nearly 98% in the mixed cultures . No significant changes in microbial predominance or bacterial sensitivities were detected over the 7-year period of study . Ampicillin, cephalothin, erythromycin, and penicillin were the most effective antibiotics against the viridans streptococci, the most prevalent organism in the infected teeth. J Lab Clin Med, 1990 Mar, 115(3), 283 - 91 Granulocyte transfusions in septic adult and newborn rats: distribution of granulocytes and effect on peripheral blood and bone marrow; Baley JE et al.; Granulocyte transfusions are increasingly being used as therapy for newborns with sepsis and neutropenia . We injected either group B Streptococcus or phosphate-buffered saline solution intraperitoneally into adult and newborn rats . Human granulocytes, labeled with chromium 51, were transfused seven hours later . When the newborn rats were killed 13 to 19 hours after injection, they had 10(2) to 10(6) cfu/gm Streptococcus organisms in both lung and brain . Only one third of the adult rats had 10(2) to 10(4) cfu/gm Streptococcus organisms in either lung or brain . A greater proportion of the transfused granulocytes was present in lung and brain tissue of newborn rats, compared with adult rats (p less than 0.05), irrespective of infection . Granulocyte transfusion did not change the peripheral blood leukocyte count in adult rats but increased the count in newborn rats (p less than 0.05) . The immature myeloid pool in the bone marrow of adult rats increased significantly with either infection or transfusion (p less than 0.01) . The immature pool in newborn rats increased significantly only with infection (p greater than 0.001), although the combination of infection and transfusion also had a significant effect on the pool (p less than 0.01) . Infection and both infection and transfusion, but not transfusion alone, significantly affected the mature myeloid bone marrow pool in adult and newborn rats (p less than 0.001) . The depletion of the mature myeloid elements of the bone marrow in response to infection was dramatic in neonatal rats, compared with that in adult rats . Both transfused granulocytes and hematogenously spread streptococci lodge in the brains and lungs of neonatal rats more effectively than in those of adult rats. J Clin Oncol, 1990 Mar, 8(3), 453 - 9 Septicemia in pediatric oncology patients: the significance of viridans streptococcal infections; Weisman SJ et al.; One hundred nine consecutive episodes of septicemia were retrospectively evaluated in 61 children with malignancy . In addition, the records of all pediatric oncology patients who received high-dose cytarabine (HDAC) chemotherapy were reviewed . Gram-positive organisms accounted for 82.6% of the septicemic episodes . In the total group, coagulase-negative staphylococci and viridans streptococci accounted for 35.8% and 28.4% of the episodes, respectively . In granulocytopenic patients, viridans streptococci were the most common pathogens (36.8%) . In the subset of patients who received HDAC, 62.5% of the septicemic episodes were caused by viridans streptococci . Pulmonary complications developed in nine (29%) of the total cases of viridans streptococcal sepsis, whereas these complications occurred in only eight (10.3%) of the septic episodes caused by other organisms . In patients who had viridans septicemia, prior treatment with HDAC did not increase the incidence of pulmonary complications . In septic children with malignancy, our results demonstrate a high incidence of gram-positive organisms, including viridans streptococci, which were once regarded as culture contaminants. Kansenshogaku Zasshi, 1990 Mar, 64(3), 321 - 7 Antigenicity of group B Streptococcus strain "M9" and its prevalence in Japan; Sugiyama M et al.; Serological typing of group B streptococci is important for the epidemiological study of group B streptococcal infections . These days, non typable (NT) strains by conventional serotypes were on an increase . In 1984, strain "M9" was isolated from a pregnant woman in Meijo Hospital, Nagoya City; herein the antigenicity and prevalence of strains typed as "M9" were investigated and discussed . The results obtained were as follows: 1) It was confirmed that strain "M9" had a new polysaccharide antigen, different from conventional types, Ia, Ib, II, III, IV and V, type candidate NT6 and type candidate 7271, as found by precipitation and precipitation absorption reaction . This procedure, moreover, was useful for differentiation type candidate NT6 and 7271 from "M9" because of their provisionality . 2) Group B streptococci typed as "M9" were isolated not only from carriers but from patients who were newborn babies and suffered from sepsis . 3) Strain "M9" was not necessarily located in Nagoya City but in Chiba and in Kyoto, this type was isolated from clinical materials already in 1979 . 4) It was observed that polysaccharide "M9" liked to combine with protein "R" and without other proteins, as our collection extends. Bone Marrow Transplant, 1990 Mar, 5(3), 179 - 82 Options and limitations of long-term oral ciprofloxacin as antibacterial prophylaxis in allogeneic bone marrow transplant recipients; De Pauw BE et al.; The efficacy and safety of ciprofloxacin as long-term antibacterial prophylaxis after allogeneic bone marrow transplantation were assessed prospectively . Eighty-nine recipients of lymphocyte-depleted marrow grafts were each given ciprofloxacin orally, 500 mg twice daily . Fever developed in 71 out of 78 evaluable patients (91%) and was accompanied by positive blood cultures in 42 cases (59%) . 'Viridans' streptococci, all but one with reduced in vitro susceptibility to ciprofloxacin, accounted for 35 episodes of bacteraemia . Thirty-three episodes occurred in patients given anthracyclines compared with only two episodes in other patients (chi 2 = 5.58: p less than 0.05) . All bacteraemic fevers occurred within 11 days post-transplant . Gram-negative sepsis did not occur in any patient . Sixteen patients died but none due to a bacterial cause . Allergy to ciprofloxacin was registered in three out of 76 assessable cases (4%). Zentralbl Bakteriol, 1990 Mar, 272(3), 294 - 305 Cross-reactive polysaccharide antigens (types a, d, and h) of the mutans group of streptococci: different molecular forms of the type as distinguishable by monoclonal antibodies; Ota F et al.; As compared to the previous precipitin inhibition tests differences were found in the reactivities of monoclonal antibodies (MAbs), a-4 and a-84 with Streptococcus cricetus (serotype a) in an enzyme immunoassay using whole cells, purified cell wall antigen and haptenic sugars coated onto microtitre wells . Investigation into the differences led to the finding that the purified antigen from S . cricetus cells consisted mainly of three forms with different molecular weights and sugar contents . MAb a-4 reacted with a high molecular weight form (AgI, molecular weight of 46,000) and low molecular weight forms (AgII and AgIII, molecular weights of 9,800 and 20,000, respectively) whereas MAb a-84 reacted only with the high-molecular form . Gas chromatographic analysis revealed that all antigens contained rhamnose, galactose and glucose but in different ratios of the sugars . Although the binding site of AgII/AgIII with MAb a-4 seemed to be slightly different from that of AgI with MAb a-84, the predominant immunodeterminant of the antigens was considered to be the same . On the basis of these results, the chemical structures of the antigenic determinants are suggested . The nature of the antigen-antibody reactions is discussed. J Clin Microbiol, 1990 Mar, 28(3), 628 - 30 Whole-cell protein patterns of nonhemolytic group B, type Ib, streptococci isolated from humans, mice, cattle, frogs, and fish; Elliott JA et al.; Whole-cell protein and physiological patterns of nonhemolytic group B, type Ib, streptococci isolated from humans, cattle, frogs, fish, and mice were compared . Isolates from humans, fish, and mice were identical . Only minor differences were seen in the isolates from human, bovine, and frog sources . Nonhemolytic group B streptococci from humans, fish, and mice and, to a lesser extent, from cattle and frogs share several characteristics, including a high similarity in proteins (on the basis of molecular weight); this suggests that they may have a common ancestry. Br J Surg, 1990 Mar, 77(3), 260 - 4 Current hypotheses on synergistic microbial gangrene; Kingston D et al.; We have reviewed spreading infections of the dermis, with special reference to the importance of synergy in their causation . Evidence for this is accumulating from both clinical studies and from studies in laboratory animals . Necrotizing fasciitis (rapid spread over 24 h) can be caused by beta-haemolytic streptococci, sometimes with Staphylococcus aureus, or by mixed infections of aerobes and anaerobes, often of gut origin . Animal studies provide good evidence that S . aureus can potentiate the beta-haemolytic streptococcal infection in necrotizing fasciitis . There is also evidence that mixtures of aerobes and anaerobes can act synergistically, but animal models for necrotizing fasciitis have not been developed . Anaerobic cellulitis (variable rate of spread from hours to days) can be caused by mixed aerobes and anaerobes or by mixed clostridia . Animal studies provide good evidence for synergy in the former . Meleney's synergistic postoperative gangrene (slow spread over weeks) may be cutaneous amoebiasis: the animal model of Brewer and Meleney relates to the more rapid infections of anaerobic cellulitis. J Reprod Med, 1990 Mar, 35(3 Suppl), 322 - 8 Etiology and treatment of post-cesarean-section endometritis after cephalosporin prophylaxis; Hillier S et al.; To describe the microbiologic etiology of post-cesarean endometritis developing after perioperative cephalosporin prophylaxis, endometrial samples were obtained from 27 women with a triple-lumen catheter . The women were assigned in a double-blind, randomized fashion to receive either ticarcillin/clavulanate, 3.1 g, or cefoxitin, 2 g, administered every six hours, until the clinical signs of infection resolved . A total of 149 microorganisms (84 facultative and 65 obligate anaerobes) were recovered from 26 women, for a mean of 5.5 isolates per specimen . One endometrial specimen was sterile . Bacteroides and Peptostreptococcus species were the most frequent isolates, followed by Gardnerella vaginalis, Enterococcus, facultative gram-negative rods and Mycoplasma hominis . Each of the isolates was tested for beta-lactamase activity . At least one beta-lactamase-producing isolate was recovered from 56% of the specimens . Susceptibility testing of endometrial isolates demonstrated that 96% of 118 potential pathogens (Gardnerella, Bacteroides, Peptostreptococcus, enterococci and streptococci) were susceptible to ticarcillin/clavulanate . By comparison, 86% of these isolates were susceptible to cefoxitin in vitro . Women who were treated with ticarcillin/clavulanate were less likely to have a temperature greater than 38 degrees C for two or more days (8% vs . 57%, P = .01) . Also, there was a trend toward a decreased duration of uterine tenderness in the ticarcillin/clavulanate group, but it did not attain statistical significance (60% vs . 86%, P = .4) . However, the overall clinical success rate with these single-agent treatments was not different for the two groups (77% vs . 79%, P = 1.0).(ABSTRACT TRUNCATED AT 250 WORDS) Oral Surg Oral Med Oral Pathol, 1990 Mar, 69(3), 331 - 8 Chlorhexidine prophylaxis for chemotherapy- and radiotherapy-induced stomatitis: a randomized double-blind trial; Ferretti GA et al.; Patients receiving cytotoxic antineoplastic therapy often have treatment-associated stomatitis . A 0.12% chlorhexidine digluconate mouthrinse was evaluated (15 ml, three times a day) in a prospective, double-blind randomized trial as prophylaxis against cytotoxic therapy-induced damage to oral soft tissues . Seventy subjects, forty inpatients receiving high-dose chemotherapy and thirty outpatients receiving high-dose head and neck radiation therapy, were evaluated . Chlorhexidine mouthrinse significantly reduced the incidence of oral mucositis in the chemotherapy group on day 14 (p less than 0.02) and at 1 week follow-up on day 28 (p less than 0.002) . Mucositis in the patients undergoing chemotherapy who received chlorhexidine also resolved more rapidly . Mucositis severity was significantly less compared to the control chemotherapy group on day 14 (p less than 0.03), day 21 (p less than 0.04), and on 1 week follow-up (p less than 0.02) . Concomitant trends in the reduction in oral streptococci and yeast were noted in the chemotherapy group receiving chlorhexidine mouthrinse . Although no differences were observed in oral mucositis between the control and chlorhexidine groups of patients undergoing high-dose radiotherapy, similar reductions of oral microflora to those seen in the chemotherapy population were also noted for patients undergoing radiation therapy who received chlorhexidine . Although generally not significant, some increase in gram-negative bacilli was noted in the chlorhexidine-treated patients in both the chemotherapy and radiotherapy groups, but there was no correlation with increased systemic infection . Prophylactic chlorhexidine mouthrinse reduces oral mucositis and microbial burden in patients with cancer undergoing intensive chemotherapy. Rev Chil Pediatr, 1990 Mar-Apr, 61(2), 109 - 12 {Epidemic outbreak of acute post streptococcal glomerulonephritis}; Berrios X; An outbreak of post streptococcal acute glomerulonephritis (PSAGN) was recorded in the South East Health Service (SEHS) of Santiago, Chile, between 1984 and 1987 . Some aspects related to its epidemiology and natural history are discussed . This outbreak was preceded by streptococcal skin infection (SSI) in 60% of cases vs . 36% during the previous period . At the same time it was observed an increased isolation rate of group A beta hemolytic streptococci (GABHS) of skin origin, and a high prevalence of anti-DNase B antibodies (ADB) in the general population, what reveals an important skin-GABHS reservoir in the community . In Chile, skin infections with GABHS are frequently secondary to scabies . The trend of scabies in the last years has been similar to that of PSAGN . The need for control and treatment of scabies is emphasized to interrupt the epidemiological chain . The protection of household contacts with Benzathin Penicillin is recommended because lower secondary attack rate has been observed in prophylaxis versus non protected groups. Nichidai Koko Kagaku, 1990 Mar, 16(1), 27 - 36 {Non-cariogenicity of erythritol as a substrate}; Kawanabe J; Erythritol is a sugar alcohol which is obtained through a cultivation of glucose and Aureobasidium sp . The sugar is about 70-80% as sweet as sucrose and is also non-hygroscopic . The effect of erythritol on cariogenicities of mutans streptococci (serotype a-h) and certain oral microorganisms was studies . Erythritol was not utilized as a substrate for the growth, lactic acid production and plaque formation of mutans streptococci (serotype a-h) . It did not serve as a substrate for cellular aggregation of mutants streptococci (serotype d, g, h) and was not utilized water-insoluble glucan synthesis and cellular adherence by glucosyltransferase from S . mutans PS-14 (c) or S . sorbrinus 6715 (g) . Erythritol was not also utilized for the growth and lactic acid production of certain oral microorganisms although some growth was seen with Actinomyces viscosus . SPF SD rats infected with S . sobrinus 6715 were fed a diet containing 26% erythritol or 26% sucrose for 53 days . A significantly (p less than 0.01) lower caries score (mean +/- SE; 3.1 +/- 0.5) was observed in the rat fed a diet containing erythritol than the control (60.5 +/- 2.0) . The caries inhibition rate is 94.9% . Also, rats infected with S . mutans PS-14 were fed a diet containing 56% erythritol chocolate or 56% sucrose chocolate for 58 days . The mean total caries score of rats fed a diet containing 56% erythritol chocolate was 6.7 +/- 0.8, while the mean total caries score of rats fed a diet containing 56% sucrose chocolate was 82.8 +/- 2.8 . The value between both groups was significant at 0.01 level, and the caries inhibition rate is 91.9%. FEMS Microbiol Lett, 1990 Mar 1, 56(1-2), 35 - 9 Opacity factor from group A streptococci is an apoproteinase; Saravani GA et al.; Opacity factor (OF) is an enzyme, elaborated by certain serotypes of group A streptococci, which produces opalescence in mammalian sera . OF has been designated a lipoproteinase . Lipoproteins are complex structures and many enzymes are involved in their catalysis . We therefore set out to establish which of the many enzymes OF could be . Results showed that OF rendered high density lipoprotein (HDL) insoluble, accounting for the opalescence in serum, and altered its electrophoretic mobility . Electron microscopy revealed that OF caused an aggregation of HDL and an alteration in molecule shape . OF specifically split apoprotein AI of HDL into two fragments demonstrable by SDS-PAGE . We therefore designate OF as an apoproteinase. J Dent Res, 1990 Mar, 69(3), 861 - 4 Mutans streptococci in plaque from margins of amalgam, composite, and glass-ionomer restorations; Svanberg M et al.; Levels of mutans streptococci in plaque samples from margins of Class II amalgam (Dispersalloy), composite (P-10), and glass-ionomer (Ketac Silver) restorations were compared . Fifty-one children, each having one of the restorations in a permanent first molar, were part of an inter-individual comparison, giving 17 restorations of each material . The age of the children, the age of the restorations, and the salivary levels of mutans streptococci were comparable in the three groups . Another seven children--each having both a composite and a glass-ionomer restoration of the same age placed on contralateral premolar or molar teeth--were part of an intra-individual comparison . The percentage mutans streptococci of total CFU count in plaque was higher on composite (mean 13.7) and amalgam (mean 4.3) than on glass-ionomer (mean 1.1) restorations in the inter-individual comparison, and higher on composite (mean 4.2) than on glass-ionomer (mean 0.4) restorations in the intra-individual comparison . In both comparisons, the differences in values between samples from glass-ionomer restorations and samples from composite or amalgam restorations were statistically significant (p less than 0.05). Am Rev Respir Dis, 1990 Mar, 141(3), 648 - 53 Oxygen radical-dependent bacterial killing and pulmonary hypertension in piglets infected with group B streptococci; Bowdy BD et al.; The mechanism by which bacteria are cleared by the pulmonary circulation and the relation of this process to development of hemodynamic abnormalities are not understood . This study tested the hypotheses that clearance of Group B Streptococcus (GBS) during transit through the pulmonary circulation of infant piglets is related to oxygen radical-dependent bacterial killing and that killing of the organism is linked to development of pulmonary hypertension . GBS were radiolabeled with 111In and infused intravenously for 15 min (10(8) organisms/kg/min) into infant piglets ranging in age from 5 to 14 days . Lung specimens were excised at termination of the GBS infusion or 45 min thereafter, and both the relative deposition and viability of the bacteria were determined . The percentage of infused GBS recovered in lung tissue did not differ between the two time points (26 +/- 7% versus 29 +/- 8%), but the relative viability at termination of the infusion, 50 +/- 11%, was reduced to 19 +/- 4% within 45 min . Treatment with an oxygen radical scavenger, dimethylthiourea (DMTU), failed to influence the pulmonary deposition of GBS but significantly increased viability of the organism from 21.4 +/- 2.6 to 33.3 +/- 5.3% . As expected, GBS infusion was accompanied by pulmonary hypertension and arterial hypoxemia; DMTU attenuated these responses by 52 and 78%, respectively.(ABSTRACT TRUNCATED AT 250 WORDS) Ann Trop Paediatr, 1990 Mar, 10(1), 39 - 43 Survey of infection in babies at the Khoula Hospital, Oman; Rajab A et al.; A 12-month prospective study of infection was carried out in the special care baby unit (SCBU), Khoula Hospital, Muscat, Sultanate of Oman . During this period, 8720 babies were born in the hospital and 1265 were admitted to the SCBU . Altogether, 490 babies were of less than 36 weeks' gestation . A total of 190 babies (160 born in the hospital, 30 born before admission) satisfied the criteria for infection . The most common clinical presentation was pneumonia . There was one outbreak of iatrogenic infection . Infection was confirmed microbiologically in 76 of 190 symptomatic babies . Staphylococcus aureus was the most common pathogen and was isolated from 48 infected babies (25%) . Beta-haemolytic streptococci were isolated from superficial sites only in eight babies . Klebsiella spp were the commonest enteric bacteria isolated, but they were rarely associated with infection . Of 46 babies who had bacteraemia, 9 also had meningitis . Nine of the 46 babies died, including 6 of the 9 who had meningitis . The mortality following Gram-negative infection was higher than that following Gram-positive infection . Fourteen per cent of infected babies born in hospital and 27% of those born before admission died . A high proportion of bacteria isolated were resistant to ampicillin and/or gentamicin . Results suggest that alternative antibiotics would be more appropriate for initial treatment . The study shows that in developing countries, unsophisticated research, using basic facilities, can be of value in identifying the problems of infection and in recognizing possible solutions to them. Harefuah, 1990 Feb 15, 118(4), 205 - 7 {Sore throat: an analysis of medical management in a community clinic}; Furst A et al.; The diagnostic approach to sore throat and its treatment by 7 doctors was studied in 692 community clinic patients . Redness of the throat, the commonest clinical feature in all age groups, was present in 88% . The prevalence of other clinical findings varied in the different age groups . 54% of the patients, most of whom were less than 13 years old, were treated initially with antibiotics . Most of the physicians prescribed penicillin V (average, 8.4 days) . From 11 (13%) of the throat cultures taken from children under the age of 4, beta hemolytic streptococci (BHS) were grown . Based on throat cultures, antibiotics had been given unnecessarily in 53% of those in whom it was initially prescribed, and wrongly withheld in 10% of those who initially did not receive them . This study reveals an urgent need for a rapid and accurate method of detecting BHS in patients with sore throat. Epidemiol Infect, 1990 Feb, 104(1), 119 - 26 The epidemiology of beta-haemolytic non-group A streptococci isolated from the throats of children over a one-year period; Cimolai N et al.; The incidence of beta-haemolytic non-Group A streptococci (BHNAS) in the throats of a paediatric population was examined over a 1-year period . There was minimal seasonal fluctuation of Lancefield groups including species and biotypes within Groups C and G streptococci . A trend of increasing incidence with age of Streptococcus anginosus ('Streptococcus milleri') (possessing Groups C and G Lancefield antigens) was evident . A clinical impression of streptococcal pharyngitis was more common in patients with large-colony Groups C or G streptococci isolated from their throats compared with those patients where other BHNAS were isolated . This study is requisite to the planning of case control studies which are required to test the association of BHNAS (especially Groups C and G subgroups) and pharyngitis. Clin Cardiol, 1990 Feb, 13(2), 94 - 8 Native valve infective endocarditis in the 1970s versus the 1980s: underlying cardiac lesions and infecting organisms; Weinberger I et al.; A retrospective review of the records of 135 patients with proven or suspected endocarditis, seen between January 1970 and December 1987, is presented . Among the findings: (1) Mitral valve prolapse (MVP) as an underlying lesion was more common in the 1980s group of patients (22%) than in the 1970s group (6%, p less than 0.01); (2) no significant difference was found in the occurrence of pathogens between the 1970s and the 1980s groups of patients; (3) in most patients (17 of 19) with MVP, the organisms isolated were Streptococci viridans; (4) most patients (15 of 17) with MVP had undergone a dental procedure without prior antibiotic treatment in the two months prior to admission . Prophylactic antibiotic treatment is suggested in patients with MVP undergoing dental procedure, especially in a subset of patients with flail or redundant valve leaflet as 16 of our MVP patients (out of 17) had this pathology on echocardiogram. J Infect Dis, 1990 Feb, 161(2), 236 - 41 Effect of fibronectin on IgA-mediated uptake of type III group B streptococci by phagocytes; Yang KD et al.; Previous studies have shown that a type-specific IgA monoclonal antibody alone or in combination with fibronectin (Fn) enhances protective efficacy in two animal models of group B streptococcal infection . To investigate the mechanisms by which IgA mediates protection, the effects of Fn on phagocytosis of group B streptococci (GBS) opsonized with a type III-specific IgA monoclonal antibody were examined . Specific IgA alone or in combination with Fn did not promote the phagocytosis of GBS by polymorphonuclear leukocytes (PMNL) . Fibronectin also had no significant effect on phagocytosis of IgA-opsonized GBS by monocytes . Specific IgA alone promoted phagocytosis of GBS by culture-derived macrophages in a dose-dependent fashion . Fibronectin enhanced macrophage uptake of the GBS opsonized in a suboptimal concentration of specific IgA (phagocytic index = 2.32 +/- 0.56 vs . 3.26 +/- 0.48 with Fn; P less than .05) . These data suggest that protection against GBS in neonatal rats by a combination of Fn and specific IgA is mediated by macrophages rather than by PMNL or monocytes . Fibronectin may have a critical role in host defense at sites where IgA and macrophages predominate. J Bacteriol, 1990 Feb, 172(2), 696 - 700 Coregulation of type 12 M protein and streptococcal C5a peptidase genes in group A streptococci: evidence for a virulence regulon controlled by the virR locus; Simpson WJ et al.; Group A streptococci express at least two surface-associated virulence factors, the antiphagocytic M protein and the antichemotactic streptococcal C5a peptidase (SCP) . Preliminary evidence suggested that the biosynthesis of these two proteins is coordinately controlled and subject to simultaneous phase variation . To explore this possibility further, a series of phase-switching and phase-locked M- variants were assayed for SCP by enzyme-linked immunosorbent assay inhibition and for SCP-specific mRNA by dot blot hybridization . All M- cultures produced diminished amounts of SCP antigen and specific mRNA, whereas revertants produced quantities equivalent to those of the wild-type M+ culture . A phase-locked strain that harbors a deletion in a region upstream of the M12 and SCP genes, termed the virR locus, failed to produce SCP antigen or SCP-specific transcripts . The SCP-specific transcript produced by M+ bacteria was shown by Northern (RNA) blot hybridization to be 4 kilobases in size, distinguishing it from the transcript which encodes M protein . These data demonstrate that phase switching of both SCP and M12 proteins is at the transcriptional level and that expression is under the control of the upstream virR locus . We propose that the genetic determinants of these proteins and of colony morphology comprise a virulence regulon. Infect Immun, 1990 Feb, 58(2), 332 - 40 Colloidal gold immunolabeling of immunoglobulin-binding sites and beta antigen in group B streptococci; Coleman SE et al.; We have characterized the immunoglobulin A (IgA)-Fc-binding properties and beta-antigen expression of several strains of group B streptococci by using ultrastructural immunocytochemistry . Colloidal gold-labeled tracers were used with intact and sectioned bacteria in order to gain information regarding the location and distribution of cell surface and cytoplasmic IgA-Fc-binding molecules and beta antigen . Colloidal gold (5- or 15-nm particles) was conjugated to IgA to characterize IgA-binding properties and to IgG to test for IgG binding . Rabbit anti-beta antiserum was reacted with the bacteria and then with protein G labeled with 15-nm colloidal gold particles . A double-labeling technique was used for simultaneous localization of IgA-Fc- and anti-beta-antibody-binding properties on sectioned bacteria . The data corroborated previous results which indicated that (i) IgA-Fc-binding and IgA-Fc-nonbinding forms of beta antigen can be secreted by strains which do not express beta antigen on the cell surfaces (HG806, VC75); (ii) differences in levels of expression of beta antigen and/or IgA-Fc-binding proteins can be detected among various group B isolates; (iii) group B streptococci do not express human IgG-Fc-binding proteins; and (iv) not all forms of beta antigen are capable of binding human IgA. J Antimicrob Chemother, 1990 Feb, 25(2), 209 - 16 Comparison of four methods for the determination of MIC and MBC of penicillin for viridans streptococci and the implications for penicillin tolerance; James PA; Four methods of MIC and MBC determination were examined to compare their reproducibility and ability to detect penicillin tolerance . The MIC and MBC of penicillin were determined for 28 strains of viridans streptococci by a microdilution method, a macrodilution method, a membrane method, and a gradient-plate method using a spiral-plating device . The macrodilution, membrane and gradient plate methods were found to be acceptable for MIC determination with a reproducibility to within one doubling dilution, but only the gradient method gave acceptable reproducibility for MBC determinations . The consequence of these findings with respect to penicillin tolerance is discussed. J Dent Res, 1990 Feb, 69(2), 442 - 6 Sorbitol adaptation of dental plaque in people with low and normal salivary-secretion rates; Kalfas S et al.; Caries-related bacteriological and biochemical factors were studied in 12 persons with low and 11 persons with normal salivary-secretion rates before and after a four-week period of frequent mouthrinses with 10% sorbitol solution (adaptation period) . After the adaptation period, an increase in total numbers of sorbitol-fermenting bacteria and mutans streptococci was found in plaque samples from both groups . The pH drop in dental plaque in situ after a mouthrinse with sorbitol was more pronounced after the adaptation period, especially in the group with the low salivary-secretion rate . Increased acid production in plaque from sorbitol was also observed in the two groups in vitro . The composition of the fermentation end-products was affected by the sorbitol exposure . It is suggested that in subjects with diminished natural protection against caries development, such as patients with low salivary-secretion rate, a cariogenic potential of sorbitol should be considered when this polyol is included in products that might be used frequently. Ann Thorac Surg, 1990 Feb, 49(2), 319 - 20 Group F streptococcal empyema from aspiration of a grass inflorescence; Baethge BA et al.; A previously healthy 15-year-old boy was seen with a loculated right lower lobe empyema . Group F beta-hemolytic streptococci were cultured from the pleural fluid . Surgical intervention was required . An unsuspected aspirated grass inflorescence and a bronchopleural fistula were discovered during a decortication procedure. Am J Med Sci, 1990 Feb, 299(2), 87 - 93 Bacterial endocarditis at a small community hospital; Kim EL et al.; Clinical features, microbiology, and predisposing factors are described in 56 patients with bacterial endocarditis (BE) treated over a 12-year period at a small community hospital in Hawaii . The average age of patients was 52.0 years . The mean duration of symptoms was 28.8 days (range 1 to 240 days) . Streptococci was the most frequently identified causative organism, present in 61% of the cases . Gram-negative bacilli were isolated from six patients (11%) . Fourteen patients (25%) required cardiac surgery; the most common condition leading to surgery was severe valvular insufficiency, followed by congestive heart failure and recurrent embolism . Eighty-two percent of the patients in the series survived . The leading causes of death were congestive heart failure and cerebrovascular accidents. Am J Clin Pathol, 1990 Feb, 93(2), 270 - 2 Clinical relevance of viridans and nonhemolytic streptococci isolated from blood and cerebrospinal fluid in a pediatric population; Hamoudi AC et al.; Laboratory records were reviewed to assess the clinical relevance of isolating viridans (VS) and nonhemolytic (NHS) streptococci from blood and cerebrospinal fluid (CSF) specimens in a pediatric setting . During a nine-month period, 722 of 6,569 blood cultures and 113 of 2,023 CSF cultures were positive for one or more organisms . There were 26 VS and 10 NHS blood isolates from 30 patients and five NHS isolates from the CSF of five additional patients . The patients ranged in age from five weeks to 16 years . The charts of 34 patients were reviewed for evidence of sepsis or meningitis and the physician's response to the positive cultures . Three patients had subacute bacterial endocarditis (SBE) with multiple positive blood cultures . All other patients, including six oncology patients, failed to show a positive correlation between the isolation of VS or NHS and the disease process . Speciation and MIC testing were performed on 13 isolates, including those from all SBE and four oncology patients . Because of the lack of significance of VS and NHS from blood and CSF specimens in patients other than those with SBE, the authors conclude that extensive microbiologic workup of VS and NHS is not necessary without appropriate clinical indications such as SBE or immunosuppression. Cell Immunol, 1990 Feb, 125(2), 526 - 34 M protein deficient streptococcal cell walls can induce acute and chronic arthritis rats; DeJoy SQ et al.; Cell walls from M+ and M- protein variants of group A streptococci were examined for their arthritogenicity in female Lewis rats . Intraperitoneal administration of both of these sonicated cell wall preparations caused a severe acute and chronic arthritis in recipient rats . Histological evaluation of the hind paw of these rats indicated synovial lining hyperplasia, cell infiltration in the subsynovial space, pannus formation, and erosions of bone and cartilage . Joint pathology was similar in the hind paws of rats immunized with cell walls prepared from either the M+ or the M- protein variants . Cell-mediated immunity was also similar when lymph nodes were exposed to cell walls derived from these two preparations . A recombinant M6 protein from streptococci did not elicit a proliferative response from lymph nodes prepared from arthritic rats . These observations indicate that the M protein that has previously been implicated in auto-immunity does not have a critical role in the pathogenesis of streptococcal cell wall arthritis in rats. Zh Mikrobiol Epidemiol Immunobiol, 1990 Feb, (2), 10 - 3 {The morphology of microcolonies as a criterion for recognizing bacteria in the differentiation of Streptococcus pyogenes and Streptococcus group B}; Khadzhiev S et al.; The authors studied the diagnostic importance of the morphology of microcolonies of S . pyogenes and group B streptococci in comparison with the currently used tests for the differentiation of these two species: the bacitracin test, the hydrolysis of sodium hippurate and the CAMP test . The standard tests proved to be positive in 94-97% and microcolonies had typical morphology in 86-95.7% . The statistical indices of the diagnostic effectiveness of differential tests varied within 93.8-98.9% . The diagnostic value of the study of the morphology of colonies was characterized by the following data: the sensitivity and prognostic negative value of the study were 95% for S . pyogenes and 86-89% for group B streptococci, while its specificity and prognostic positive value were 100% due to the absence of false positive results. Biull Eksp Biol Med, 1990 Feb, 109(2), 167 - 9 {Group A streptococcal polysaccharide--stimulator of nonspecific cytotoxic reaction in autologous system of spleen cells}; Gnezditskaia EV et al.; p4 was shown the ability of group A streptococcal polysaccharide (A-PS) to stimulate nonspecific cytotoxic effect of spleen cells on autologous adherent cells (macrophages) . The stimulating effect can be observed in vivo under the treatment of spleen cells with A-PS and any antigen (BSA, PPD, M-protein of group A streptococci) . In the presence of antigen A-PS can induce nonspecific cytotoxic effect of normal spleen cells (mice CBA, BaLB/c) and of the mice with DHT and therefore these two immunologic phenomena do not depend on each other . Because A-PS has cross-reactive (CR) determinant with thymus epithelial antigen (factor), it can be assumed that via the CR determinant A-PS links with T-cells receptor for this thymus factor and thus realized the stimulating effect as it's functional analogue. FEMS Microbiol Lett, 1990 Feb, 55(3), 257 - 60 Proteolytic activity of oral streptococci; Homer KA et al.; Streptococcus mutans and Streptococcus sobrinus were the least proteolytic of 8 species of oral streptococci while Streptococcus oralis and Streptococcus sanguis were the most proteolytic . Degradation of FITC-BSA was significantly correlated with the hydrolysis of synthetic endopeptidase substrates . As S . oralis strains proliferate in dental plaque in the absence of dietary food their success, in vivo, might be due partially to their greater proteolytic activity compared to other oral streptococci. Isr J Med Sci, 1990 Feb, 26(2), 71 - 3 Epidemiology of group B streptococci colonization and disease in mothers and infants: update of ongoing 10-year Jerusalem study; Eidelman AI et al.; A study in 1984 of the colonization rates of Group B beta hemolytic streptococci (GBS) in 257 Jewish and 189 Arab parturient women revealed rates of 5.4 and 1.6% respectively . In 1987, a study of 116 Jewish women noted a rte of 3.5% . GBS colonization rates in the newborns of the three groups were 1.8, 1.3 and 1.1% respectively . No statistically significant differences were noted between any of the maternal or neonatal groups . A review of the period 1982-87 revealed a GBS neonatal sepsis attack rate of 0.2/1,000 live births . These data confirm the persistent low incidence of GBS colonization and disease in the Jerusalem area. Pediatr Infect Dis J, 1990 Feb, 9(2), 97 - 100 An outbreak of acute rheumatic fever in Tennessee; Westlake RM et al.; From January, 1987, until July, 1988, a significant increase in newly diagnosed cases of acute rheumatic fever was noted at our hospital . In sharp contrast to the 3 cases seen in 1986, 14 cases were diagnosed in 1987 (a significant increase from 1985 to 1986, P = 0.001) . In the first 6 months of 1988 an additional 12 new cases were diagnosed (a further significant increase from 1987, P = 0.02) . No further cases were diagnosed between July, 1988, and September, 1989 . The major clinical manifestations were carditis in 73%, polyarthritis in 58% and chorea in 31% . In 15 of 26 patients an antecedent illness which included pharyngitis was noted; the remainder of patients were asymptomatic . Group A beta-hemolytic streptococci were isolated from 13 of 19 children cultured . Isolates from two patients with acute rheumatic fever were submitted for M typing: one isolate was mucoid M18/T18; the other isolate was a mucoid nontypable strain . The demographic characteristics of the 26 patients agree with classic descriptions in that patients were more likely to be urban, to come from large families and to have low incomes; racial breakdown of the group mirrored the Tennessee pediatric population . These characteristics stand in contrast to reports of recent outbreaks which describe suburban high income patients . These data suggest that practitioners should be again aware of acute rheumatic fever and that aggressive identification and treatment of streptococcal pharyngitis should continue to be a relevant public health concern. J Clin Microbiol, 1990 Feb, 28(2), 336 - 9 Direct detection of group B streptococci from vaginal specimens compared with quantitative culture; Kontnick CM et al.; Determination of prenatal vaginal carriage of group B streptococci (GBS) is important in the management of newborns . A pronase extraction-latex particle agglutination method (Streptex; Wellcome Diagnostics, Dartford, England) was used to rapidly detect GBS species-specific antigen directly from vaginal specimens . It was compared with quantitative and broth enrichment cultures . A total of 434 vaginal swab specimens were obtained before delivery . GBS cultures were positive for 14.7% of the specimens (64 of 434) . Colony counts ranged from 2 to greater than 10(6) CFU per swab . The sensitivities of the direct antigen analysis were 19% (12 of 64) for all cultures and 63% (12 of 19) for specimens heavily colonized with GBS (greater than 10(4) CFU per swab) . The specificity of the antigen test was 99.7%, with only one false-positive . There were three false-negative tests with colony counts of greater than 10(6) CFU per swab . The predictive values were 92% for a positive antigen test and 88% for a negative antigen test . The direct immunochemical detection of GBS antigen can be useful in a population of heavily colonized women . Direct latex particle agglutination does not appear to be salutary for a lightly colonized population and does not appear to be able to replace either culture or antigen detection after growth amplification at this time. J Bacteriol, 1990 Feb, 172(2), 727 - 34 Presence of chromosomal elements resembling the composite structure Tn3701 in streptococci; Le Bouguenec C et al.; Tn3701, carried by Streptococcus pyogenes A454, is the first chromosomal composite element to be described; it contains in its central region Tn3703, a transposon similar to Tn916 . A comparison by DNA-DNA hybridization of Tn3701 with omega(cat-tet) and Tn3951, carried by Streptococcus pneumoniae BM6001 and by Streptococcus agalactiae B109, respectively, revealed that the two latter structures are also Tn3701-like composite elements . The DNAs of 27 other antibiotic-resistant group A, B, C, and G streptococci and of S . pneumoniae BM4200 showed sequence homologies to Tn3701 (14 strains, including BM4200), to the regions of Tn3701 outside of Tn3703 (5 strains), and to Tn916 alone (8 strains) . The DNAs of five strains did not detectably hybridize with any probe . The tetM gene was identified in most chromosomal genetic elements coding for tetracycline-minocycline resistance . Since Tn3701-like elements are widely disseminated among antibiotic-resistant streptococci (47% of the 34 strains studied), we propose that Tn3701 be considered the prototype of chromosomal composite elements. Infect Immun, 1990 Feb, 58(2), 515 - 22 Phenotypic characterization of Streptococcus sanguis virulence factors associated with bacterial endocarditis; Herzberg MC et al.; Certain strains of Streptococcus sanguis adhere (Adh+) selectively to human platelets and, in plasma, induce them to aggregate (Agg+) into in vitro thrombi . In this study, we examined 18 recent endocarditis and dental plaque isolates of microorganisms that were biotyped as S . sanguis for coexpression of platelet interactivity phenotypes with another possible virulence factor in bacterial endocarditis, dextran synthesis . Detectable production of extracellular glucosyltransferase ranged from 0.2 to 66 mU/mg of culture fluid for 10 representative strains tested . Production of extracellular or cell-associated glucosyltransferase, fructosyltransferase, and soluble or insoluble dextrans was not necessarily coexpressed with platelet interactivity phenotypes, since the levels of production of soluble and insoluble dextrans varied among representative Adh+ Agg+ and Adh- Agg- strains . Analysis of a second panel of 38 fresh dental plaque isolates showed that S . sanguis distributes in a reproducible manner into the possible phenotype groups . Strains with different platelet interactivity phenotypes were distinguished with a panel of four murine monoclonal antibodies (MAbs) raised against Adh+ Agg+ strain 133-79 and screened to rule out artifactual reactions with antigenic components in culture media . The MAbs reacted selectively with Adh+ Agg+ strains in a direct-binding, whole-cell, enzyme-linked immunosorbent assay and also inhibited their interactions with platelets . Analysis of minimal tryptic digests of many strains, including variants that failed to bind the MAbs, suggested that some noninteractivity phenotypes possess cryptic surface determinants . Since the ability to adhere to platelets and induce them to aggregate is relatively stable, these traits may be useful in a phenotyping scheme for these Lancefield nontypeable streptococci. Pediatr Dent, 1990 Feb, 12(1), 20 - 3 Class II glass ionomer/silver cermet restorations and their effect on interproximal growth of mutans streptococci; Berg JH et al.; The release of fluoride from glass ionomer materials is one of the most important features of this newly implemented material, and the remineralization effects of this phenomenon have been documented (Hicks and Silverstone 1986) . This paper examines the effects of glass ionomer/silver cermet restorations on the plaque levels of interproximal mutans streptococci . Fifteen patients with Class II lesions in primary molars were selected for study . Interproximal plaque samples were obtained from each of the lesion sites and from one caries-free site approximal to a primary molar . One lesion was restored with composite resin to serve as a treated control to the glass ionomer/silver cermet (Ketac Silver, ESPE/Premier Sales Corp., Norristown, Pennsylvania) test site . A sound (unaltered) interproximal site served as the untreated control site . Plaque samples were collected before and at one week, one month, and three months post-treatment . Samples were serially diluted to enable colony counts of mutans streptococci . One week post-treatment counts showed that the glass ionomer/silver cermet restorations significantly reduced (P less than 0.05) the approximal plaque levels of mutans streptococci . Conversely, the untreated and treated control sites did not exhibit reductions in approximal plaque levels of mutans streptococci . These results indicate that glass ionomer restorations may be inhibitory to the growth of mutans streptococci in dental plaque approximal to this restorative material in the primary dentition. Arch Dis Child, 1990 Feb, 65(2), 207 - 11 Neonatal pneumonia; Webber S et al.; All babies admitted to the neonatal unit during a period of 41 months were prospectively studied to find out the incidence, aetiology, and outcome of neonatal pneumonia, and the value of routine cultures of endotracheal tubes . Pneumonia of early onset (before age 48 hours) occurred in 35 babies (incidence 1.79/1000 live births) . In 20 (57%) it was caused by group B streptococci . Blood cultures showed the presence of organisms in 16 of the 35 (46%) . There were 41 episodes of pneumonia of late onset in 39 babies . Thirty six of the 39 were preterm, and 34 were artificially ventilated (10% of all ventilated babies) . Endotracheal tube colonisation had occurred in 94% of these, most commonly by Gram negative organisms and Staphylococcus epidermidis . In only one of seven cases with simultaneous bacteraemia was the same organism grown from cultures of the blood . After controlling for gestational age and duration of artificial ventilation there was no difference in the incidence or timing of endotracheal tube colonisation between babies who did and did not have pneumonia of late onset . Ten babies with pneumonia of early onset (29%) died; all were preterm infants . Only one death (2%) was associated with an episode of pneumonia of late onset . Routine surveillance cultures were not helpful in predicting and managing pneumonia of late onset. J R Soc Health, 1990 Feb, 110(1), 15 - 6, 19 Rheumatic heart disease in schoolchildren in western district, Saudi Arabia; al-Sekait MA et al.; The prevalence of rheumatic heart disease was assessed among schoolchildren aged between 6-15 years in the Western District . A sample size of 9,418 (10% of the target population) underwent cardiac evaluation . The prevalence of rheumatic heart disease was 24 per 10,000 schoolchildren (6-15 years) . The prevalence was higher in rural areas and in females . This survey revealed that the carrier rate of beta-hemolytic streptococci was 34%. J Dent Res, 1990 Feb, 69(2), 477 - 82 Characterization of monoclonal antibodies against glucosyltransferase synthesizing water-insoluble glucan from Streptococcus sobrinus B13; Ochiai K et al.; Four hybrid cell lines secreting monoclonal antibodies (McAbs) against glucosyltransferase synthesizing water-insoluble glucan (GTase-I) were generated by fusion of myeloma cells (P3U1) with splenocytes from mice immunized with GTase-I from Streptococcus sobrinus B13-N . Cell lines 29E7, 21GC7, and 42HB8 were found to secrete an IgG2a-type immunoglobulin, and 29EG, an IgM-type immunoglobulin . These two isotypes of McAbs were used for the determination of the binding sites on the GTase molecule, with use of an enzyme-linked immunosorbent assay . The binding site for McAb 29EG was different from the site that bound other McAbs . McAb 29EG was found to inhibit water-insoluble glucan synthesis by GTase-I by 50%, and 29E7 was found to inhibit it weakly . However, other McAbs did not show any inhibitory effect in spite of binding to GTase-I . McAb 42HB8 strongly inhibited GTase-I-mediated adherence of heat-killed cells of S . sobrinus B-13N to glass surfaces . When the McAbs were tested for their cross-reactivity among GTase preparations from different mutans streptococci, McAb 29EG reacted with S . cricetus and S . sobrinus, but not with other mutans streptococci . Three other McAbs, 21GC7, 29E7, and 42HB8, were found to react only with the enzyme from S . sobrinus . These findings indicated that the specificity of the McAbs studied varied with respect to the antigenic sites on the GTase-I molecule, and that some of the sites differed in their functions. Med Clin (Barc), 1990 Jan 13, 94(1), 12 - 4 {Antibiotic sensitivity of strains of group A beta-hemolytic streptococci isolated recently}; Alos JI et al.; The present study investigated the sensitivity of 35 group A beta-hemolytic streptococci strains, isolated from clinical samples in 1988 and 1989, to 12 antibiotics . The minimal inhibitory concentrations of each antibiotic were measured by the agar dilution method . All strains were sensitive to penicillin G, ampicillin, oxacillin, cefazolin, cefotaxime, erythromycin, clindamycin, vancomycin and ciprofloxacin . It was concluded that, in our area, Streptococcus pyogenes still has an excellent sensitivity to penicillin G and to other antibiotics which may be a therapeutic alternative in allergic patients or an empiric treatment in infections likely to be produced, among other organisms, by S . pyogenes. Tidsskr Nor Laegeforen, 1990 Jan 10, 110(1), 50 - 3 {Sore throat . Rapid detection of beta hemolytic group A streptococci by a coagglutination method}; Holte M et al.; In Norway anually half a million consultations are for acute sore throat . The clinical differentiation between streptococcal and non-streptococcal infection remains poor . A reliable diagnosis of beta-hemolytic streptococcal infections requires a screening test . In a multicenter study from general practice the rapid test Phadirect Strep A was compared with cultivation at two microbiological laboratories . 257 patients were included and the prevalence of beta-hemolytic streptococci was 41.6% . The results of valid calculations were: Sensitivity 70-77%; Specificity 86-89%; Positive predictive value 74-82%; Negative predictive value 81-88% . The results were considered in relation to body temperature and signs of local infection in the throat . There was no correlation between clinical signs and occurrence of beta-hemolytic streptococci . The Phadirect Strep A test was acceptably sensitive and specific for use in general practice . The test is easy to perform, and the results are available after five minutes . The test seems to be useful, and is an improvement in the daily management of patients with acute throat infections, especially in relation to the question of whether or not to prescribe antibiotics. Biochemistry, 1990 Jan 9, 29(1), 234 - 48 Complete structure of the polysaccharide from Streptococcus sanguis J22; Abeygunawardana C et al.; The cell wall polysaccharides of certain oral streptococci such as Streptococcus sanguis strains 34 and J22, although immunologically distinct, act as receptors for the fimbrial lectins of Actinomyces viscosus T14V . We report the complete covalent structure of the polysaccharide from S . sanguis J22 which is composed of a heptasaccharide subunit linked by phosphodiester bonds . The repeating subunit, which contains alpha-GalNAc, alpha-rhamnose, beta-rhamnose, beta-glucose, and beta-galactose all in the pyranoside form and beta-galactofuranose, is compared with the previously published structure of the polysaccharide from strain 34 . The structure has been determined almost exclusively by high-resolution nuclear magnetic resonance methods . The 1H and 13C NMR spectra of the polysaccharides from both strains 34 and J22 have been completely assigned . The stereochemistry of pyranosides was assigned from JH-H values determined from phase-sensitive COSY spectra, and acetamido sugars were assigned by correlation of the resonances of the amide 1H with the sugar ring protons . The 13C spectra were assigned by 1H-detected multiple-quantum correlation (HMQC) spectra, and the assignments were confirmed by 1H-detected multiple-bond correlation (HMBC) spectra . The positions of the glycosidic linkages were assigned by detection of three-bond 1H-13C correlation across the glycosidic linkage in the HMBC spectra . The positions of the phosphodiester linkages were determined by splittings observed in the 13C resonances due to 31P coupling and also by 1H-detected 31P correlation spectroscopy. Eur J Pediatr, 1990 Jan, 149(4), 256 - 8 Evaluation of two ELISA tests for the rapid detection of group A streptococci; Egger P et al.; We examined 579 oropharyngeal swab specimens from children presenting with pharyngitis in order to compare two rapid diagnostic ELISA tests for group A streptococcal antigen: the TestPack Strep A (TPSA), and the Direct Strep A EIA (DSAE), with an anaerobically incubated sheep blood agar culture . The sensitivities of the methods were respectively 60.8% (TPSA) and 64.4% (DSAE), the specificities 98.3% (TPSA) and 93.2% (DSAE), the positive predictive values 88.6% (TPSA) and 70.3% (DSAE) and the negative predictive values 92.0% (TPSA) and 91.2% (DSAE) . We conclude that the TPSA is easy to interpret and is sufficiently specific to initiate treatment in patients with a positive test . It is not sufficiently sensitive to ensure negative or intermediate results . The performance of the DSAE test is similar but the specificity is slightly lower and more false positive results occur. Rev Infect Dis, 1990 Jan-Feb, 12(1), 112 - 7 Treatment of endocarditis caused by relatively resistant nonenterococcal streptococci: is penicillin enough? DiNubile MJ. Most cases of endocarditis are caused by nonenterococcal streptococci . Some of these organisms are classified as relatively resistant to penicillin on the basis of minimum inhibitory concentrations (MICs) greater than 0.1-0.2 microgram/mL . Almost all authorities recommend that endocarditis caused by relatively resistant streptococci be treated with high doses of penicillin combined with 2-6 weeks of an aminoglycoside rather than the potentially shorter, less toxic, and more flexible regimens used for exquisitely sensitive streptococci (MIC, less than 0.1-0.2 microgram of penicillin/mL) . The data to support this recommendation are limited and inconclusive . We review the relevant clinical experience, experimental models, and theoretical considerations . Penicillin alone is probably adequate therapy for most cases of native valve endocarditis caused by relatively resistant streptococci; in certain patients, it may be the preferred treatment. J Clin Microbiol, 1990 Jan, 28(1), 5 - 7 Antibiotic resistance patterns of group B streptococci in pregnant women; Berkowitz K et al.; This study examined the antibiotic resistance patterns of group B streptococci (GBS) isolated from gravid women . A total of 156 vaginal and cervical isolates of GBS were examined for resistance to penicillin, ampicillin, clindamycin, cefoxitin, gentamicin, and erythromicin . No resistance to penicillin or ampicillin was found, nor was penicillinase production demonstrated . A high level of resistance to gentamicin was noted (91%) . Of the isolates examined, 9, 9.5, and 15.3% exhibited either resistance or intermediate susceptibility to erythromycin, clindamycin, and cefoxitin, respectively . Thirty strains (19%) exhibited a multiple antibiotic resistance pattern . Given the high penicillin and ampicillin treatment failure rates when attempting to eradicate vaginal GBS colonization and our findings of higher and multiple drug resistance patterns of GBS, the selection of an alternative antibiotic regimen is of considerable clinical importance . We recommend that routine reporting of GBS susceptibilities by clinical laboratories be adopted. Ann Fr Anesth Reanim, 1990, 9(3), 269 - 74 {Infections of soft tissues by bacterial synergism}; Fichelle A et al.; The treatment of synergistic bacterial soft tissue infections includes usually surgical debridements and radical excisions of necrotic tissues, antibiotic therapy and volumic resuscitation . Hyperbaric oxygen therapy did not prove efficient in these plurimicrobial infections . Their severity is due to virulence synergy of aerobic and anaerobic micro organisms in the involved areas . Sixty patients were admitted in the Surgical Intensive Care Unit (december 1980-march 1989) for severe synergistic soft tissue infections . From 1980 to the end of 1983 the initial surgical treatment was extensive with wide excisions . The antibiotic therapy was selected primarily against anaerobes and gram negative rods . Since 1984 antibiotic therapy was changed to take into account all the micro-organisms found in the initial cultures, especially encountered streptococci species (43 times/60 patients) . Initial surgery, after fluid resuscitation and antibiotic therapy, included debridements, colostomy in case of perineal lesion and excisions limited to the really necrotic areas . Under antibiotic therapy according to the bacteriological results, surgical management was performed daily during the first week, later when required . In these series, 14 patients died (23.3%) . The mortality during the first period (1980-1983) was high: 7/2 (31.8%) and decreased to 7/38 (18.4%) in the second period (1984-1989) . Cellulitis is potentially a highly lethal infection . Early recognition as well as adequate medical and surgical management may be lifesaving. Ter Arkh, 1990, 62(3), 30 - 4 {The etiology of acute pneumonias in middle-aged and elderly persons}; Nonikov VE et al.; As many as 356 patients afflicted with acute pneumonias (of these, 225 were from 60 to over years of age) underwent examinations according to the program including bacteriological analysis of the mucus and detection of antigens and specific antibodies in the blood serum . The etiology of acute pneumonia was established in 346 patients (97.2%) . In the etiological structure of acute pneumonia, there prevailed bacteria, among which pneumococci, streptococci and hemophilic bacilli occurring both in the form of monocultures and as a constituent part of associations were mostly demonstrable . Acute pneumonias caused by Legionella, Klebsiella and staphylococci were encountered comparatively seldom . The rate of the demonstration of Mycoplasma and viral bacterial associations varied depending on the epidemiological situation . In young persons, acute pneumonias were induced primarily by bacterial monocultures, Mycoplasma, and viral bacterial associations . The latter ones were demonstrated more frequently in persons over 60 . The authors review the information content of the employed diagnostic program for the verification of bacterial monocultures and associations of causative agents . Note that penicillin, tetracyclines and biseptol are less effective in respect of bacterial associations detectable in elderly persons. Caries Res, 1990, 24(3), 198 - 202 In vitro screening of Chinese medicinal toothpastes: their effects on growth and plaque formation of mutans streptococci; Wu-Yuan CD et al.; Many plant extracts or derivatives have been incorporated into commercial toothpastes to treat oral diseases related to caries or periodontal diseases in China . However, no information is available concerning their in vitro effects on oral bacteria . Thirty-one Chinese medicinal toothpastes were selected for this study . Their ability to inhibit growth, in vitro plaque formation and glucosyltransferase (GTF) activity of Streptococcus sobrinus B13 and Streptococcus mutans 3209 were examined . Eighty-seven percent of the tested toothpastes inhibited the growth of the mutans streptococci, with zones ranging from 0.8 to 2.5 cm . At 10 mg/ml, 74% of the toothpastes inhibited in vitro plaque formation by S . mutans . Among these, 60% completely suppressed water-insoluble glucan synthesis from sucrose by GTF . Based on data obtained from our study, the incorporation of natural plant products or their derivatives into dentifrices seems a feasible means of promoting oral health and controlling dental diseases. Indian J Med Res, 1990 Jan, 91, 21 - 3 Etiology of liver abscess with special reference to anaerobic bacteria; Gupta U et al.; Specimens of pus from 78 patients with liver abscesses were cultured using anaerobic culture techniques in an attempt to ascertain the etiologic role of anaerobes . Bacteria were isolated from 28 of the 78 specimens, 9 with anaerobes and or microaerophilic streptococci . Two pus specimens yielded mixed growth . Fourteen liver abscess pus specimens were subjected to direct gas liquid chromatography for detection of volatile and nonvolatile fatty acids (VFA/NVFA) . Two of the 3 specimens positive for multiple VFA were bacteriologically sterile--an indirect evidence of the presence of anaerobic bacteria at the site of infection bringing the number of patients with anaerobic infection to 11 (14.1%). Arch Oral Biol, 1990, 35(2), 163 - 6 In vivo dental plaque-forming ability and cariogenicity of the bacterium Streptococcus bovis in gnotobiotic rats; Willcox MD et al.; Germ-free Fisher rats, fed on a high sucrose diet, were monoinfected with Streptococcus bovis strains . High levels of fissure caries were formed by three strains; one strain produced moderate levels; another produced only very low levels . No strain could produce approximal or buccal/lingual lesions . All strains could colonize the fissures of teeth in the lower jaw, as shown by scanning electron microscopy . The most cariogenic strains were associated with caries scores similar to those of Strep . salivarius and members of the mutants streptococci. NCI Monogr, 1990, (9), 117 - 22 Combination and single-agent empirical antibacterial therapy for febrile cancer patients with neutropenia and mucositis; Shenep JL; The role of mucositis in infectious complications in the patient with cancer is poorly understood . Consequently, neither the presence nor the severity of mucositis is routinely considered in the selection of specific antibacterial agents for the initial empirical therapy of the febrile cancer patient . In a study of children receiving remission induction chemotherapy for acute nonlymphocytic leukemia, the number of febrile days correlated more closely with the degree of mucositis than with the number of days of neutropenia . Oral mucositis appears to predispose cancer patients to systemic infections with alpha-hemolytic streptococci, Capnocytophaga, and Candida species . Overall, studies of single-drug versus combination therapy for the initial empirical therapy of febrile, neutropenic cancer patients indicate that monotherapy approaches the efficacy of combination therapy, although combination therapy may be preferred for certain cohorts of cancer patients . A concern that is closely related to the issue of combination therapy versus monotherapy is the need for vancomycin in the initial empirical regi