Streptococci

J Ophthalmic Nurs Technol, 1990 May-Jun, 9(3), 106 - 9
Periorbital cellulitis in infancy; Molarte AB et al.; To our knowledge, no previous study of periorbital cellulitis has focused on its specific characteristics found only in infants (less than 1 year of age.) We retrospectively studied 30 cases of infantile periorbital cellulitis treated at Harbor-UCLA Medical Center from 1977 to 1988 . Characteristics of the disorder in our infants older than 1 month were similar to earlier reports of older children in terms of etiology, radiological and bacteriological findings, and course . However, compared with our older infants, our seven neonates (7 to 30 days old) had a higher incidence of ruptured dacryocele (29% vs 0%) and unknown source of the infection (43% vs 4%); but a lower incidence of preceding upper respiratory infection (14% vs 78%), abnormal sinus films (0% vs 22%), and positive blood cultures (14% vs 30%) . Of the positive cultures, Hemophilus sp was the most common pathogen among the older infants (35%), while Streptococcus and Staphylococcus were the most frequent among the neonates (71%) . All infections remained preseptal and responded well to intravenous antibiotics.

Pediatr Neurol, 1990 May-Jun, 6(3), 209 - 10
Cranial nerve palsies in Streptococcus pneumoniae meningitis; Chu ML et al.; Cranial nerve palsies are uncommon in nontuberculous bacterial meningitis . We report a patient with Streptococcus pneumoniae meningitis, multiple cranial nerve involvement, and cerebellar signs suggestive of basilar meningitis . Nontuberculous bacterial meningitis should be considered in the differential diagnosis of basilar meningitis.

Antonie Van Leeuwenhoek, 1990 May, 57(4), 245 - 52
Involvement of human mucous saliva and salivary mucins in the aggregation of the oral bacteria Streptococcus sanguis, Streptococcus oralis, and Streptococcus rattus; Koop HM et al.; The contribution of human parotid (Par) and submandibular/sublingual (SM/SL) saliva and of the human whole salivary mucin fraction (HWSM) to saliva-induced bacterial aggregation was studied for S . sanguis C476, S . oralis I581, and S . rattus HG 59 . The mucous SM/SL saliva showed a much higher aggregation potency towards the S . sanguis and S . oralis strain than did the serous Par saliva . The SM/SL saliva-induced aggregation was observed after 30 min, at 60 min followed by the Par saliva-induced aggregation, and showed a 4-fold higher aggregation titer of 128 for S . sanguis, and an 8-fold higher titer of 516 for S . oralis . In contrast, the Par saliva showed a slightly higher aggregation activity than the SM/SL saliva towards S . rattus as judged by a twofold higher titer of 64 . Morphologically, however, the SM/SL saliva-induced aggregation of S . rattus was far more pronounced as was also found for S . sanguis . Finally, the HWSM-induced aggregation showed a 4 to 8-fold higher titer than the originating salivary source, measuring 2048 for S . oralis and 128 for S . rattus . Moreover, no difference was observed in aggregation activity between the HWSM from whole saliva of a blood group O donor and the HWSM from SM/SL saliva of a blood group A donor . All the data point to an important, though not exclusive role of the human salivary mucin fraction in the saliva-induced aggregation of these strains.

Pediatr Res, 1990 May, 27(5), 514 - 8
Deficiencies in opsonic defense to pneumococci in the human newborn despite adequate levels of complement and specific IgG antibodies; Geelen SP et al.; We studied the major determinants of opsonophagocytosis against Streptococcus pneumoniae serotypes 14 and 19 in paired cord/maternal sera from 27 healthy term and 24 preterm infants in an attempt to gain more insight in the susceptibility of newborns to pneumococcal infection . For both pneumococcal serotypes studied, opsonic activity in neonatal sera varied greatly, but was moderately to profoundly deficient when compared to paired maternal sera, both in preterm (34.5 and 34.9% of the activity in maternal serum, for serotypes 14 and 19, respectively, p less than 0.001 for both) and in term serum (43.5 and 52.7% of the activity in maternal serum, for serotypes 14 and 19, respectively, p less than 0.001 for both) . The opsonic deficiency in preterm sera could be ascribed to a diminished level of the major opsonins for pneumococci, i.e . complement factor C3 deposited on the bacterial surface (69.5 and 66.2% of C3 deposition in maternal serum on serotypes 14 and 19, respectively, p less than 0.01 for both) and specific anticapsular IgG antibodies (48.5 and 14.1% of maternal levels for serotypes 14 and 19, respectively, p less than 0.001 for both) . However, the opsonic defect in serum from term infants could not be explained in a similar way, because C3 deposition and specific anticapsular IgG levels were equal to the values found in the paired maternal sera . Therefore, we conclude that the opsonic defect in newborn serum for pneumococci cannot be solely explained by a deficiency in the major opsonins for these bacteria . A dysfunction in these opsonins seems to be a more likely explanation for the observed opsonic defect in the neonate.

Mutat Res, 1990 May, 235(3), 195 - 201
Excision-repair capacity in Streptococcus pneumoniae: cloning and expression of a uvr-like gene; Sicard N et al.; Although deficient in photoreactivation and some SOS-like functions, Streptococcus pneumoniae has the capacity to carry out excision repair when exposed to UV light . The repair ability and sensitivity to UV irradiation or treatment with chemical agents in the wild type and a UV-sensitive mutant strain indicate that UV-induced pyrimidine dimers might be repaired in pneumococcus by a system similar to the uvr-dependent system in Escherichia coli . A gene complementing the mutation conferring UV sensitivity of the mutant strain has been cloned . The coding region directs the synthesis of a polypeptide with a molecular weight of 78 kDa . The relationship with uvr-like protein in E . coli is discussed.

Ann Thorac Surg, 1990 May, 49(5), 706 - 11; discussion 712-3
Valve repair in acute endocarditis; Dreyfus G et al.; Forty patients were operated on in the early phase of active endocarditis between 1980 and 1988 . Indications for operation were heart failure (30 patients), severe valvular regurgitation (4), uncontrolled sepsis (2), septic emboli (3), and other (1 patient) . Time between onset of endocarditis symptoms and operation ranged from 12 to 45 days (mean, 30 days) . The aortic valve was involved in 3 patients; the mitral valve, in 28; both valves, in 7; and the tricuspid valve, in 2 . There was no previous underlying valve pathology in 40% . Lesions found were cusp perforation (17 patients), annular abscess (4), vegetation (13), and chordal rupture (22) . Positive blood cultures were found in 30 patients (75%) . Bacterial findings were Streptococcus in 12 patients (30%), Staphylococcus in 15 (37.5%), gram-negative in 3 (7.5%), and unknown in 10 (25%) . Criteria to perform valve repair were adequate antibiotic therapy for at least 1 week and large excision of all macroscopically involved tissues . In all cases, Carpentier's reconstructive techniques were used . Perioperative mortality was 2.5% (1 patient) . Reoperation was necessary in 1 patient . Late mortality was 2.5% (1 patient) . Repair was assessed either by angiography or by Doppler echocardiography before hospital discharge: 32 patients showed no regurgitation, whereas 7 had mild regurgitation (3 aortic, 4 mitral) . Mean follow-up of 30 months was achieved in all survivors . There was no recurrence of endocarditis and no reoperation for valvular insufficiency . We conclude that valve repair in acute endocarditis is possible and effective in most instances.

Ann Thorac Surg, 1990 May, 49(5), 701 - 5; discussion 712-3
Heart valve operations in patients with active infective endocarditis; David TE et al.; Sixty-two consecutive patients underwent heart valve operation for active infective endocarditis . There were 42 men and 20 women whose mean age was 49 years (range, 21 to 79 years) . The infection was in the aortic valve in 37 patients, the mitral valve in 18, the aortic and mitral valves in 5, and the tricuspid valve in 2 . Twenty-four patients had prosthetic valve endocarditis . Staphylococcus and Streptococcus were responsible for 86% of the infections . Annular abscess was encountered in 33 patients . Complex valve procedures involving reconstruction of the left ventricular inflow or outflow tract or both were performed in 31 patients . There were three operative deaths (4.8%) . Predictors of operative mortality were prosthetic valve endocarditis, preoperative shock, and annular abscess . Patients were followed for 1 month to 130 months (mean follow-up, 43 months) . Only 1 patient required reoperation for persistent infection . There were ten late deaths . Most survivors (96%) are currently in New York Heart Association class I or II . The 5-year actuarial survival was 79% +/- 7% . These data demonstrate excellent results in patients with native valve endocarditis, and support the premise that patients with prosthetic valve endocarditis should have early surgical intervention.

J Dent Res, 1990 May, 69(5), 1154 - 9
Caries incidence in intact rats infected with Streptococcus sobrinus via transmission from desalivated cagemates; Madison KM et al.; The purpose of this study was to determine the influence of caging desalivated S . sobrinus-infected rats on the caries incidence in intact, previously uninfected cagemates . Weanlings were divided as follows: Stage I: Twenty desalivated animals paired with 20 intact animals (Group I); 20 intact animals paired with 20 intact animals (Group II) . Animals were infected with S . sobrinus and fed diet 2000 and 10% sucrose water . After five weeks, ten paired animals from each group were killed . Desalivated animals had statistically higher (p less than 0.05) caries scores than did other animals . Stage II: The remaining Stage I infected animals from Groups I and II were paired with 40 new uninfected animals 15 days of age and fed cariogenic diets . After five weeks, new intact animals paired with Stage I desalivated animals had significantly higher smooth-surface enamel caries scores (38.0; SE 7.84) than new intact animals paired with Stage I intact animals (11.15; SE 3.69) . Moreover, new intact animals caged for only five weeks with Stage I desalivated animals developed smooth-surface caries (38.0; SE 7.84) to a degree comparable with that in all Stage I intact animals in the experiment for ten weeks (36.6, SE 9.5; and 30.05, SE 4.1) . The data suggest that desalivation may select a readily transmissible strain of S . sobrinus, which demonstrates enhanced virulence.

Infect Immun, 1990 May, 58(5), 1479 - 80
Evidence that a low-affinity sucrose phosphotransferase activity in Streptococcus mutans GS-5 is a high-affinity trehalose uptake system; Poy F et al.; High-affinity sucrose uptake in the oral pathogen Streptococcus mutans is mediated by the phosphoenolpyruvate-dependent phosphotransferase system . In this report, we provide evidence that a lower-affinity sucrose phosphotransferase system in S . mutans GS-5, previously described by others, is in fact a high-affinity trehalose uptake system that also recognizes sucrose as a substrate.

Infect Immun, 1990 May, 58(5), 1290 - 5
Cloning and expression of the gene encoding the fructose-1,6-diphosphate-dependent L-(+)-lactate dehydrogenase of Streptococcus mutans; Hillman JD et al.; The fructose-1,6-diphosphate-dependent lactate dehydrogenase from Streptococcus mutans JH1000 was purified by a modification of published methods . The sequence of 27 amino-terminal amino acids was determined, which allowed us to construct a 17-base DNA probe that had 32-fold degeneracy . The probe was used to screen a genomic library in pBR322 . Of 18 reactive clones, 1 was found that expressed lactate dehydrogenase (LDH) activity identical to that of S . mutans with regard to dependence on fructose-1,6-diphosphate, thermal inactivation profile, and inhibition by sodium oxamate . Extracts of this clone possessed a protein band that comigrated in sodium dodecyl sulfate-polyacrylamide gel electrophoresis with purified LDH from JH1000 . Compared with controls, the clone was shown to produce elevated amounts of L-(+)-lactic acid during growth in the presence of glucose, thereby indicating that the activity was expressed in vivo . This result was substantiated by demonstrating that the activity could complement a mutation in the fermentative D-(-)-LDH of Escherichia coli . Subcloning showed that the S . mutans LDH subunit is encoded by a 1.2-kilobase gene . Our ability to clone this gene is expected to have great practical significance in the construction of an effector strain for use in the replacement therapy of dental caries.

J Med Assoc Thai, 1990 May, 73(5), 253 - 7
Sensorineural hearing loss in children recovered from purulent meningitis: a study in Thai children at Ramathibodi Hospital; Charuvanij A et al.; Hearing loss is one of the serious complications of bacterial meningitis . Conventional audiometry and auditory brainstem response (ABR) methods were used to detect this complication in eighteen children who recovered from bacterial meningitis treated at Ramathibodi Hospital from January 1983 to December 1987 . Six patients (33%) were found to have persistent bilateral sensorineural hearing loss . Among them, the causes of meningitis were: Hemophilus influenzae (3 patients), Streptococcus pneumoniae (1 patient), Streptococcus agalactiae (1 patient) and Escherichia coli (1 patient) . Various clinical and demographic factors were examined in relation to the hearing loss, but no significant correlation was observed . Since meningitis often affects small children and makes conventional audiometry tests difficult, ABR was found to be a more effective method for testing this group of patients.

Rev Infect Dis, 1990 May-Jun, 12 Suppl 4, S394 - 400
Neonatal susceptibility and immunity to major bacterial pathogens; Ferrieri P; Neonatal bacterial sepsis has continued in this decade to contribute significantly to neonatal mortality and morbidity and is a critical determinant of outcome in infants of very low birth weight despite the availability of antibiotics . The group B Streptococcus and Escherichia coli are the predominant pathogens for the newborn infant . Studies on the epidemiology, microbiology, and immunology of group B streptococcal disease are more extensive than those on E . coli disease . Type-specific antibodies, polymorphonuclear leukocytes, and complement are integral to immunity against group B Streptococcus, and experimental data are presented to support the importance of these components . The newborn infant is handicapped by temporary deficiencies in host defenses, and approaches for restoring immunocompetence, such as immunization of the mother or passive administration of intravenous immunoglobulins or other immune factors, are presented for consideration . Further studies are required to demonstrate the safety, feasibility, and efficacy of these approaches.

Rev Infect Dis, 1990 May-Jun, 12(3), 518 - 9
Bacterial infection as a presenting manifestation of visceral leishmaniasis; Garces JM et al.; Two patients admitted to the hospital because of severe bacterial infection were diagnosed as having visceral leishmaniasis . The types of bacterial infection were perianal abscess and pneumonia; Escherichia coli and Streptococcus pneumoniae were isolated from exudates and blood cultures, respectively . A third patient admitted because of acute necrotizing infection of the pharynx and visceral leishmaniasis is also discussed . Cultures from this patient failed to yield pathogens . Anemia, leukopenia, or thrombocytopenia was present in all patients, and bone marrow aspirate revealed the presence of Leishmania in macrophages . We conclude that in areas where leishmaniasis is endemic, early bone marrow aspirate should, in most instances, be performed in patients with bacterial infection associated with anemia, leukopenia, or thrombocytopenia if hepatomegaly and/or splenomegaly is present.

Rev Infect Dis, 1990 May-Jun, 12(3), 416 - 22
Streptococcus pneumoniae infections of the female genital tract and in the newborn child; Westh H et al.; Streptococcus pneumoniae is not a part of the resident vaginal flora . However, in some women S . pneumoniae can be a transient part of the vaginal flora, and pelvic infection can occur, especially if a predisposing condition exists (e.g., use of an intrauterine contraceptive device, a recent birth, or gynecologic surgery) . In the preantibiotic era, pneumococcal genital infection was more common than today, and the rate of lethality was high--26% for localized infection and 74% for peritonitis . During the last 25 years, all 24 patients reported worldwide survived their pneumococcal genital infections, including nine patients at our hospital; in contrast, five of 12 women died between 1938 and 1952 . Pneumococci can rarely be isolated as the only pathogen in cases of bartholinitis . Neonatal S . pneumoniae disease with an early onset has an intrapartum pathogenesis . Of 23 reported pediatric patients (including one whom we treated), 48% died and 13% survived with neurologic sequelae . The prognosis for these children has not improved during the last 10 years.

Res Vet Sci, 1990 May, 48(3), 306 - 9
Sequestration of N-acetyl-beta-D-glucosaminidase in somatic cells during experimental bovine mastitis induced by endotoxin, Staphylococcus aureus or Streptococcus agalactiae; Kaartinen L et al.; Experimental mastitis was induced in cows by intramammary infusion of endotoxin, Staphylococcus aureus or Streptococcus agalactiae . The inflammatory response was monitored by somatic cell counting and N-acetyl-beta-D-glucosaminidase (NAGase) . NAGase activity was analysed in fresh milk samples in parallel with samples treated by a cycle of freezing and thawing combined with detergent treatment to release the cell-bound NAGase . Before the udder reacted by inflammation, the total NAGase activity consisted of free extracellular activity . Later on when the inflammation was established, much of the milk NAGase remained sequestered intracellularly . S agalactiae was linked with a high degree of cellular NAGase sequestration indicating a blockage of the lysosomal release function from the phagocytes . S aureus delayed the inflammatory response.

J Reprod Med, 1990 May, 35(5), 558 - 60
Group A beta-hemolytic Streptococcus as a cause of toxic shock syndrome . A case report; Whitted RW et al.; Group A beta-hemolytic Streptococcus (pyogenes) has been associated recently with toxic-shock-like syndrome similar to staphylococcal toxic shock as described originally in 1978 . A group A beta-hemolytic streptococcal infection occurred in a recent postpartum patient and clinically resembled staphylococcal toxic shock.

Surg Gynecol Obstet, 1990 May, 170(5), 403 - 6
Percutaneous placement of femoral central venous catheter in patients undergoing transplantation of bone marrow; Lazarus HM et al.; Five patients undergoing transplantation of autologous bone marrow underwent percutaneous placement of a double lumen central venous catheter into the inferior vena cava by way of the femoral vein . All had conditions that precluded access to the superior vena cava or other sites in the upper part of the torso . Patients ranged in age from 18 to 59 years . The double lumen central venous catheter was inserted using aseptic technique in the operating room, and the catheter exit site was dressed using sterile technique every 48 hours afterward . Patients received all irradiated blood product transfusions, intravenous fluids, intravenous antibiotics, parenteral alimentation and autologous bone marrow reinfusion through the catheter . The duration of severe neutropenia (less than 500 neutrophils per microliter) and severe thrombocytopenia (less than 20,000 platelets per microliter) ranged from zero to 24 days (median of 22 days) and five to 20 days (median of 15 days), respectively . Catheters remained in the groin area 23 to 45 days (median of 35 days) . Complications included one catheter-related Streptococcus species infection and one Escherichi coli bacteremia . These infections resolved with the catheter in place after appropriate institution of antibiotics . No episodes of thrombosis, kinking, migration, extravasation of drugs or local infection were noted . Central venous catheters can be safely inserted and maintained in the groin area even in severely immunocompromised patients receiving bone marrow transplants.

Bull Tokyo Dent Coll, 1990 May, 31(2), 155 - 62
A rapid diagnosis of anaerobic infection in the oro-maxillary region by gas-liquid chromatography; Tanaka JI et al.; The relationship between volatile fatty acids (VFAs) in pus and infecting bacterial species was examined in order to establish a rapid identification system for anaerobic microorganisms in purulent inflammation in the oro-maxillary region . VFAs were detected by the direct injection of pus into gas-liquid chromatography (GLC) . Bacterial examination was carried out by anaerobic culture using blood agar plates . The bacterial identification was carried out mainly according to the VPI manual . Analysis of the direct VFA patterns of each sample resulted in 5 groups . The following bacterial species were the main isolates in each group: Streptococcus intermedius in Group A, Peptostreptococcus micros in Group B, Fusobacterium nucleatum in Group C, Bacteroides gingivalis in Group D, and Peptostreptococcus anaerobius in Group E . The profile of VFAs produced in the PYG culture medium of the above isolated bacteria was compared with the direct VFA patterns . Agreement ratios between direct and PYG VFA patterns were as follows: Group A, 47.1%; Groups B and C, 45.0%; Group D, 87.5%; and Group E, 62.9% . The acetic acid concentration was more than 14 x 10(-4) meq/ml in Group B, the butyric acid concentration was more than 7 x 10(-4) meq/ml in Group C, and the iso-caproic acid concentration was more than 14 x 10(-4) meq/ml in Group E . In these cases, it was found that the agreement ratios between the direct and PYG FVA pattern were high . In Group D, irrespective of the concentration of iso-valeric acid detected, the agreement ratio was very high . The antibiotic susceptibility of the isolates was studied . Efficiency rates of ABPC, PIPC, CCL, CEZ, CMZ, SBT/CPZ, JM, CLDM, MINO and GM were relatively low and resistant rates were high for the gram-negative rods.

J Am Acad Dermatol, 1990 May, 22(5 Pt 1), 886 - 92
Use of mupirocin ointment in the treatment of secondarily infected dermatoses; Breneman DL; A double-blind, randomized, vehicle-controlled study was conducted to evaluate the safety and efficacy of 2% mupirocin ointment in the treatment of secondarily infected dermatoses . One hundred six patients were enrolled, 92 of whom were evaluable for efficacy . There was a significantly greater rate of eradication of Staphylococcus aureus and total pathogens in mupirocin-treated patients than in control subjects . Analysis of the clinical data relative to all pathogens showed a significant difference in skin infection evaluations performed at the interim and follow-up visits, which favored the mupirocin-treated groups . In those patients infected with S . aureus or Streptococcus pyogenes, there was a significant difference at end-point that favored mupirocin in seven clinical ratings and the skin infection evaluation at follow-up . Mild local adverse effects were noted in a small percentage of patients in each group . Mupirocin appears to be safe and effective for the treatment of secondarily infected dermatoses, especially in those infections caused by Staphylococcus aureus.

J Am Acad Dermatol, 1990 May, 22(5 Pt 1), 879 - 83
Mupirocin: a new topical antibiotic; Leyden JJ; One hundred fifty-three strains of Staphylococcus aureus recovered from infected eczema frequently demonstrated resistance to multiple antibiotics . Penicillin and ampicillin resistance was extremely frequent (88%), methicillin resistance was found in nearly 14% of strains, and erythromycin and tetracycline resistance was present in 16% . S . aureus strains were uniformly sensitive to vancomycin, mupirocin, and cephalosporins . Experimental infections in human volunteers showed topical therapy with 2% mupirocin was more effective than oral erythromycin in suppression of both S . aureus and Streptococcus pyogenes.

J Bacteriol, 1990 May, 172(5), 2675 - 87
Isolation and molecular genetic characterization of the Bacillus subtilis gene (infB) encoding protein synthesis initiation factor 2; Shazand K et al.; Western blot (immunoblot) analysis of Bacillus subtilis cell extracts detected two proteins that cross-reacted with monospecific polyclonal antibody raised against Escherichia coli initiation factor 2 alpha (IF2 alpha) . Subsequent Southern blot analysis of B . subtilis genomic DNA identified a 1.3-kilobase (kb) HindIII fragment which cross-hybridized with both E . coli and Bacillus stearothermophilus IF2 gene probes . This DNA was cloned from a size-selected B . subtilis plasmid library . The cloned HindIII fragment, which was shown by DNA sequence analysis to encode the N-terminal half of the B . subtilis IF2 protein and 0.2 kb of upstream flanking sequence, was utilized as a homologous probe to clone an overlapping 2.76-kb ClaI chromosomal fragment containing the entire IF2 structural gene . The HindIII fragment was also used as a probe to obtain overlapping clones from a lambda gt11 library which contained additional upstream and downstream flanking sequences . Sequence comparisons between the B . subtilis IF2 gene and the other bacterial homologs from E . coli, B . stearothermophilus, and Streptococcus faecium displayed extensive nucleic acid and protein sequence homologies . The B . subtilis infB gene encodes two proteins, IF2 alpha (78.6 kilodaltons) and IF2 beta (68.2 kilodaltons); both were expressed in B . subtilis and E . coli . These two proteins cross-reacted with antiserum to E . coli IF2 alpha and were able to complement in vivo an E . coli infB gene disruption . Four-factor recombination analysis positioned the infB gene at 145 degrees on the B . subtilis chromosome, between the polC and spcB loci . This location is distinct from those of the other major ribosomal protein and rRNA gene clusters of B . subtilis.

Vet Microbiol, 1990 May, 22(4), 319 - 28
Summer mastitis in heifers: a bacteriological examination of secretions from clinical cases of summer mastitis in Denmark; Madsen M et al.; A total of 166 samples of secretions collected from Danish heifers suffering from clinically diagnosed summer mastitis were examined bacteriologically . One hundred and sixty three samples yielded positive findings whereas no growth was obtained from 3 specimens . The majority of samples revealed a mixed flora in which the predominant components were Actinomyces pyogenes, Peptostreptococcus indolicus, a microaerophilic coccus (Stuart-Schwan coccus), Fusobacterium necrophorum, Bacteriodes melaninogenicus and Streptococcus dysgalactiae . Pure cultures were recovered in only 7% of cases . P . indolicus was isolated from 875 of the cases, a microaerophilic coccus from 84%, A . pyogenes from 72%, Fusobacterium necrophorum from 52%, Str . dysgalactiae from 37%, B . melaninogenicus from 33% and various unidentified obligate anaerobic Gram-negative rods from 31% . The results confirm the complex bacterial aetiology of summer mastitis.

Respir Med, 1990 May, 84(3), 225 - 8
Pneumocystis carinii pneumonia in patients with AIDS in Central Africa; McLeod DT et al.; Over a period of 11 months, 37 patients infected with the Human Immunodeficiency Virus (HIV) presenting with symptoms of bronchopulmonary disease were investigated . Patients presented with cough, weight loss, fever and dyspnoea . Investigations included fibreoptic bronchoscopy with bronchoalveolar lavage and transbronchial biopsy . In eight patients (22%) Pneumocystis carinii was found . Pulmonary infiltrates were found on chest radiographs of six patients, while in the remaining two patients chest radiographs showed clear lung fields . P . carinii was found in two patients with pulmonary Kaposi's sarcoma . Infection with P . carinii often occurred with other pathogens: Streptococcus pneumoniae was found in four patients, Staphylococcus aureus in two and tuberculosis in two . P . carinii pneumonia does occur in patients with HIV infection in Africa and the diagnosis is relatively simple to make provided that transbronchial biopsy and bronchoalveolar lavage are carried out through a fibreoptic bronchoscope and specimens examined after appropriate staining . However, the prevalence of P . carinii in patients with HIV infection in Africa appears to be lower than that found in patients with HIV infection in Europe and North America.

J Appl Bacteriol, 1990 May, 68(5), 485 - 90
Molecular taxonomic studies on Streptococcus uberis types I and II . Description of Streptococcus parauberis sp . nov; Williams AM et al.; The nucleotide sequences of 16S ribosomal-RNA of Streptococcus uberis types I and II were determined by reverse transcriptase . Comparative analysis of the sequence data showed that the two types are phylogenetically distinct and worthy of separate species status . A new species Streptococcus parauberis is proposed for the type II strains . The type strain of Strep . parauberis is NCDO 2020.

Gene, 1990 Apr 30, 89(1), 69 - 75
Cloning and expression of gene fragments encoding the choline-binding domain of pneumococcal murein hydrolases; Sanchez-Puelles JM et al.; The cloning in Escherichia coli of the 3' moieties of the lytA and cpl-1 genes is described, coding for the C-terminal regions of the lytic amidase of Streptococcus pneumoniae and the phage Cp-1 lysozyme, respectively . The truncated genes were overexpressed in E . coli and the purified polypeptides showed a great affinity for choline, although they were devoid of cell wall-degrading activity . Biochemical and circular dichroism analyses indicated that these are the domains responsible for the specific recognition of the choline-containing pneumococcal cell walls by the lytic enzymes . The data presented here suggested that these choline-binding domains can function independently of their catalytic domains.

Klin Wochenschr, 1990 Apr 17, 68(8), 427 - 30
Fulminant group A streptococcal infections . Report of two cases; Christen RD et al.; We describe two female patients presenting with spontaneous peritonitis and fulminant Streptococcus pyogenes (Strep . pyogenes) septicemia and shock . Both patients recovered completely upon immediate antibiotic therapy, initially with broad range combination therapy effective against Strep . pyogenes, which was switched to penicillin G when culture results became available . This isolated strain in case 1 was M-type 28, which is the M-type most often isolated from vaginal swabs (as commensal) and from blood from patients with puerperal sepsis . Patient 1 had signs and symptoms of a toxic shock-like syndrome, including rapid onset of fever and shock, skin rash, desquamation of palms and soles, and multisystem involvement with vomiting, diarrhea, myalgia, renal failure, and severe disorientation without focal neurological deficits.

J Am Vet Med Assoc, 1990 Apr 15, 196(8), 1230 - 5
Herd benefit-to-cost ratio and effects of a bovine mastitis control program that includes blitz treatment of Streptococcus agalactiae; Erskine RJ et al.; Twelve dairy herds that had participated in the Pennsylvania Dairy Herd Improvement Association (DHIA) program for at least 12 months, that had a 12-month mean DHIA somatic cell count greater than 700,000 cells/ml, and that had greater than 25% of lactating cows infected with Streptococcus agalactiae participated in a herd blitz treatment program . Initially, quarter milk samples for bacteriologic culturing were collected from all lactating cows . Subsequently, all cows identified as infected with Str agalactiae were treated, using a commercial penicillin-novobiocin intramammary infusion product . In addition, a herd mastitis management program of postmilking teat dipping and treatment of all cows at the start of the nonlactating period was instituted . Thirty days after the initial herd visit, samples from all lactating cows were again cultured, and cows infected at that time were treated . Twelve months after the initial herd visit, samples from all lactating cows were again cultured . Mean prevalence of infection with Str agalactiae decreased (P less than 0.05) from 23.0% of quarters and 41.6% of cows initially to 3.4% of quarters and 9.3% of cows at 30 days and 1.6% of quarters and 4.2% of cows at 1 year . Mean herd DHIA somatic cell count decreased (P less than 0.05) from 918,000 cells/ml initially to 439,000 cells/ml at 30 days and 268,000 cells/ml at 1 year.(ABSTRACT TRUNCATED AT 250 WORDS)

Ned Tijdschr Geneeskd, 1990 Apr 14, 134(15), 770 - 2
{A child with pneumonia caused by a multiresistant pneumococcus}; Verhoef-Verhage EA et al.; Strains of Streptococcus pneumoniae resistant to penicillin have not previously been reported in The Netherlands . Now we have to report the isolation in November 1988 of a multiresistant pneumococcus (minimal inhibitory concentration 2 mg/l) from sputum of a three-year-old child from Poland . We advise isolating patients from abroad (Spain, Poland) in hospital and checking their bacteriological status to prevent introduction of penicillin resistant pneumococci into the Dutch population.

Carbohydr Res, 1990 Apr 2, 198(1), 67 - 77
Structural studies of the capsular polysaccharide from Streptococcus pneumoniae type 7A; Backman-Marklund I et al.; Application of methylation analysis, specific degradations, and n.m.r . spectroscopy to the capsular polysaccharide elaborated by Streptococcus pneumoniae type 7A indicates a hexasaccharide repeating-unit with the structure (Formula; see text).

Nippon Ganka Gakkai Zasshi, 1990 Apr, 94(4), 408 - 12
{The antibody titer to streptococcal and staphylococcal L-form in Behçet's disease}; Ogawa T et al.; The antibody titer to streptococcal and staphylococcal L-form was determined in the serum of Behcet's disease by enzyme-linked immunosorbent assay . These L-form bacteria were induced by the penicillin disk method . In 12 patients with Behcet's disease, the antibody titer to streptococcal L-form was significantly lower than that in the 14 normal controls by Student's t-test (p less than 0.025) . The antibody titer to staphylococcal L-form, however, showed no statistical difference between the patients and the controls . In Behcet's disease, antibody formation to streptococcus pyogenes, as well as its L-form, may be specifically disturbed.

Indian J Ophthalmol, 1990 Apr-Jun, 38(2), 66 - 9
Clinicobacteriological correlates of congenital dacryocystitis; Bareja U et al.; One hundred and fourteen eyes with congenital dacryocystitis have been studied clinically and bacteriologically . Gram positive cocci constituted the major bacterial isolates (57.9%) with streptococcus pneumoniae predominating (28.9%) . The most effective antibiotic was cloxacillin with an overall efficacy of 77% . Normal conjunctival flora was sterile in majority (75%) of cases . Positive cases showed preponderance of gram positive cocci (21.6%) with staphylococcus albus (13.3%) being the major isolate . Normal nasal flora revealed diphtheroids (alone or in combination) to be the commonest bacteria (62.1%) . A statistically significant correlation was not observed between the normal conjunctival or nasal flora and flora from the affected eyes.

Postgrad Med J, 1990 Apr, 66(774), 314 - 5
Osteomyelitis complicating Streptococcus milleri endocarditis; Barham NJ et al.; A patient with osteomyelitis of the spine complicating bacterial endocarditis due to Streptococcus milleri is discussed . To our knowledge, this is the first time this organism has been associated with this complication.

Antibiot Khimioter, 1990 Apr, 35(4), 32 - 4
{Comparative analysis of antibiotic sensitivity of Streptococcus pneumoniae strains isolated from patients and carriers}; Ivanov NA et al.; The data on antibiotic sensitivity of 38 strains of S . pneumoniae isolated from children and 46 strains isolated from carriers are presented . The isolates from the carriers had significantly higher sensitivity to benzylpenicillin, ampicillin, methicillin, oxacillin, cefazolin, erythromycin, oleandomycin and lincomycin . Resistance to gentamicin was more frequent in the strains isolated from the carriers . Among the strains of S . pneumoniae isolated from the patients and carriers representatives of serovar K19 were more frequent . There were no statistically reliable difference in them by sensitivity to benzylpenicillin, ampicillin, cefazolin, lincomycin and rifampicin . Still, the isolates from the carriers were much more sensitive to methicillin, oxacillin, oleandomycin and erythromycin.

J Trop Pediatr, 1990 Apr, 36(2), 63 - 5
Bacterial meningitis in the newborn: a Kuwaiti experience; Zaki M et al.; Forty-five neonates with bacterial meningitis admitted to a regional hospital in Kuwait over a 5-year period are reported . The attack rate was 6.7/10,000 live births . Listeria monocytogenes was the most common bacteria isolated (31 per cent), followed by Streptococcus agalactiae (15 per cent), and Escherichia coli (11 per cent) . Gram negative pathogens constituted 38 per cent of the total . Ten patients died (22 per cent) and 10 (28 per cent of the survivors) developed severe neurological sequelae.

Vet Microbiol, 1990 Apr, 22(2-3), 249 - 57
Isolation and characterization of temperature-sensitive mutants of Streptococcus suis: efficacy trial of the mutant vaccine in mice; Kebede M et al.; A model of experimental Streptococcus suis infection was developed in young mice . Minimum lethal dose (MLD) values were calculated for four virulent serotypes (1/2, 1, 2, 3) of S . suis using this model . Temperature-sensitive (ts) mutants of S . suis serotypes 1/2 and 1-8 were isolated and characterized on the basis of their growth kinetics and reversion rates . Ts mutants of S . suis 1/2, 1, 2, and 3 were tested as vaccines against the virulent homologous and heterologous challenges in mice . The protection provided was evaluated by analyzing the clinical signs, death or survival . Homologous but not heterologous protection was noted in all mice vaccinated with the mutant strains . Ts mutants of S . suis 1/2 provided 100% protection against challenge by virulent strains of S . suis 1/2, 1, and 2.

J Reprod Med, 1990 Apr, 35(4), 429 - 30
Streptococcus pneumoniae associated with second-trimester chorioamnionitis . A case report; Bruno R et al.; Streptococcus pneumoniae is found rarely in the normal vaginal flora but appeared to be the cause of chorioamnionitis and premature rupture of the membranes in a 16-week gestation . Both S pneumoniae and Ureaplasma urealyticum were recovered from cervical specimens, but only the Streptococcus grew from samples taken between the placental amnion and chorion.

Pediatr Cardiol, 1990 Apr, 11(2), 77 - 81
Infectious endocarditis in children; Parras F et al.; With the object of analyzing current characteristics of infectious endocarditis (IE) in children, we carried out a retrospective study of 23 cases of IE in children under 15 years of age seen at the Hospital Ramon y Cajal in Madrid (Spain) between 1977 and 1985 . The incidence was high (1.3 cases per 1000 children admitted) . The male/female ratio was 2:1 . Eight patients were under 2 years of age and 15 over 2 years, the majority being adolescents . The two groups presented marked etiological and prognostic differences . Congenital heart disease was the predisposing factor in 20 of the 23 cases . Streptococcus viridans (nine cases) and Staphylococcus aureus (eight cases) were the most frequent organisms . Fourteen cases were on a native valve and nine were secondary (seven of these on prosthetic patches) . In spite of advances in therapy, IE continues to be a severe illness: the mortality rate in our series was 26% . Factors associated with a poor prognosis were: age less than 2 years, Staphylococcus aureus as the causative agent, and the presence of prosthetic material.

J Clin Periodontol, 1990 Apr, 17(4), 268 - 72
Multiple periodontal abscesses after systemic antibiotic therapy; Topoll HH et al.; Multiple periodontal abscesses were reported in medically compromised patients . We examined patients with a non-contributory medical history referred for the treatment of numerous periodontal abscesses . All patients had taken oral broad spectrum antibiotics 1 to 3 weeks prior to the outburst of the abscesses (8 patients: penicillin, 2 patients: tetracycline) . The patients suffered from advanced periodontal disease, 82% of the examined sites showed probing depths greater than 3 mm, 56% attachment loss greater than 3 mm . Subgingival plaque samples were analysed from 2 different abscess sites . Bacteroides gingivalis (19/20), Fusobacterium nucleatum (13/20) and Streptococcus intermedius (13/20) were the most prevalent anaerobic microbiota . Strains resistant to the prescribed antibiotic were found in 55% (11/20) of the subgingival plaque samples . It was concluded that in patients with advanced periodontal disease, systemic antibiotic therapy without subgingival debridement may change the composition of the subgingival microbiota, thus favouring the outburst of multiple periodontal abscesses.

J Antimicrob Chemother, 1990 Apr, 25 Suppl C, 107 - 13
Bacteraemia--a New York perception; Neu HC et al.; Positive blood cultures (in total 7541) obtained from patients of varied social background in a New York medical centre between 1984 and 1989 are reviewed . Streptococcus pneumoniae predominated in community-acquired infections, and coagulase-negative staphylococci and Staphylococcus aureus in nosocomial infections, the latter often arising from intravenous lines . The reported trend towards Gram-positive isolates is confirmed in this series.

Aust N Z J Med, 1990 Apr, 20(2), 177 - 8
Streptococcus zooepidemicus cellulitis and bacteraemia in a renal transplant recipient; McKeage MJ et al.; A case of renal transplant recipient with Streptococcus zooepidemicus (Lancefield group C) cellulitis and bacteraemia is described . Human infections with this organism are very rare and this is the first case report of cellulitis caused by S . zooepidemicus . While animals are the reservoir for most human infections, a source was not defined in this patient.

J Med Microbiol, 1990 Apr, 31(4), 259 - 70
Surface-associated properties of Streptococcus milleri group strains and their potential relation to pathogenesis; Willcox MD et al.; Thirty strains from the Streptococcus milleri (anginosus) group (SMG) obtained from various sources were tested for a range of characters that could be associated with pathogenicity and the results were compared with those for type strains of S . sanguis, S . mutans and S . pyogenes . The SMG strains were heterogeneous in all tests . Most (18) belonged to one of the Lancefield groups with group F predominating . Adherence of strains isolated from abscesses to buccal epithelial cells was greater than that of other strains (p = 0.033) . Compared with strains of S . sanguis, SMG strains were generally not aggregated by human saliva . They differed from the type strain of S . pyogenes in their relative ability to bind fibrinogen and fibronectin; they were less effective in binding fibrinogen (0.33-4.28% cf . 22% for S . pyogenes) and generally more effective in binding fibronectin (0.49-12.37% cf . 0.95%) . Strains isolated from infections were statistically better at binding fibronectin than other strains (p less than 0.001) . The ability of strains to adhere to saliva-coated hydroxyapatite (SHA) varied 10-fold, from 0.16-16.35% . The amount of fibronectin bound by SMG strains correlated with their ability to adhere to SHA (p less than 0.001) . The hydrophobicity of the strains, as measured in the hexadecane partition assay, ranged from 0.0% to 99.0% . Some strains carried both positive and negative cell-surface charges and some strains with a highly hydrophobic cell surface also possessed a relatively high cell-surface charge . A minority of strains possessed a net positive cell-surface charge . Neither hydrophobicity nor cell-surface charge was related to the capacity of strains to adhere to SHA . Strains of SMG co-aggregated weakly with strains of Veillonella parvula, V . dispar, Actinomyces viscosus and A . naeslundii.

J Infect Dis, 1990 Apr, 161(4), 736 - 40
Does naturally acquired IgG antibody to cell wall polysaccharide protect human subjects against pneumococcal infection?
Musher DM, Watson DA, Baughn RE.
Antibody to the non-serotype-specific cell wall polysaccharide (CWPS) of Streptococcus pneumoniae has been said to confer a degree of non-serotype-specific protection against pneumococcal infection . The hypothesis underlying the present study was that if this antibody is protective, relatively higher levels are likely to be detected in patients who are colonized by pneumococci but do not have infection, those who have febrile bronchitis but do not have pneumonia, and those who have pneumococcal pneumonia but are not bacteremic . Mean IgG reactive with CWPS by ELISA in 15 healthy young adults was 43.9 micrograms/ml and in 126 randomly selected hospital patients of all ages was 41.9 micrograms/ml . In subjects with chronic bronchitis with or without known pneumococcal carriage, mean anti-CWPS IgG was 87.7 micrograms/ml . In three groups of patients (3 with acute purulent tracheobronchitis, 13 with nonbacteremic pneumococcal pneumonia, and 14 with S . pneumoniae bacteremia) at the time of admission, mean antibody levels were essentially identical, 104.9-110.1 micrograms/ml . The data suggest that naturally present anti-CWPS IgG does not protect against the evolution of acute pneumococcal infection from colonization to acute purulent bronchitis, from bronchitis to pneumonia, or from pneumonia to bacteremia.

J Infect Dis, 1990 Apr, 161(4), 728 - 35
Pneumococcal polysaccharide vaccine in young adults and older bronchitics: determination of IgG responses by ELISA and the effect of adsorption of serum with non-type-specific cell wall polysaccharide; Musher DM et al.; Available pneumococcal vaccines provide only limited protection for certain at-risk populations . Fifteen healthy young adults and 11 older chronic bronchitics received 23-valent pneumococcal vaccine . ELISA showed that IgG reactive with capsular polysaccharides from Streptococcus pneumoniae serotypes 3, 4, 8, 14, and 19F increased after vaccination . Bronchitics exhibited lesser responses for four of these serotypes, although differences between the groups were significant only for serotype 3 . Adsorption of postvaccination sera with pneumococcal cell wall polysaccharide significantly reduced mean antibody levels in both groups and lowered the proportion of sera that demonstrated type-specific antibody responses . Reactive IgG was largely restricted to the IgG2 subclass . Pneumococcal vaccine may provide suboptimal protection of older adults because antibody responses to some capsular polysaccharides are lower in elderly bronchitics than in healthy young adults . A substantial proportion of measured antibody reflects IgG reactive with cell wall polysaccharides rather than with type-specific, capsular constituents, suggesting that antibody responses in subjects of all ages deserve reappraisal.

Infect Immun, 1990 Apr, 58(4), 1043 - 7
Isolation, characterization, and inhibition kinetics of enolase from Streptococcus rattus FA-1; Huther FJ et al.; One aspect in a broad spectrum of possible mechanisms of cariostatic reactions of fluoride is its interaction with the metabolism of oral bacteria . Information on the mechanisms and kinetics of fluoride inhibition of essential enzymes of the glycolytic pathway of the relevant bacteria is lacking . In this work, the isolation and purification of enolase from Streptococcus rattus and its characterization are described . The enzyme has been isolated in a monomeric (22 kilodaltons) and dimeric (49 kilodaltons) form . The Km for 2-phosphoglycerate is 4.35 mM . Fluoride inhibition kinetics have competitive character, while phosphate in concentrations above 2 mM and in the presence of 0.5 mM fluoride alters the inhibition kinetics from competitive to noncompetitive . Without fluoride, 2 mM phosphate has a slight stimulatory effect on the enzyme . Monofluorophosphate has a noncompetitive inhibiting effect on the enzyme . This finding suggests that the effect of phosphate may be due to an additional binding of fluoride to the enolase, resulting in a conformational change of the enzyme.

Arq Bras Cardiol, 1990 Apr, 54(4), 265 - 9
{Endocarditis caused by Streptococcus bovis and colorectal neoplasms}; Grinberg M et al.; PURPOSE--To evaluate the association of Streptococcus bovis endocarditis with large bowel neoplasms . PATIENTS AND METHOD--Twenty episodes (19 patients) of Streptococcus bovis endocarditis (5.05%) selected from 396 episodes of endocarditis followed up from 1978 to 1990 . The mean age was 57.68 years, 16 (84.21%) were males . Previous heart disease was not known in nine (45%) . Previous manipulation that might induce bacteremia was identified in three patients . Symptoms related to neoplasia of the digestive system were not informed . The mean time of follow up (17 cases) was 33.76 months, standard deviation 27.37 months . Sixteen patients were submitted to colonic evaluation (barium enema in 11, colonoscopy in 5 patients, and both were performed in 5 patients) . RESULTS--Bowel neoplasias were diagnosed in 12 (75%) of 16 patients submitted to colonic evaluation, one colonic adenocarcinoma in one (8.33%), patient, histologic benign polyps in eight (66.6%) . Two patients are waiting for colonoscopic resection . In one patient the polyp was lost after colonoscopic resection . CONCLUSION--The high incidence of large bowel neoplasia in patients with Streptococcus bovis endocarditis indicates that evaluation of the large bowel must be performed on in patients with S . bovis endocarditis in order to diagnose neoplasias, even in the absence of symptoms of bowel disease.

Zh Mikrobiol Epidemiol Immunobiol, 1990 Apr, (4), 3 - 7
{The physicochemical and biochemical characteristics of the cell walls in M+ and M- variants of Streptococcus group A type 29}; Bitko SA et al.; The amino acid composition of cell walls and surface proteins, isolated from virulent (M+) and avirulent (M-) streptococcal strains (group A, type 29) has been determined by the method of E . H . Beachey et al . The kinetics of the lysis and proteolysis of streptococcal cell walls with muramidase and protease obtained from Actinomyces levoris and streptolysin has been studied . The constants describing the progress rates of these processes has been determined; their values in case of both lysis and proteolysis are higher in virulent strains than in avirulent ones.

Vet Med (Praha), 1990 Apr, 35(4), 193 - 9
{Determination of antibodies to Streptococcus agalactiae in the milk of dairy cows using the ELISA test}; Madr P et al.; A sensitive 4-layers ELISA test for determination of antibodies against the pathogens of Streptococcus agalactiae in cows' milk was used for diagnosis of mastitis, with the aim to broaden these methods . Antigen was linked on the solid phase in the form of the whole bacteria, and milk was tested, diluted in the ratio of 1:10 . Antigen bound-specific antibodies were labelled with pig antibodies against bovine immunoglobulins and in the next layer with rabbit antibody conjugated with peroxidases against pig immunoglobulins . After test visualisation and reading on the photometre, the results were given in the positivity per cent as a 100-multiple of the proportion of absorbance of the unknown sample and the positive control after subtraction of the negative control . Milk was examined in 36 dairy cows from three various breeding herds by that method . The samples were parallelly examined bacteriologically and cytologically . In the milk of dairy cows with positive S . agalactiae finding, the main level of antibodies expressed a positivity per cent, was 15.0%, while in bacteriologically negative animals it was only 6.2% . The dairy cows were divided into 8 groups, characterizing various stages of mastitis, according to the results of the individual treatments.

Biochem J, 1990 Apr 1, 267(1), 171 - 7
Expression and purification of a truncated recombinant streptococcal protein G; Goward CR et al.; The gene for Protein G from Streptococcus strain G148 was cloned and expressed in Escherichia coli . The regions on the gene corresponding to the albumin-binding domains and the Fab-binding region were then deleted by site-directed mutagenesis . The translation of regions corresponding to the cell-wall- and membrane-binding domains was prevented by introduction of stop codons upstream of these domains . This recombinant DNA sequence codes for a protein (G') that contains repetitive regions and that binds only the Fc portion of IgG, analogously to Protein A . Translation of the sequence produces a protein with an Mr of about 20,000 . The nucleotide sequence differs from those published previously {Guss, Eliasson, Olsson, Uhlen, Frej, Jornvall, Flock & Lindberg (1986) EMBO J . 5, 1567-1575; Olsson, Eliasson, Guss, Nilsson, Hellman, Lindberg & Uhlen (1987) Eur . J . Biochem . 168, 319-324} . The protein can be substantially purified on a large scale by chromatography on IgG-Sepharose 4B . Homogeneous Protein G' can be prepared by anion-exchange f.p.l.c . on Mono Q HR . This Protein G' has a pI of 4.19 and SDS/PAGE gives an apparent anomalous Mr of 35,000.

Oral Surg Oral Med Oral Pathol, 1990 Apr, 69(4), 502 - 5
The microbiology of periapical granulomas; Iwu C et al.; Of the 16 periapical granulomas studied, 14 (88%) yielded a positive growth when homogenized and cultured . The concentration of colony-forming units per milliliter of the suspension ranged from 10(1.3) to 10(4.0) (mean 10(2.2)) . A total of 47 isolates comprising 26 (55%) facultative anaerobes and 21 (45%) strict anaerobes were obtained . The organisms most commonly cultured were Veillonella species (15%), Streptococcus milleri (11%), Streptococcus sanguis (11%), Actinomyces naeslundii (11%), Propionibacterium acnes (11%), and Bacteroides species (10%) . Most of the organisms (96%) were sensitive to either amoxicillin, clindamycin, or tetracycline, whereas only 45% were sensitive to metronidazole.

J Infect Dis, 1990 Apr, 161(4), 741 - 6
Demonstration and characterization of buoyant-density subpopulations of group B Streptococcus type III; Hakansson S et al.; Group B Streptococcus (GBS) type III (18 strains) was investigated for the presence of buoyant-density subpopulations; 10 strains originated from invasive isolates causing early-onset septicemia, and 8 were colonizing isolates from pregnant women . By repeated processing in hypotonic density gradients of Percoll, high- (HD) and low-density (LD) subpopulations were recovered from all strains . Synthesis of type-specific polysaccharide (TPS) was increased in the invasive isolates and their respective LD variants compared with the colonizing strains and their LD subpopulations . Production of capsular TPS correlated directly with synthesis of soluble TPS; there was an inverse exponential relationship between soluble TPS production and buoyant density . LD variants were more resistant to phagocytic killing by human polymorphonuclear leukocytes (PMNL) than were the original strains and HD variants . In a luminol-enhanced chemoluminescence assay, LD variants elicited a weak, slow response . In contrast, the HD subpopulations evoked a prompt, strong respiratory burst in the PMNL.

Clin Prev Dent, 1990 Apr-May, 12(1), 18 - 21
Bicarbonate-based powder and paste dentifrice effects on caries; Tanzer JM et al.; The effects of sodium bicarbonate-based powder and paste dentifrices on dental caries and Streptococcus sobrinus recoveries in rats were studied . Three S . sobrinus 6715-13WT infected groups of specific pathogen-free weanling rats, consuming a diet which contains 56% sucrose, were topically treated with either demineralized water, dentifrice paste, or dentifrice powder . Both the paste and powder contained 0.22% (w/w) NaF . All topical treatments were given for one min daily per rat, five days a week . Animals' teeth were swabbed for recovery of 6715-13WT and total recoverable flora . Recoveries of 6715-13WT were 75% lower from both powder-treated and paste-treated dentifrice than from water-treated rats' teeth (p less than 0.001) . Total caries scores were 45% lower for the powder-treated and 43% lower for the paste-treated rats than the water-treated ones (p less than 0.01) . The major portion of the caries inhibition was evident on smooth tooth surfaces, 68% for powder-treated and 65% for paste-treated by comparison with water-treated animals (p less than 0.01), although a lesser caries reduction was also evident in tooth fissures (sulci) . Thus, both powder and paste formulations of a sodium bicarbonate-based dentifrice containing 0.22% NaF equally and potently inhibited caries in rats, challenged bacteriologically and dietarily to develop severe caries.

Biophys J, 1990 Apr, 57(4), 779 - 96
Energy transduction in the bacterial flagellar motor . Effects of load and pH; Khan S et al.; The effect of load and pH on the relation between proton potential and flagellar rotation has been studied in cells of a smooth-swimming Streptococcus strain . The driving potential, speeds of free-swimming bacteria, and rotation rates of bacteria tethered to glass by a single flagellum were measured . The relation between rotation rate of tethered bacteria and potential was remarkably linear up to nearly -200 mV . The relation between swimming speed and potential exhibited both saturation and threshold, as previously observed in other species . The form of these relations depended on pH . The equivalence of the electrical and chemical potential components of the proton potential in enabling swimming depended on the voltage . Our observations may be most simply accommodated by a kinetic scheme that links transmembrane proton transits to a tightly coupled work cycle . The properties of this scheme were elucidated by computer simulations of the experimental plots . These simulations indicated that the protonable groups that participate in the rate limiting reactions have a fractional electrical distance between three-fourths to all of the way toward the cytoplasm with a corresponding mean proton binding affinity of 10(-7.3)-10(-7.0) M, respectively.

Scand J Dent Res, 1990 Apr, 98(2), 112 - 9
Expulsion mechanism of xylitol 5-phosphate in Streptococcus mutans; Pihlanto-Leppala A et al.; The expulsion mechanism of xylitol 5-phosphate in Streptococcus mutans ATCC 25175 was studied using resting cells incubated in the presence of 14C-xylitol . The expulsion appeared to be a two-step process: xylitol 5-phosphate was first hydrolyzed to xylitol and inorganic phosphate, and the xylitol was subsequently expelled from the cells . The dephosphorylation step appeared to be energy-requiring and it was most likely associated with a phosphatase which was active on xylitol 5-phosphate . Two to three successive cultivations of the cells in the presence of 6% xylitol increased this enzyme activity 4.3-fold . These results are in accordance with the presence of an energy-dependent xylitol 5-phosphate cycle in S . mutans, which is regulated by exogenous xylitol.

Antimicrob Agents Chemother, 1990 Apr, 34(4), 510 - 4
Effects of dosage, peak and trough concentrations in serum, protein binding, and bactericidal rate on efficacy of teicoplanin in a rabbit model of endocarditis; Chambers HF et al.; The effect of dosage and the relative importance of peak and trough concentrations in serum for efficacy of teicoplanin were examined in a rabbit model of aortic valve endocarditis . Concentrations of teicoplanin in serum exceeded the MIC by several hundredfold, yet teicoplanin was less rapidly bactericidal than penicillin both in vitro and for endocarditis caused by a strain of Streptococcus sanguis . Because teicoplanin was 90% protein bound in rabbit serum, low free-drug concentrations probably resulted in less activity in vivo than in vitro . Because teicoplanin has a relatively low bactericidal rate and a high degree of protein binding, a sustained concentration in serum several times greater than the MIC may be important for efficacy in vivo . An intravenous regimen with relatively high peak concentrations in serum was less effective than an intramuscular regimen for endocarditis caused by a strain of Staphylococcus aureus, indicating that high peaks are unlikely to be an important determinant of efficacy . The therapeutically more relevant concentration in serum may be the trough.

J Chemother, 1990 Apr, 2(2), 108 - 12
Oral ciprofloxacin for treatment of acute bacterial pharyngotonsillitis; Esposito S et al.; The clinical efficacy and tolerability of ciprofloxacin orally administered at the dosage of 250 mg twice a day was evaluated in 25 patients affected by acute bacterial pharyngotonsillitis . All patients were non-responders to previous conventional antibiotic therapies due to in vitro resistance of the responsible bacteria, or possibly the low antibiotic concentration at the infection site . None of the patients had infections caused by group A beta-haemolyticus streptococcus . Treatment with ciprofloxacin lasted for 5-10 days (mean 6.7) . A favorable clinical response was observed in 92% of patients (15 resolutions and 7 improvements) at the end of the therapy and two weeks later (follow-up) . One patient was not evaluable because of the unfortunate onset of glossitis that caused the interruption of the treatment . No other side-effects were recorded in the other 24 patients . The bacteriological response was excellent: 83% bacteriological eradication, 13% persistence and super-infection in only one patient (4%) . Ciprofloxacin administered orally at low dosages is highly effective in the treatment of bacterial pharyngotonsillitis and is also well tolerated.

Pediatr Res, 1990 Apr, 27(4 Pt 1), 349 - 52
Group B streptococcus promotes oxygen radical-dependent thromboxane accumulation in young piglets; Shook LA et al.; Both thromboxane A2 and oxygen-derived free radicals appear to play central roles in group B streptococcus (GBS)-induced pulmonary hypertension in piglets . This study tested the hypothesis that GBS promotes oxygen radical-dependent thromboxane accumulation and pulmonary hypertension in infant piglets . Piglets 4-12 d old were anesthetized and prepared for assessment of pulmonary arterial pressure and arterial blood gases . In control animals, GBS (10(8) organisms/kg/min for 15 min) increased mean pulmonary artery pressure by 30 +/- 1.5 torr and reduced arterial PO2 by 100 +/- 20 torr . Thromboxane A2, radioimmunoassayed in venous blood as thromboxane B2, increased by 2452 +/- 800 pg/mL . A second group of piglets was treated with dimethylthiourea (DMTU: 750 mg/kg), a putative oxygen radical scavenger . In these animals, GBS increased pulmonary arterial pressure by only 7 +/- 1 torr and reduced arterial PO2 by a modest 10 +/- 8 torr . Importantly, thromboxane B2 content in venous blood failed to increase above control levels in DMTU-treated animals . The protective effects of DMTU in GBS-treated piglets could not be ascribed to inhibition of cyclooxygenase or thromboxane synthase because the oxygen radical scavenger failed to attenuate increases in pulmonary arterial pressure and venous thromboxane B2 content or reductions in arterial PO2 caused by i.v . infusions of arachidonic acid . DMTU also did not ameliorate pulmonary hypertension evoked by the thromboxane mimetic U44069, thereby suggesting that the scavenger did not act as an end-organ antagonist of thromboxane receptors . These observations suggest that GBS promotes accumulation of thromboxane A2 and attendant pulmonary hypertension through an oxygen radical-dependent mechanism.

Invest Ophthalmol Vis Sci, 1990 Apr, 31(4), 696 - 701
Differential binding of P . aeruginosa and S . aureus to corneal epithelium in culture; Panjwani N et al.; Adherence of bacteria to corneal epithelium is a prerequisite for corneal infection . We used two methods to study the binding of Pseudomonas aeruginosa and Staphylococcus aureus to rabbit corneal epithelial cells in culture . In the first method, rabbit corneal epithelial cells grown on glass slides were incubated with P . aeruginosa or S . aureus (10(7) CFU/ml) at room temperature for 90 min, and the bacterial binding to the epithelial cells was examined by light microscopy . Both P . aeruginosa and S . aureus bound to epithelial cells . P . aeruginosa was bound to the cell periphery whereas S . aureus was bound randomly to the cell surface . In the second method, suspension cultures of corneal epithelial cells were used . In contrast to the findings in cultures on slides, binding pattern with cells in suspension was similar for both species and resembled that for S . aureus in cultures on slides . A much greater number of P . aeruginosa (186 +/- 11 bacteria/epithelial cell) than S . aureus (30 +/- 1.5 bacteria/epithelial cell) bound to epithelial cells grown on glass slides . In contrast, a similar number of P . aeruginosa (25 +/- 5.1) and S . aureus (20 +/- 4.7) bound to epithelial cells grown in suspension cultures . Using either method, Escherichia coli and Streptococcus pyogenes did not bind significantly (less than 5/cell) to corneal epithelial cells . The above methods should prove useful for characterization of bacterial binding to corneal epithelial cells in culture.

Cornea, 1990 Apr, 9(2), 102 - 7
Recurrent postoperative endophthalmitis; Stern GA et al.; We treated five patients for postoperative endophthalmitis who demonstrated an initially good response to intravitreal management of their infection and then suffered a later recurrence . Four of the five patients received a single intravitreal injection of antibiotics as the only intravitreal therapy, and the fifth patient received a single antibiotic injection in addition to a partial vitrectomy . All recurrent infections occurred between 10 and 21 days after the original intravitreal injection of antibiotics . At the time of the recurrence, all five patients remained culture positive with the same organism that was initially isolated . The bacterial species isolated were S . epidermidis, group D streptococcus, P . acnes, P . mirabilis, and P . aeruginosa . All patients were ultimately sterilized with repeated intravitreal injections of antibiotics, vitrectomy, and/or intraocular lens removal . Factors that were related to recurrent infection were marginal susceptibility of the organism to the originally injected antibiotics, infection with a slowly replicating organism, and infection with a gram-negative bacillus . A single intravitreal injection of antibiotics may only partially treat bacterial endophthalmitis . Patients should be observed for at least 3 weeks following treatment of endophthalmitis for recurrence of their infection, and aggressive management, including vitrectomy and repeated intravitreal injections of antibiotics, should be used to treat recurrent infections.

Oral Microbiol Immunol, 1990 Apr, 5(2), 98 - 107
Humoral immunity in root caries in an elderly population . 1; Butler JE et al.; IgA, IgG and IgM antibody activity (ELISA Units/ml) to Streptococcus mutans, Actinomyces viscous and Escherichia coli CF8 in serum, parotid saliva and whole saliva was measured using the amplified ELISA (a-ELISA) while the concentration (microgram/ml) of each isotype of immunoglobulin as well as albumin and lactoferrin, was determined using sandwich ELISAs . Selection of suitable reagents from those commercially available was based on specificity tests using purified human immunoglobulin; most polyclonal reagents required further absorption to attain class specificity . Cross-absorption studies indicated the absence of patient antibodies that were cross-reactive among the bacteria studied, except for IgM in some cases . Expression of response in ELISA Units (E.U.) per microgram of immunoglobulin, i.e . specific activity, revealed that IgG specific activity was significantly higher in parotid saliva than in either whole saliva or serum for all bacteria studied; serum and whole saliva did not differ except for the higher specific activity in whole saliva to E . coli . The value of one E.U . was determined using the Comparative Antibody-immunoglobulin Capture Assay (CACA) . Using this novel method, we estimated that about 0.05 percent of serum IgA was specific for Streptococcus mutans, 0.008 for Actinomyces viscosus and 0.004 for Escherichia coli CF8 . The percentage of specific IgM antibodies was higher than for IgA and IgG . The concentration of IgA anti-Streptococcus mutans, Actinomyces viscosus and Escherichia coli levels are approximately 92 ng/ml, 25 ng/ml and 16 ng/ml in whole saliva and 46 ng/ml, 9.4 ng/ml and 6.3 ng/ml in parotid saliva.(ABSTRACT TRUNCATED AT 250 WORDS)

Oral Microbiol Immunol, 1990 Apr, 5(2), 72 - 6
Some aspects of protease production by a strain of Streptococcus sanguis; Rogers AH et al.; Our previous studies indicated that Arginine (Arg) plays a key nutritional role in Streptococcus sanguis P4A7 and that this organism can grow on whole casein as the sole nitrogen source . Its protease activities were therefore studied after glucose-limited continuous culture in a chemically-defined medium with either free amino acids or casein as the nitrogen source . Both culture supernatant and cell-associated endopeptidase (EP) and exopeptidase (amino-AP and carboxy-CP) activities were determined . Growth rate (mu) had little effect on EP, 75% of which was consistently in culture supernatants; AP and CP both decreased as mu was increased and both were predominantly cell-associated . At high growth pH, EP was substantially increased while AP and CP activities were optimal at pH 7 . The most striking nutritional effect occurred under nitrogen limitation (glucose excess) when EP and AP were greatly increased and CP greatly decreased . It was concluded that S . sanguis is well equipped to scavenge its environment for Arg under a wide range of growth conditions.

Biochim Biophys Acta, 1990 Mar 26, 1033(3), 273 - 6
Characterization of cross-reactive polysaccharide antigen with serotype a and d strains from Streptococcus sobrinus 6715; Takada K et al.; The polysaccharide antigen (designated SI) from Streptococcus sobrinus 6715 (serotype g) which cross-reacts with serotype a and d strains was purified by a specific anti-cross-reactive g-a antibody-Sepharose 4B affinity column . By a double immunodiffusion analysis, the SI antigen was found to lack the serotype-specific g site, but contained the cross-reactive sites g-a, g-d and g-(a-d) on a single molecule . Polysaccharide SI was composed of galactose, glucose and rhamnose in a molar ratio of 4.79:1.52:1 . The results of the test on the inhibition of the precipitin reaction and methylation analysis suggested that the cross-reactive site g-a of the SI antigen appeared to have two regions, one containing galactose residues and the other, beta-linked glucose residues.

Carbohydr Res, 1990 Mar 25, 197, 93 - 100
Synthesis of di- and tri-saccharides related to the polysaccharide from Streptococcus pneumoniae type 23 and a study of their inhibition in the precipitin reaction; Ray AK et al.; Syntheses of methyl 2-O-beta-L-rhamnopyranosyl-beta-D-galactopyranoside (9), methyl 2-O-alpha-L-rhamnopyranosyl-beta-D-galactopyranoside (13), and methyl 4-O-beta-D-glucopyranosyl-2-O-alpha-L-rhamnopyranosyl-beta-D- galactopyranoside (16) in good yields are described . Both 13 and 16 significantly inhibit antigen-antibody precipitation in the S . pneumoniae Type 23 immune system . The results indicate that the rhamnosyl group in the side chain of the repeating unit of the antigen is alpha and not beta as reported previously, and that the trisaccharide related to 16 is the immunodominant group.

J Immunol, 1990 Mar 15, 144(6), 2327 - 33
CD18-dependent and -independent mechanisms of neutrophil emigration in the pulmonary and systemic microcirculation of rabbits; Doerschuk CM et al.; Neutrophil (PMN) migration in the systemic and pulmonary circulation of rabbits was compared by using different inflammatory stimuli to determine the role of the leukocyte adhesion complex, CD11/CD18, in each of these vascular beds . The adhesion complex was blocked by administering the anti-CD18 mAb 60.3 . The data show that mAb 60.3 blocks PMN emigration into inflammatory foci in the abdominal wall produced by implanting sponges containing either hydrochloric acid, Streptococcus pneumoniae, Escherichia coli endotoxin, or PMA . mAb 60.3 also inhibited PMN emigration in response to peritoneal instillation of S . pneumoniae . The effect of mAb 60.3 on PMN emigration in the lungs varied depending upon the stimulus . PMN failed to migrate into the PMA-induced pneumonia; however, mAb 60.3 pretreatment only partially inhibited endotoxin-induced pneumonia and did not inhibit S . pneumoniae or hydrochloric acid-induced pneumonias . PMN lavaged from the alveolar spaces in the Streptococcal pneumonia had similar quantities of mAb 60.3 bound to their surfaces as the circulating PMN . We conclude that the CD11/CD18 complex mediates PMN adherence in the systemic circulation . However, PMN adherence in the pulmonary circulation may occur by either CD18-dependent or -independent mechanisms that are specific to the inciting stimulus.

Infect Immun, 1990 Mar, 58(3), 687 - 94
Synthesis and immunological properties of conjugates composed of group B streptococcus type III capsular polysaccharide covalently bound to tetanus toxoid; Lagergard T et al.; A synthetic scheme for covalently binding group B streptococcus type III to tetanus toxoid (TT), using adipic acid dihydrazide as a spacer, is described . Type III alone or as a conjugate with TT was injected subcutaneously into laboratory mice, and the type-specific and TT antibody responses elicited by these immunogens were assayed . Type III-TT elicited significantly higher levels of type-specific antibodies after each immunization than did the type III alone . These levels were related to the dosage of the conjugate, enhanced by Freund adjuvant, and exhibited booster responses . Type III alone elicited only immunoglobulin M (IgM) antibodies in Swiss albino mice and mostly IgM and low levels of IgG antibodies of the IgG3 subclass in BALB/c mice . Type III-TT conjugates, in contrast, elicited mostly IgG antibodies in both strains of mice . IgA type III antibodies were not detected . The first two immunizations with the conjugates elicited type III antibodies in the IgG1 and in the IgG3 subclasses . Low levels of IgG2a type III antibodies were detected after a third injection of type III-TT . Conjugate-induced antibodies facilitated opsonization of group B streptococcus type III organisms and did not react with the structurally related pneumococcus type 14 . TT alone or as a component of type III-TT induced mostly antibodies of the IgG class: IgG1 levels were the highest of the four subclasses . No IgA TT antibodies were detected . The conjugation procedure, therefore, enhanced the immunogenicity of and conferred T-cell dependent properties to the type III while preserving the immunogenicity of the TT component . The T-cell dependent properties of the conjugates were responsible for stimulating IgG type III antibodies which could be boosted . Evaluation of type III-TT conjugates in antibody-negative women of child-bearing age is planned.

Int Endod J, 1990 Mar, 23(2), 92 - 6
Stimulation of the growth of Streptococcus sanguis (NCTC 7864) by zinc in vitro; Meryon SD et al.; Zinc, which is present in many materials used in dentistry, including restorative and endodontic materials and mouthwashes, is reputedly bactericidal . However, the addition of this element at concentrations in the range 10-50 ppm to cultures of Streptococcus sanguis (NCTC 7864) stimulated the growth of the micro-organism relative to that of controls . A second antibacterial element, namely fluoride, reduced growth . Similar results were obtained whether the organism was grown aerobically or anaerobically . In view of the susceptibility of some organisms to zinc, the results of this study may help to explain conflicting reports in the literature; the results will vary depending on which organism is predominant.

Kinderarztl Prax, 1990 Mar, 58(3), 143 - 9
{Enterococci as pathogens of severe infections in newborn infants and young infants}; Halle E et al.; We report about severe perinatal infections caused by enterococci during a 5 year-period . Between January 1983 and December 1987 8 infants were treated in the Department of Neonatology of the Charite-Hospital, 5 of them died . In 4 of the infants this infection was of the early onset type and in 4 infants the infection had a late onset . The clinical course of the four infants with early onset type was very similar to that of infants with group-B-streptococcus disease . The increase of severe infections caused by enterococci in 1987 (7 cases) is unclear . One cause of the increase could be, that the chemotherapy of septicemia and meningitis in the Department of Neonatology of the Charite is the combination cefotiam and gentamicin or cefotaxime and gentamicin . Enterococci are resistant to all cephalosporins and a selection of these pathogens after this therapy is possible . In vitro and clinical experience has demonstrated, that a ampicillin-gentamicin combination constitutes effective therapy for enterococcal infection.

Minerva Cardioangiol, 1990 Mar, 38(3), 85 - 8
{Bacterial endocarditis in pregnancy . Description of 2 cases and review of the literature}; Zamprogno R et al.; Bacterial endocarditis in pregnancy is uncommon . We described two cases: the first case of endocarditis, caused by staphylococcus epidermidis (at the 35th week of pregnancy) was complicated by severe aortic valvular insufficiency; the second case, endocarditis caused by streptococcus alpha hemolytic (at the 32nd week of pregnancy) was complicated by severe mitral valvular insufficiency associated with multiple systemic emboli . Therapy consisted, in the first case of partum-induction followed by antibiotic therapy; in the second case it consisted of specific antibiotic therapy followed by gestation . There was no maternal or fetal mortality in the two cases.

P N G Med J, 1990 Mar, 33(1), 55 - 7
Massive empyema in a five-week-old baby: a case study; Spicer PE; A 5-week-old male child was admitted to Tabubil Hospital with a rapidly progressive, fulminating right-sided empyema which necessitated thoracotomy and drainage . The causative organism was a haemolytic Streptococcus.

Antimicrob Agents Chemother, 1990 Mar, 34(3), 467 - 9
Comparative in vitro activities of several new fluoroquinolones and beta-lactam antimicrobial agents against community isolates of Streptococcus pneumoniae; Mazzulli T et al.; The in vitro susceptibilities of 551 community isolates of Streptococcus pneumoniae from the Canadian province of Ontario to several new fluoroquinolones and beta-lactam antimicrobial agents were determined by a broth microdilution technique . Eight (1.5%) of these isolates were moderately susceptible (MICs, greater than or equal to 0.12 and less than or equal to 1.0 microgram/ml) to penicillin; none was resistant . Temafloxacin, ciprofloxacin, and ofloxacin (MICs for 90% of strains tested, between 1 and 2 micrograms/ml) were the most active fluoroquinolones tested, and BMY-28100 (MIC for 90% of strains tested, 0.25 microgram/ml) was the most active of the new beta-lactams tested.

FEMS Microbiol Lett, 1990 Mar 1, 56(1-2), 223 - 7
Complete nucleotide sequence of the sr gene from Streptococcus mutans OMZ 175; Ogier JA et al.; The nucleotide sequence encoding the SR protein of Streptococcus mutans OMZ 175 (serotype f) has been determined . The sr gene consists of 4667 bp and codes for a 171177 Da protein . Comparison of the inferred amino acid sequence with the one of PAc antigen from S . mutans MT 8148 (serotype c) indicates a 88% conservation of amino acid residues which reflects the close relatedness of both proteins . Major differences in amino acid composition are located at the C-terminal part of the sequence where only 298 amino acids of the terminal 420 are conserved.

Zentralbl Bakteriol, 1990 Mar, 272(3), 276 - 82
Isolation and characterization of hyaluronidases from Streptococcus dysgalactiae, S . zooepidemicus and S . equi; Sting R et al.; 10 out of 10 cultures each of Streptococcus dysgalactiae and S . zooepidemicus and 6 out of 10 cultures of S . equi tested for hyaluronidase produced this enzyme . Hyaluronidase could be precipitated from the cell-free culture supernatant with ammonium sulphate and purified by chromatography on DEAE-cellulose, isoelectric focussing and preparative polyacrylamide gel electrophoresis . The isoelectric points of the hyaluronidases from S . dysgalactiae and S . equi were near pH 5, of that from S . zooepidemicus near pH 6 . The hyaluronidases from S . dysgalactiae, S . zooepidemicus and S . equi had molecular weights of about 55,000 D . Maximal enzyme activities developed between 40 degrees C and 45 degrees C and pH 5.6 and 5.8 . The Michaelis constants ranged from 7.5 x 10(-2) to 8.8 x 10(-2) mg/ml . Hyaluronidase activities were stimulated by Ca++, Mg++, Mn++, Co++, K+, and Li+ and inhibited by Zn++ and Cd++.

Ann Clin Lab Sci, 1990 Mar-Apr, 20(2), 140 - 6
Low levels of unsaturated transferrin as a predictor of survival in pneumococcal pneumonia; Lambert CC et al.; A study was conducted to evaluate factors which might influence the prognosis of persons with pneumonia owing to Streptococcus pneumoniae . Serum iron, total iron binding capacity and unbound iron binding capacity (UIBC), were evaluated in 35 such patients . Of the 10 patients with UIBC levels less than 130 micrograms per dl on admission to the hospital, six died, three had complications, and only one recovered uneventfully . Of the 25 surviving patients, 21 (84 percent) had UIBC greater than 130 micrograms per dl on admission . Positive blood cultures were also correlated with survival . However, the strongest prognostic indicator was the combination of UIBC and blood culture results . Only 14 percent of patients with abnormalities in both parameters survived, whereas 80 percent to 88 percent of those with negative blood culture and/or normal UIBC survived . This suggests that insufficient unsaturated transferrin may facilitate bacteremia and contribute to lethality of pneumococcal pneumonia.

J Reprod Med, 1990 Mar, 35(3), 297 - 8
Neonatal Streptococcus pneumoniae septicemia and meningitis . A case report; Di Nello CH et al.; Neonatal septicemia/meningitis from Streptococcus pneumoniae occurred in a 36-hour-old infant . The mother had no overt evidence of infection . This case illustrates the pathogenic potential of this common bacterium in the neonate.

Scand J Immunol, 1990 Mar, 31(3), 361 - 6
Low T- and B-cell reactivity is an apparently paradoxical request for murine immunoprotection against Streptococcus mutans . Murine protection can be achieved by immunization against a B-cell mitogen produced by these bacteria; Soares R et al.; C57BL/6 mice thymectomized as adults or depleted of CD4+ cells were much less susceptible than intact conventional mice to the B-cell mitogenic and specific immunosuppressive effects of a protein designated as F5'EP-Sm secreted by Streptococcus mutans . These mice were also considerably more resistant to infection by these bacteria than intact individuals . The immunosuppressor effect of F5'EP-Sm was also abrogated, however, in conventional intact mice when immunized intraperitoneally against heat-inactivated F5'EP-Sm . On the other hand, resistance to bacterial infection could be achieved by immunization of conventional intact C57BL/6 mice against heat-inactivated F5'EP-Sm by intraperitoneal or intradermal routes even when the animals were infected 3 months after immunization and even when the immunization procedure did not include Freund's adjuvant, which was the case with the intradermal route . Interestingly, the protection against the bacterial infection was accompanied by only a minor increase in specific serum antibodies against F5'EP-Sm . These results are discussed in the context of adequate strategies for immunoprotection against Streptococcus mutans and other micro-organisms which are secretors of substances that share both B-cell mitogenic and immunosuppressive properties and which are thus able to suppress the immune response by overstimulation of the immune system of the host.

J Vet Pharmacol Ther, 1990 Mar, 13(1), 43 - 8
Effects of experimentally induced Streptococcus suis infection on the pharmacokinetics of penicillin G in pigs; Zeng ZL et al.; The pharmacokinetics of potassium penicillin G were studied in both healthy (n = 8) and experimentally Streptococcus-suis-infected (n = 6) pigs following intramuscular administration (15,000 iu/kg) . Streptococcus-suis infection was induced artificially in young cross-bred pigs by subcutaneous inoculation with 9 x 10(8) to 10(9) colony-forming units of S . suis . The rectal temperature of infected pigs was significantly increased (P less than 0.01) before penicillin G injection and this was maintained for 8 h after the drug was given . Other clinical symptoms were also present . The serum concentration-time data for penicillin were found to fit a one-compartment open model with first-order absorption in the two groups of pigs . Significant changes were not observed between healthy and diseased pigs in following parameters: A, Ka, Ke and Tmax . However, in diseased pigs, significant increases (P less than 0.01) were found in Vd and ClB, and significant decreases (P less than 0.01) in Cmax and AUC occurred . The increased body clearance (ClB) and greater apparent volume of distribution (Vd) of penicillin G could partly explain why the serum values of the drug were much lower in diseased pigs than in healthy pigs.

J Perinatol, 1990 Mar, 10(1), 60 - 4
The role of the lumbar puncture in the admission sepsis evaluation of the premature infant; Hendricks-Munoz KD et al.; Premature infants with respiratory distress commonly receive evaluation for sepsis, including a lumbar puncture, within a short time after admission to a neonatal intensive care unit . We questioned the use of the lumbar puncture during the early sepsis evaluation, and since 1979, have omitted this procedure as part of the initial evaluation for sepsis (within 6 hours of birth) of premature infants . We monitored this policy to detect any change in the incidence of meningitis, and now report results accumulated over a 7-year period . From 1979 to 1986, 1390 inborn premature infants of 34 weeks' gestation or less were evaluated for early sepsis within 6 hours of birth . Thirty-two infants (2.3%) were diagnosed with sepsis . Fifteen of these infants died in the first 24 hours of life . Meningitis was not demonstrated by autopsy evaluation . The surviving 17 infants diagnosed with sepsis did not have meningitis . One hundred twenty-three infants whose initial blood cultures were negative developed infection later in their hospital course . Eleven of these 123 infants had infections with perinatally acquired organisms; two had group B streptococcus (GBS) meningitis . Their cases were not compatible with missed meningitis . The remaining 112 infants developed nosocomial infections of which 38.3% developed meningitis without associated bacteremia . These results suggest that the omission of the lumbar puncture in the early sepsis evaluation of the premature infant did not result in any missed meningitis and spared many infants the procedure shortly after birth . The lumbar puncture, however, continues to be vital in the assessment of late infections of the neonate.

Immunology, 1990 Mar, 69(3), 443 - 8
A thymus-independent (type 1) phosphorylcholine antigen isolated from Trichinella spiralis protects mice against pneumococcal infection; Lim PL et al.; A phosphorylcholine (PC)-containing glycoprotein of 68,000 molecular weight (MW) was isolated from Trichinella spiralis . The potential of this antigen (Tsp) as a species-specific vaccine against Streptococcus pneumoniae was studied in both immunologically deficient (CBA/N) and normal (CFW) mice . Unlike the PC determinant found in S . pneumoniae, Tsp is a type 1 thymus-independent (TI-1) antigen, as it was able to stimulate PC-specific antibody production in CBA/N animals, though less well than in CFW mice . Immunological memory to this antigen was observed in both strains of mice, and the predominant class of antibodies formed was IgM . In further studies, Tsp-immunized CFW mice were protected against a fatal challenge of S . pneumoniae type 3 . Protection in these animals is probably mediated by the PC-specific antibodies present, which comprised 87.9% of antibodies reactive to S . pneumoniae, or 58.7% of total antibodies formed.

Infect Immun, 1990 Mar, 58(3), 838 - 40
Size of the Streptococcus mutans GS-5 chromosome as determined by pulsed-field gel electrophoresis; Tudor JJ et al.; Rare cutting restriction endonucleases were used to cut the Streptococcus mutans chromosome into large fragments . Restriction enzymes utilizing recognition sites containing 6-, 7-, or 8-base-pair sequences with only G and C nucleotides produced few fragments, most of which were greater than 100 kilobase pairs in size . Addition of the fragments from digests of SmaI, NotI, ApaI, RsrII, and EagI yielded a molecular size for the S . mutans GS-5 genome of 2,819 +/- 60 kilobase pairs.

Infect Immun, 1990 Mar, 58(3), 667 - 73
Sequence analysis of the gene for the glucan-binding protein of Streptococcus mutans Ingbritt; Banas JA et al.; The nucleotide sequence of the gbp gene, which encodes the glucan-binding protein (GBP) of Streptococcus mutans, was determined . The reading frame for gbp was 1,689 bases . A ribosome-binding site and putative promoter preceded the start codon, and potential stem-loop structures were identified downstream from the termination codon . The deduced amino acid sequence of the GBP revealed the presence of a signal peptide of 35 amino acids . The molecular weight of the processed protein was calculated to be 59,039 . Two series of repeats spanned three-quarters of the carboxy-terminal end of the protein . The repeats were 32 to 34 and 17 to 20 amino acids in length and shared partial identity within each series . The repeats were found to be homologous to sequences hypothesized to be involved in glucan binding in the GTF-I of S . downei and to sequences within the protein products encoded by gtfB and gtfC of S . mutans . The repeated sequences may represent peptide segments that are important to glucan binding and may be distributed among GBPs from other bacterial inhabitants of plaque or the oral cavity.

Zhonghua Min Guo Xiao Er Ke Yi Xue Hui Za Zhi, 1990 Mar-Apr, 31(2), 69 - 75
Septic arthritis in early infancy; Wang CH et al.; Septic arthritis in infants who are less than two months of age is a rare condition . During a recent seven-year period, eighteen cases of infantile septic arthritis were diagnosed at Mackay Memorial Hospital . The ratio of males to females was 1.6:1 . The most common symptoms were crying during diaper change, and an immobile and swollen joint . Nonspecific symptoms such as fever, poor appetite and lethargy were uncommon . The hip was the most commonly affected joint with the knee taking second place . Ten cases (55%) demonstrated concomitant osteomyelitis . A bacterial etiology was established in 16 cases (88%) . The predominant pathogens were S . aureus (5 cases) followed by group B streptococcus (4 cases) . Total parenteral nutrition was the predisposing factor of infection in 4 of the 5 S . aureus arthritis cases . The duration of treatment ranged from 21 to 44 days . Two patients developed sequelae: namely discrepancies in leg length, and a limping gait . Early diagnosis and prompt antibiotic treatment are crucial elements in the prevention of disabling and catastrophic sequelae in young infants who have septic arthritis . In addition, open drainage is highly recommended in hip and shoulder arthritis.

Rev Eur Odontoestomatol, 1990 Mar-Apr, 2(2), 127 - 30
{Bacteriocins of Streptococcus mutans: mutacins}; Baca Garcia P et al.; A bioliographic survey about the production of a certain bactericidal substance (mutacins) by Streptococcus mutans has been done . The importance of bacteriocins of this micro-organism is due to its utility as a possible anti-caries agent performing as an influential factor in the colonization of the oral cavity, and also for serving for the typing of bacteria as an epidemiological "finger printing", determining the way of transmission of this micro-organism . Besides of stressing its clinical and epidemiological utility, we develop a review of other microbiological aspects.

Oralprophylaxe, 1990 Mar, 12(1), 36 - 40
{Demonstration of Streptococcus sobrinus in human oral cavity}; Gehring F et al.; From 133 saliva samples of humans we isolated 32 strains (24%) of Streptococcus sobrinus on an BYCSB selective medium . The very hard colonies of S . sobrinus on this medium were characterized by a distinct chalky white halo of water insoluble glucan ("glucan-halo") produced in large amounts from the sucrose by extracellular glucosyltransferase which has diffused out into the isolation medium . All of the isolated S . sobrinus strains fermented ordinarily mannitol and sorbitol, but not raffinose and melibiose . The occurrence of this special subspecies within the S . mutans-group may play a more important role in the etiology of dental caries of caries-active persons in the future.

Oralprophylaxe, 1990 Mar, 12(1), 22 - 5, 27
{In-vitro plaque accumulation on different filling materials}; Einwag J et al.; The influence of the surface roughness of dental filling materials as well as of specific properties of materials on plaque accumulation was to be tested in a comparative study for various materials (Degulor S, Amalcap SAS, Visio Dispers, Ketak-Fil, CuproDur, Harvard Cement) was to be tested in a comparative investigation . For this purpose, the different materials were placed in a Streptococcus mutans NCTC 10449 culture medium containing sucrose, and incubated for three days at 37 degree C . Following this, the specific accumulation of polysaccharides formed outside of cells (plaque) was subjected to gravimetric analysis . Filling materials that take a high polish (Degulor S, Amalcap SAS, Visio Dispers) accumulated only 25 to 50% as much plaque as did cements . Within the group of cements there were also differences (up to 40%) in spite of similar surface roughness . These differences are presumably due to properties specific to the materials . In preliminary examinations of the products named, antibacterial effects were registered in three cases (Degulor S, Harvard Cement and Cupro-Dur--inhibiting areola between 1 and 7.5 mm).

Microb Pathog, 1990 Mar, 8(3), 189 - 96
Relationship between intracellular survival in macrophages and pathogenicity of Streptococcus suis type 2 isolates; Williams AE; Naturally-occurring Streptococcus suis type 2 meningitis affects pigs and man; experimental models of the disease have also been established in pigs and mice . A sustained, high-level bacteraemia is an important phase preceding the development of S . suis type 2 meningitis . The main cellular clearance mechanism for circulating bacteria is the resident hepatic and splenic macrophages . The interaction between various isolates of S . suis type 2 and murine macrophages was investigated to determine whether there were differences in the outcome of the interaction that would reflect observed differences in pathogenicity . Phagocytosed non-pathogenic isolates were killed whereas intracellular pathogenic organisms survived and replicated within phagosomes in the absence of anti-S . suis type 2 antibody and complement . The addition of anti-S . suis type 2 antibody and complement to macrophages containing ingested pathogenic organisms resulted in inactivation of the intracellular bacteria . Thus whilst the pathogenicity of S . suis type 2 isolates may be related to an ability to survive within macrophages, immunity to S . suis type 2 meningitis may result from anti-S . suis type 2 antibody preventing pathogenic organisms surviving within macrophages.

Zh Mikrobiol Epidemiol Immunobiol, 1990 Mar, (3), 26 - 31
{Microbiologic and histomorphologic characteristics of experimental Mycoplasma-pneumococcus infection}; Baizhomartov MS et al.; The specific features of the development of Mycoplasma pneumoniae and Streptococcus pneumoniae infections in mice have been studied in cases of mixed and monoinfections . As shown in this study, mixed infection is characterized by the mutual inhibition of the proliferation of both pneumococci and mycoplasmae in the lungs, the liver and the spleen of the animals, while the associative interaction of these infective agents in isolated mouse lung tissue is characterized by the inhibition of pneumococcal proliferation only . In mixed infection the early activation of cells of the immunocompetent system is observed, which is accompanied by the development of mainly cell-mediated immune processes manifested as delayed hypersensitivity with the late formation of fibrillogenesis . During the development of mixed mycoplasmal-pneumococcal infection the histopathology of mycoplasmal infection prevails, which is probably due to the early formation of delayed hypersensitivity to M . pneumoniae in the animals.

Bol Med Hosp Infant Mex, 1990 Mar, 47(3), 146 - 52
{Streptococcus group B in the etiology of neonatal infection}; Solorzano-Santos F et al.; Group B Streptococcus (GBS) causes maternal infections during perinatal period and serious neonatal infections . Their frequency in our country is still unknown . This study analyzed the clinical and epidemiological characteristics of 13 neonates inborn at the Instituto Nacional de Perinatologia with early or late onset group B streptococcal infection . The incidence of early onset diseases (EOGBS) was 0.7 cases/1,000 live births among 20,054 inborn, and 1 case/20,000 live births of late onset diseases . EOGBS was more common in preterm newborn (median 33.2 w), low birth weight (median 2.025 g) with several maternal risk factors . Lethality rate was 38.5% (5/13) . GBS is a recent important pathogen in our institute that must be investigated in another institution of our country . Group B Streptococcus; neonatal septicemia; neonatal pneumonia.

Semin Respir Infect, 1990 Mar, 5(1), 10 - 29
Bacterial pneumonia in solid organ transplantation; Mermel LA et al.; Approximately 4% of recipients of solid organ transplants in the United States develop bacterial pneumonia in the posttransplant period, often in the first 3 months following transplantation . The incidence of bacterial pneumonia is highest in recipients of heartlung (22%) and liver transplants (17%), intermediate in recipients of heart transplants (5%), and lowest in renal transplant patients (1 to 2%) . The crude mortality of bacterial pneumonia in solid organ transplantation has exceeded 40% in most series . Beyond those risk factors identified for nosocomial pneumonia, the occurrence of primary cytomegalovirus (CMV) infection, graft rejection, maintenance antirejection therapy with prednisone, azathioprine, and antilymphocyte globulin, antirejection therapy with high-dose corticosteroids or OKT3 and splenectomy have been associated with a significantly increased risk of bacterial pneumonia in these patients . In the first 3 months posttransplant, gram-negative bacilli, Staphylococcus aureus and Legionella predominate and mortality is very high, in excess of 60% . Thereafter, bacterial pneumonias are caused primarily by Streptococcus pneumoniae and Hemophilus influenzae, with considerably lower mortality . Bacterial pneumonia must be suspected in any transplant patient presenting with fever and cough, especially associated with dyspnea or infiltrates on chest radiograph . If large numbers of bacteria and polymorphonuclear leukocytes are not visualized in respiratory secretions the work-up should proceed directly to fiberoptic bronchoscopy with bronchoalveolar lavage and/or protected brush specimen to establish the microbiologic diagnosis as accurately as possible . For presumptive gram-negative bacillary pneumonia, the initial regimen must be effective against Pseudomonas aeruginosa . Prevention of bacterial pneumonia in transplant patients must begin with immunization against S pneumoniae and Influenza A, and include precautions taken to prevent nosocomial pneumonia . It further may include measures to prevent CMV infection and the use of trimethoprim/sulfamethoxazole prophylaxis during the first year posttransplantation . Ultimately, novel technologies such as selective antimicrobial decontamination and/or protective isolation during the early postoperative period may prove effective.

Fam Med, 1990 Mar-Apr, 22(2), 122 - 4
Evaluation in rural practice of a rapid group B streptococcus screening test; Yawn BP et al.; Group B streptococcus (GBS) is the leading cause of infant mortality from infection . A rapid screening immunoassay for GBS was evaluated in a rural obstetrical population and was found to have an unacceptably low specificity (90%) and sensitivity (50%) . With a culture proven GBS colonization rate of 6.8%, the positive predictive value of the rapid screening test was only 27%, and the negative predictive value was 96% . Current recommendations for routine vaginal cultures, on all women based on urban research data with high maternal colonization rates (15%-23%) and high prematurity rates (15%-40%) are reviewed in relation to this community's low colonization and prematurity rates.

Clin Exp Immunol, 1990 Mar, 79(3), 353 - 60
Neutrophil-potentiating factors released from stimulated lymphocytes; special reference to the increase in neutrophil-potentiating factors from streptococcus-stimulated lymphocytes of patients with Behçet's disease; Niwa Y et al.; The potentiating effect of the soluble factors released from normal or diseased lymphocytes on neutrophil functions were investigated in the presence or absence of mitogens and wall preparations of Streptococcus pyogenes . When normal T lymphocyte populations were stimulated with T cell mitogens or with streptococcal preparations, the supernatants from these cultures potentiated neutrophil chemotaxis, phagocytosis and O2- generation . Upon gel-filtration of these stimulated lymphocyte supernatants, the neutrophil-potentiating activity was inactivated by trypsin or by a 30-min incubation at 130 degrees C, but was not affected by acid treatment at pH 2 or heat treatment at 56 degrees C for 60 min . Its activity was almost not affected by antisera against human interleukin-1, interleukin-2, interferon-gamma or tumour necrosis factor . With the stimulation of T cell mitogens, the supernatants released from the lymphocytes of not only the patients with Behcet's disease but also healthy and diseased controls enhanced neutrophil functions . However, supernatants from streptococcal preparation-stimulated lymphocytes from patients with Behcet's disease had a higher potentiating effect on neutrophil functions . Our study suggests that the enhanced neutrophil functions in patients with Behcet's disease may be related to an abnormally high level of circulating activated T cells in these patients.

Appl Environ Microbiol, 1990 Mar, 56(3), 829 - 31
Formation of a clear zone on tannin-treated brain heart infusion agar by a Streptococcus sp . isolated from feces of koalas; Osawa R; Gram-positive cocci, isolated from the feces of koalas and identified as Streptococcus bovis biotype I, formed a distinct clear zone on tannin-treated brain heart infusion agar, suggesting that this isolate has the unique characteristic of degrading the tannin-protein complex.

Orthopedics, 1990 Mar, 13(3), 341 - 3
The effects of contrast dye on bacterial growth: an in vitro model; Lee WA et al.; We devised an in vitro model to examine the effects of Conray 60 contrast dye on microorganisms commonly found in septic arthritis . Using 42 culture plates in aerobic and anaerobic environments, we found no adverse effect on bacterial growth using 30, 7.5, 3.75, and 1.875% concentrations of Conray 60 contrast dye on cultures of Staphylococcus aureus, Hemophilus influenza, and Streptococcus pneumonia.

Chem Pharm Bull (Tokyo), 1990 Mar, 38(3), 717 - 20
Effect of tea polyphenols on glucan synthesis by glucosyltransferase from Streptococcus mutans; Hattori M et al.; In the course of our studies on the development of anti-plaque agents for prevention of dental caries, we investigated effects of some of tea preparations and their individual components on the glucan synthesis catalyzed by glucosyltransferase (GTF) from Streptococcus mutans . Extracts of green tea and black tea, and polyphenol mixtures showed appreciable inhibition in the synthesis of insoluble glucan . Among the components isolated from tea infusions, theaflavin and its mono- and digallates had potent inhibitory activities at concentrations of 1-10 mM against GTF . (+)-Catechin, (-)-epicatechin and their enantiomers had moderate inhibitory activities at these concentrations, while galloyl esters of (-)-epicatechin, (-)-epigallocatechin and (-)-gallocatechin had increased inhibitory activities.

J Int Med Res, 1990 Mar-Apr, 18(2), 164 - 70
Efficacy and safety of clarithromycin versus josamycin in the treatment of hospitalized patients with bacterial pneumonia; Straneo G et al.; The efficacy and safety of 500 mg clarithromycin and 1000 mg josamycin both given twice daily for a maximum of 14 days were compared in the treatment of 72 hospitalized patients with bacterial pneumonia . The predominant pathogens isolated were Streptococcus pneumoniae and Staphylococcus aureus . Clinical success was reported for 91.5% of patients treated with clarithromycin and for 87.0% of those treated with josamycin . Eradication of the causative pathogen was noted in 85.7% of patients receiving clarithromycin and in 90% of those receiving josamycin . Adverse events considered probably to relate to therapy were experienced by 2% of patients treated with clarithromycin and by 12.5% of those treated with josamycin; one patient treated with josamycin was withdrawn because of severe nausea and moderate vomiting . Treatment with clarithromycin at half the dosage of josamycin was found to have comparable efficacy and to be associated with a lower incidence of adverse events.

Zhonghua Ya Yi Xue Hui Za Zhi, 1990 Mar, 9(1), 26 - 32
{Isolation and biotyping of Streptococcus mutans among preschool children in Kaohsiung city}; Chen HS et al.; Strains of streptococcus mutans were isolated from the saliva of preschool children in Kaohsiung City . The unstimulated whole saliva samples were inoculated onto modified Gold's agar plates and incubated for 24-48 hours anaerobically at 37 degrees C . Strains of S . mutans were classified according to Shklair and Keene's biochemical methods and biotyped according to the methods of Farghaly et al . S . mutans could be detected in 102 (89.5%) of 114 preschool children . The most common biotype of S . mutans in single isolation was biotype I (72.9%) . The percentages of the other biotypes are as follows: biotype II (5.2%), biotype III (7.3%), biotype IV (7.3%) and biotype V (7.3%) . Our study revealed that the deft index was significantly higher in children who were biotype I carriers than in those who were nonbiotype I carriers . This observation suggests that biotype I may be related to the higher incidence of dental caries in our preschool children.

J Perinatol, 1990 Mar, 10(1), 27 - 31
Complement C3 deposition onto bacteria by neonatal serum is not enhanced after the infusion of intravenous immunoglobulin; Lassiter HA et al.; To determine the effect of intravenous immunoglobulin (IVIG) on the capacity of serum from septic neonates to deposit complement C3 and IgG onto the bacteria isolated from their blood, 500 mg/kg of IVIG was administered to 18 neonates suspected of being septic . Blood was obtained just before the infusion, and again 15 minutes after its completion . Group B streptococcus type II, group B streptococcus type III, Staphylococcus aureus, and Staphylococcus epidermidis were isolated from the pre-infusion blood of four neonates . Bacteria were incubated with the appropriate serum, washed, and the amount of C3 and IgG subsequently bound to the organisms was quantified by radioimmunobinding assay . Sera from the four septic neonates and sera from four neonates of similar gestational age but whose blood cultures were negative were compared with pooled sera from healthy adults . Before the administration of IVIG, C3 deposition onto the bacteria by sera from five of the seven neonates tested was significantly less than that observed for adult sera . Following the infusion, no increase in C3 deposition was observed for any of the seven sera assayed, and in two cases C3 deposition fell significantly . In contrast, in seven of eight cases, IVIG enhanced the IgG deposition to levels greater than or equal to those observed for adult sera . Therefore, following the infusion of IVIG into neonates with proven or suspected sepsis, the deposition of C3 onto invasive bacteria by their serum was not enhanced even though IgG deposition was increased.

Paediatr Indones, 1990 Mar-Apr, 30(3-4), 120 - 4
Sydenham's chorea; Danial R et al.; P, an Indonesian boy, 5 years old, 15 kg of body weight and 110 cm of body length, was admitted to the PTP IX Hospital on March 30, 1987 with cerebral palsy . The patient had fever since 10 days before admission which lasted 7 days; he showed restlessness by involuntary movements when catching, thus when holding something in his hand, it fell off . He had difficulty in walking and talking . On physical examination, were hyperemic the tonsils and pharynx; there was muscular hypotonia, flexed arms and metacarpophalangeal extension . Laboratory findings showed leukocytosis, increased ASTO titer, positive CRP and normal cerebral spinal fluid . Head CT scan showed no abnormality . Electrocardiogram and EEG were in normal limits . Throat swab culture produced Group A Streptococcus beta hemolyticus . The diagnosis of sydenham's chorea was established . Procaine penicillin, phenobarbital and vitamins were administered to the patient . After 5 weeks in the ward the patient was doing well, and now he is working and speaking normally; he is on ambulatory treatment with 1.2 million units/month of long-acting benzathine penicillin, at the Department of Child Health, Tembakau Deli Hospital, Medan.

J Biol Chem, 1990 Feb 25, 265(6), 3161 - 7
Complete nucleotide sequence of the streptococcal C5a peptidase gene of Streptococcus pyogenes; Chen CC et al.; Streptococcal C5a peptidase (SCP), a recently discovered virulence factor of Streptococcus pyogenes, specifically cleaves the human serum chemotaxin C5a near its carboxyl terminus, destroying its ability to serve as a chemoattractant . We previously localized the SCP gene, scpA, to the 5.8-kb insert of the recombinant plasmid pTT1 . Here we present the complete nucleotide sequence of scpA and its flanking regions . The gene initiates at a TTG codon and consists of 3501 base pairs, specifying a precursor protein of 128,252 daltons . Sequences resembling the promoter and ribosome-binding site of Gram-positive organisms are found upstream of scpA . The predicted amino acid sequence reveals the presence of a 31-residue signal peptide, putative cell wall spanning and membrane anchor domains . Regions of SCP show significant similarity to the sequences involved in the formation of the active site of the prokaryotic serine protease subtilisin . Results of Southern hybridization studies indicate that sequences highly similar to that of scpA are present in all serotypes of S . pyogenes tested.

Ann Intern Med, 1990 Feb 15, 112(4), 278 - 92
Clinical uses of intravenous immunoglobulins; Berkman SA et al.; PURPOSE: To ascertain the activity of intravenous immunoglobulin in a wide range of diseases . DATA IDENTIFICATION: English-language literature search using MEDLINE (1982 to 89), review of meeting reports, and extensive hand searching of bibliographies of identified articles . STUDY SELECTION: All identified articles . DATA EXTRACTION: Study quality and specific descriptive information concerning population, intervention, and outcome measurements were assessed . RESULTS of DATA SYNTHESIS: There have been few controlled, randomized trials of intravenous immunoglobulin . Available data suggest efficacy in persons with primary immune deficiency, premature infants at risk for group B streptococcus infection, patients with Kawasaki disease, transplant recipients at risk for cytomegalovirus infection, patients with idiopathic thrombocytopenic purpura, and selected patients with chronic lymphocytic leukemia . Data are also favorable concerning the use of intravenous immunoglobulin in some other autoimmune disorders, but randomized trials are needed . Interesting areas for future study include the acquired immunodeficiency syndrome (AIDS), multiple myeloma, and lymphomas . Risks of intravenous immunoglobulin are minimal . CONCLUSION: Intravenous immunoglobulin is safe and effective in treating several human diseases . Additional randomized trials are needed.

J Am Vet Med Assoc, 1990 Feb 15, 196(4), 597 - 9
Evaluation of a scheme for predicting the gram-staining reaction of organisms causing bovine mastitis; Jones GF et al.; The accuracy of a scheme for predicting the gram-staining reaction of organisms causing bovine mastitis in cows with systemic signs of disease (anorexia) was evaluated over 1 year . Criteria for making the predictions included: season of year, stage of lactation, appearance of milk, detection and duration of teat injuries, and milk odor . It was possible to determine the cause by microbiologic culture of specimens from 136 of the 147 cows of the study . Of 78 infections caused by gram-negative (mostly coliform) organisms, 62 (79%) were predicted accurately to be caused by gram-negative organisms . Of 57 infections caused by gram-positive organisms, 45 (79%) were predicted correctly to be caused by gram-positive organisms . Correctly predicted as gram-positive organisms causing infection were: Actinomyces pyogenes in 20 of 21 (95%) cows; Staphylococcus sp in 14 of 22 (64%) cows; Streptococcus sp in 10 of 13 (77%) cows and Bacillus sp in 1 cow . Overall accuracy, in those instances when bacteria were isolated (136 cows), was 78%.

J Med Microbiol, 1990 Feb, 31(2), 133 - 6
A rapid technique for detection of resistance to chloramphenicol in Streptococcus pneumoniae and comparison with minimum inhibitory concentration and disk-diffusion methods; Walker CW et al.; Fifty-two strains of Streptococcus pneumoniae were examined for production of chloramphenicol acetyltransferase (CAT) by a rapid technique based upon induction of enzyme activity and chemical assay . This method was compared with one measuring the minimum inhibitory concentration (MIC) by agar dilution and a diffusion test with disks containing 10 micrograms, 30 micrograms and 50 micrograms of chloramphenicol . The MIC for 13 chloramphenicol-resistant strains was 16 mg/L and for 39 sensitive strains less than or equal to 4 mg/L . The chemical assay clearly distinguished resistant from sensitive strains; it was technically simple and provided results within 90 min . The distinction between sensitive and resistant bacteria in the disk diffusion assay was clearer with 10-micrograms than with 30-microgram and 50-micrograms disks . However, the chemical CAT assay, with enzyme induction, is recommended when a rapid result is required.

APMIS, 1990 Feb, 98(2), 111 - 21
An assessment of the factors contributing to the killing of type 3 Streptococcus pneumoniae by human polymorphonuclear leukocytes in vitro; Esposito AL et al.; To characterize the factors that contribute to the killing of type 3 S . pneumoniae, human neutrophils were obtained from healthy donors and incubated with viable organisms . In contrast to prior observations with other pneumococcal serotypes, killing was not detected when 10(6) colony forming units (cfu) were incubated at 37 degrees C for 2-4 hours with 10(6) neutrophils in the presence of 20-80% fresh autologous serum; further, pneumococcidal activity was not found when preopsonized bacteria and primed neutrophils were employed in the standard assay . However, when the bacterium to cell ratio was reduced to 1:100 and 1:1000, microbicidal action was detected; a 10-fold reduction in the number of viable bacteria was observed when 2 x 10(3) cfu were incubated with 2 x 10(6) neutrophils and 80% autologous serum at 37 degrees C for 4 hours . To assess the effects of serum factors on killing, bactericidal assays were performed in the presence of normal human serum (NHS), heat-inactivated human serum (HIHS) and absorbed human serum (AHS); heating reduced and absorption eliminated the capacity of serum to support killing . Studies performed with mutanolysin, an enzyme that lyses type 3 pneumococci, demonstrated that the effects of HIHS and AHS on bactericidal activity were highly correlated with alterations in the ability of the sera to support phagocytosis . Studies of neutrophil activation revealed changes in the production of superoxide anion that correlated well with phagocytosis and killing; however, the results of assays of leukotriene B4 generation and degranulation (beta-glucuronidase and lactoferrin release) were more variable . In mixing experiments, the capacity of HIHS to support killing was normalized with NHS; however, the ability of AHS to promote killing was not restored with HIHS or NHS . Thus, these studies demonstrate the relatively limited capacity of human serum to support the killing of type 3 pneumococci, and they emphasize the importance of killing assays in assessing interactions between the bacterium and neutrophils.

Photodermatol Photoimmunol Photomed, 1990 Feb, 7(1), 35 - 7
The phototoxic inhibitory effect and phototoxic killing effect of micro-organisms; Faergemann J et al.; The toxic and phototoxic growth inhibitory and killing effect of Staphylococcus aureus, S . epidermidis, Escherichia coli, Pseudomonas aeruginosa, Streptococcus pyogenus gr . A, St . viridans, Pityrosporum ovale and Candida albicans were studied . P . ovale and St . viridans were the only micro-organisms with any toxic effect against the other micro-organisms tested . P . ovale inhibited the growth of S . aureus, S . epidermidis, Ps . aeruginosa and E . coli . St . viridans inhibited the growth of S . aureus, S . epidermidis, Ps . aeruginosa, E . coli, St . pyogenus gr . A and P . ovale . This effect was only growth inhibitory and not direct killing . The activity was increased by UVA on S . aureus, S . epidermidis and Ps . aeruginosa but not on E . coli and St . pyogenes gr . A . These effects of P . ovale and St . viridans may be of importance in the defense against infections.

Pneumologie, 1990 Feb, 44 Suppl 1, 469 - 70
{Pneumonia in patients with and without immunosuppression--value of bronchoscopic biopsy technics for the detection of pathogens}; Schmitz KF et al.; Bronchoscopic diagnosis was performed in 91 patients with 100 episodes of fresh pneumonia . In already existing immunosuppression (n = 51, Group A) pathogens were most frequently identified via bronchoalveolar lavage (70%); in patients without immunosuppression (n = 49, Group B) the identification quota in respect of the central bronchial secretion (53%) and bronchoalveolar lavage (47%) were comparable . In Group A the most frequently occurring pathogens were Pneumocysti carinii (n = 18) and Aspergillus fumigatus (n = 7), in Group B Streptococcus pneumoniae (n = 8) and Staphylococcus aureus (n = 7).

Zh Mikrobiol Epidemiol Immunobiol, 1990 Feb, (2), 32 - 8
{Streptococcus pneumoniae serotypes in children with chronic inflammatory diseases of the respiratory organs}; Katosova LK et al.; During the 7-year period of observation (1982-1988) the serotypes of 276 pneumococcal strains isolated from children with chronic bronchopulmonary diseases were studied . Among the serotypes of pneumococci under study, serotypes 6, 19 and 15 held the leading place and included a half of all typed pneumococci . Dynamic observation on the serotype composition of pneumococci revealed periodic fluctuations in the occurrence of some types/groups . The regional analysis of different serotypes of pneumococci showed the common occurrence of serogroups 6 and 19, as well as some regional features in the circulation of serotypes 6, 10, 3 and rarely occurring serotypes . The study revealed that any new exacerbation of the chronic bronchopulmonary process is caused by pneumococci of some other serotype . Pneumococcal strains, resistant (3.4%) and sensitive (1.8%) to penicillin, were detected; most of them belonged to serogroup 19.

Can J Microbiol, 1990 Feb, 36(2), 123 - 30
Preliminary characterization of four bacteriocins from Streptococcus mutans; Parrot M et al.; The various properties of the inhibitory substances produced by Streptococcus mutans strains C67-1, Ny257-S, Ny266, and T8, and the fact that inhibitory zones produced could not be associated with lactic acid (or other organic acids), bacteriophages, or hydrogen peroxide indicate that these substances can be classified as mutacins . The substances produced by strains C67-1, Ny266, and T8 possessed similar properties . They were shown to be thermoresistant (100 degrees C, 30 min), low molecular weight (less than 3500) substances sensitive to proteolytic enzymes (chymotrypsin, papain, pronase E, proteinase K, and trypsin) and they were active against most of the Gram-positive bacteria tested but not against most of the Gram-negative bacteria . The substance produced by strain Ny257-S differs from the other three by its narrower activity spectrum, its lower thermoresistance (80 degrees C, 30 min), and its higher molecular weight (8,000-14,000) . The gene or the genes coding for the mutacins are probably located on the chromosome since no plasmid DNA could be detected in these four producing strains . Restriction-fragment patterns of C67-1 and T8 suggest that these strains are closely related, as supported by the strong similarity observed between the properties of their mutacins.

Antimicrob Agents Chemother, 1990 Feb, 34(2), 210 - 4
Influence of clavulanic acid on the activity of amoxicillin against an experimental Streptococcus pneumoniae-Staphylococcus aureus mixed respiratory infection; Smith GM et al.; An experimental respiratory infection caused by Streptococcus pneumoniae was established in weanling rats by intrabronchial instillation . Treatment of this infection with amoxicillin rapidly eliminated the pneumococci from the lung tissue . A beta-lactamase-producing strain of Staphylococcus aureus, when inoculated in a similar manner, did not persist adequately in the lungs long enough to permit a reasonable assessment of the therapy, but staphylococcal survival was extended in the lungs of rats infected 24 h previously with S . pneumoniae . Amoxicillin therapy was relatively ineffective against the pneumococci in this polymicrobial infection and had no effect on the growth of S . aureus . In contrast, amoxicillin-clavulanic acid eliminated the pneumococci from the lung tissue and brought about a reduction in the numbers of staphylococci . The data illustrate the utility of this model for the study of polymicrobial lung infections and demonstrate the role of amoxicillin-clavulanic acid in the treatment of polymicrobial infections involving beta-lactamase-producing bacteria.

Antonie Van Leeuwenhoek, 1990 Feb, 57(2), 97 - 107
Influence of the blood group reactive substances in saliva on the aggregation of Streptococcus rattus; Ligtenberg AJ et al.; The interaction of blood group reactive substances in saliva with bacteria was investigated by testing saliva from persons with different blood groups in a bacterial aggregation assay with Streptococcus rattus HG 59, originally S . rattus BHT . For blood group A, saliva from 10 persons out of 11 aggregated S . rattus and for blood group O, saliva from 10 persons out of 16 aggregated S . rattus . For blood group B, saliva from 6 persons out of 8 aggregated S . rattus weakly and the average aggregation activity of blood group B was much lower than for blood group A or O . In addition, saliva from 3 non-secretors did not aggregate S . rattus . The role of blood group antigens in bacterial aggregation was confirmed by inhibition studies with blood group specific sugars and various other sugars . GalNAc, specific for blood group A, inhibited bacterial aggregation by saliva whereas D-galactose, specific for blood group B, and D-fucose, specific for blood group O, did not . In addition, sialic acid, a major terminal sugar residue in mucins, also inhibited the bacterial aggregation . This study shows that the blood group and secretor status of a person may influence the interaction of saliva with bacteria in the oral cavity.

Antonie Van Leeuwenhoek, 1990 Feb, 57(2), 91 - 5
Uptake of oxygen, release and degradation of hydrogen peroxide by Streptococcus mutans NCTC 10449; van der Hoeven JS et al.; Streptococcus mutans NCTC 10499 was cultured under glucose limitation in a chemostat at varying oxygen supply . The rates of oxygen uptake and hydrogen peroxide degradation by cells from the cultures were measured polarographically using a Clark electrode . Oxygenation of the chemostat culture led to adaptation of the organism to oxygen, in that the maximum oxygen uptake rate of the cells was higher when the cells were grown at higher rate of oxygen supply . It is noted that anaerobically grown cells still exhibited significant oxygen uptake . The rate of oxygen uptake followed saturation-type kinetics and Ks values of cells for oxygen were in the micromole range . Hydrogen peroxide accumulation was not observed in aerated chemostat cultures . However, anaerobically grown cells accumulated H2O2 when exposed to oxygen . Cells from aerated cultures did not accumulate hydrogen peroxide . This may be explained by the fact that the rate of hydrogen peroxide degradation was consistently higher than the rate of oxygen uptake.

Eur J Clin Microbiol Infect Dis, 1990 Feb, 9(2), 130 - 3
Vancomycin-aminoglycoside combinations in therapy of endocarditis caused by Enterococcus species and Streptococcus bovis; Besnier JM et al.; Between 1974 and 1986, five patients with enterococcal endocarditis (three of whom had a prosthetic valve) and three patients with Streptococcus bovis endocarditis were treated with a combination of vancomycin and an aminoglycoside for a mean duration of 40 days . This regimen was prescribed because of allergy to beta-lactam (n = 7) and/or failure of previous treatment (n = 4) . Three of the eight patients underwent valve replacement . In the six evaluable patients cure was achieved with the vancomycin-aminoglycoside combination . An increase of the creatinine serum levels was observed in all cases but it was never necessary to discontinue treatment, adjustment of the vancomycin and aminoglycoside dosage according to the serum and/or serum creatinine levels allowing continuation of therapy.

J Dent Res, 1990 Feb, 69(2), 483 - 8
Colonization resistance of defined bacterial plaques to Streptococcus mutans implantation on teeth in a model mouth; Perrons CJ et al.; We investigated the ability of Streptococcus mutans C67-1 to colonize simple bacterial plaques and the effects of age and stability of the pre-formed plaque on colonization resistance . Mixed-plaques of Actinomyces viscosus WVU627, 'Streptococcus mitior' LPA-1, and Veillonella dispar OMZ193 were grown on tooth segments, mounted back to back for simulation of approximal sites in a model mouth for 66 h . S . mutans C67-1 was either included in the original inoculum or super-inoculated onto the developing plaque . Inclusion of S . mutans C67-1 did not alter the total viable counts, but the proportional composition changed due to inter-species interactions . Colonization resistance of the mixed-plaque samples developed within 24 h, although S . mutans C67-1 was always able to colonize these stagnation sites . Colonization resistance of 24-hour plaque against a fresh isolate, S . mutans CP3, was also studied . There was greater colonization resistance by the basic plaque to this organism, compared with S . mutans C67-1, although the reasons for this were not clear . These initial experiments demonstrate the way in which the factors involved in bacterial colonization resistance in microbial films on teeth can be studied under controlled conditions.

J Clin Periodontol, 1990 Feb, 17(2), 115 - 8
Comparison of plaque microflora between Chinese and Caucasian population groups; Cao CF et al.; This investigation was designed to compare the predominant plaque micro-organisms from a Chinese group of patients exhibiting periodontitis with an age-, sex- and periodontal disease-matched Caucasian group of patients . In addition to race, the 2 population groups differed with respect to diet and oral hygiene habits, or effectiveness at removing plaque . Clinical measurements were determined along with an evaluation for micro-organisms in supragingival and subgingival plaque . Although the Chinese and Caucasian population groups were similar with respect to composition of micro-organisms in subgingival plaque, notable differences were observed in supragingival plaque . The Chinese group had higher mean proportions of spirochetes, motile rods . Fusobacterium spp . and dark-pigmented Bacteroides species, while the Caucasian group had higher mean proportions of cocci, total Actinomyces spp., A . viscosus and total Streptococcus spp . in supragingival plaque . The microbial differences observed in supragingival plaque may be explained at least in part, if not totally, by the higher plaque index scores of the Chinese versus Caucasian population groups.

J Bacteriol, 1990 Feb, 172(2), 556 - 63
Characterization of transmembrane movement of glucose and glucose analogs in Streptococcus mutants Ingbritt; Dashper SG et al.; The transmembrane movement of radiolabeled, nonmetabolizable glucose analogs in Streptococcus mutants Ingbritt was studied under conditions of differing transmembrane electrochemical potentials (delta psi) and pH gradients (delta pH) . The delta pH and delta psi were determined from the transmembrane equilibration of radiolabeled benzoate and tetraphenylphosphonium ions, respectively . Growth conditions of S . mutants Ingbritt were chosen so that the cells had a low apparent phosphoenolpyruvate (PEP)-dependent glucose:phosphotransferase activity . Cells energized under different conditions produced transmembrane proton potentials ranging from -49 to -103 mV but did not accumulate 6-deoxyglucose intracellularly . An artificial transmembrane proton potential was generated in deenergized cells by creating a delta psi with a valinomycin-induced K+ diffusion potential and a delta pH by rapid acidification of the medium . Artificial transmembrane proton potentials up to -83 mV, although producing proton influx, could not accumulate 6-deoxyglucose in deenergized cells or 2-deoxyglucose or thiomethylgalactoside in deenergized, PEP-depleted cells . The transmembrane diffusion of glucose in PEP-depleted, KF-treated cells did not exhibit saturation kinetics or competitive inhibition by 6-deoxyglucose or 2-deoxyglucose, indicating that diffusion was not facilitated by a membrane carrier . As proton-linked membrane carriers have been shown to facilitate diffusion in the absence of a transmembrane proton potential, the results therefore are not consistent with a proton-linked glucose carrier in S . mutans Ingbritt . This together with the lack of proton-linked transport of the glucose analogs suggests that glucose transmembrane movement in S . mutans Ingbritt is not linked to the transmembrane proton potential.

Infect Immun, 1990 Feb, 58(2), 464 - 70
Regulation of expression of Streptococcus mutans genes important to virulence; Hudson MC et al.; Studies were initiated to investigate the regulation of Streptococcus mutans genes which are believed to be important to virulence . Operon fusions were constructed between S . mutans gene regulatory regions and a promoterless chloramphenicol acetyltransferase gene (cat) found on the plasmid pMH109 . Specifically, fusions were generated between cat and the S . mutans genes encoding fructosyltransferase (ftf) and the glucosyltransferase B/C (gtfB/C) operon . Constructs were confirmed by restriction enzyme analysis, and the fusions were subcloned into the integration vehicle pVA891 . Following generation of multimeric DNA, recombinant plasmids were introduced into the s . mutans genome by Campbell-type insertion, resulting in single-copy operon fusions . Chloramphenicol acetyltransferase specific activities were used to monitor the expression of the S . mutans gtfB/C operon and ftf determinants . The expression of these genes is increased by the presence of sucrose and is followed by a rapid decline in expression over time . Additionally, expression of the gtfB/C operon is increased in S . mutans cells bound to artificial tooth pellicles.

Infect Immun, 1990 Feb, 58(2), 315 - 9
Adherence of Staphylococcus epidermidis to fibrin-platelet clots in vitro mediated by lipoteichoic acid; Chugh TD et al.; The adherence of two strains of Staphylococcus epidermidis to human fibrin-platelet clots in vitro was investigated . Both strains were noncapsulated, nonhemagglutinating, and nonslime producers . Binding was not related to surface charge, carbohydrate profile, or hydrophobicity of the bacteria . Adherence was reduced four- to sixfold (P less than 0.001) on pretreatment of bacteria with lipase, while neuraminidase, trypsin, phospholipase C, and sodium periodate did not alter their binding . Pretreatment of bacteria with substances known to bind lipoteichoic acid (LTA), such as human albumin and anti-LTA antibodies, also resulted in a fourfold (P less than 0.001) reduction in adherence . Prior incubation of clots with free LTA, but not with deacylated LTA, produced a fourfold (P less than 0.001) decrease in the adherence of homologous and heterologous strains of S . epidermidis . A similar reduction was also observed when LTAs derived from Staphylococcus aureus and Streptococcus pyogenes were used . These data provide evidence that the lipid moiety of LTA has a central role in the adherence of S . epidermidis to fibrin-platelet clots in vitro.

Infect Immun, 1990 Feb, 58(2), 289 - 96
Surface hydrophobicity, adherence, and aggregation of cell surface protein antigen mutants of Streptococcus mutans serotype c; Koga T et al.; The pac gene of the serotype c strain Streptococcus mutans MT8148 encodes a cell surface protein antigen (PAc) of approximate 190 kilodaltons . The serotype c strain S . mutans GS-5 does not produce the 190-kilodalton PAc but produces a lower-molecular-weight protein that reacts with anti-PAc serum . The SphI-BamHI fragment of the pac gene was ligated with the S . mutans-Escherichia coli shuttle vector pSA3 . The chimeric shuttle vector was transformed into strain GS-5, and two transformants (TK15 and TK18) were isolated . These transformants produced a large amount of cell-free and cell-bound PAc of 190 kilodaltons . No plasmid was isolated from these transformants, and the EcoRI fragments of their chromosomal DNA hybridized with the erythromycin resistance gene in the shuttle vector DNA, indicating insertion of the chimeric shuttle vector DNA into the chromosomal DNA . The cell hydrophobicity of strains TK15 and TK18 as well as PAc-defective mutants constructed by inserting an erythromycin resistance gene into the pac gene of strain MT8148 was analyzed . Strains MT8148, TK15, and TK18 were hydrophobic . On the other hand, strain GS-5 and PAc-defective MT8148 transformants were hydrophilic . Resting cells of the hydrophobic strains attached in larger numbers to saliva-coated hydroxyapatite than did the hydrophilic strains . Human whole saliva induced the aggregation of cells of the hydrophobic strains but not that of cells of the hydrophilic strains . These results suggest that cell surface PAc of S . mutans serotype c participates in attachment of the streptococcal cell to experimental pellicles.

Arch Otolaryngol Head Neck Surg . 1990 Feb;116(2):205.
Peritonsillar abscess in spite of adequately performed tonsillectomy; Roos K et al.; We describe a rare case of peritonsillar abscess in a woman, in spite of an adequately performed tonsillectomy 35 years earlier . Cultures from aspirated pus yielded a heavy growth of Streptococcus milleri and Bacteroides species . No remaining tonsillar tissue could be seen . We conclude that a peritonsillar abscess might develop in spite of adequately performed tonsillectomy.

J Dairy Sci, 1990 Feb, 73(2), 373 - 80
Effect of postmilking teat antisepsis on teat canal infections in lactating dairy cows; Nickerson SC et al.; Effects of a .18% iodophor teat dip and a fatty acid plus lactic acid teat dip on teat canal infections were studied in two separate trials under experimental challenge procedures using Staphylococcus aureus and Streptococcus agalactiae . The iodophor teat dip was 90% effective in preventing new S . aureus teat canal infections and 95.6% effective in reducing progression of S . aureus teat canal infections to intramammary infections . The dip also reduced persistence of S . aureus teat canal colonizations from week to week by 94.4% . The fatty acid plus lactic acid dip had no effect on preventing S . aureus teat canal infections but reduced progression of S . aureus teat canal infections to intramammary infections by 43.8% . The fatty acid plus lactic acid dip also reduced the persistence of S . aureus teat canal infections by 39% . An insufficient number of Strep . agalactiae teat canal infections was detected in both trials for valid analyses . Neither dip had any effect on prevalence of naturally occurring, coagulase-negative staphylococcal teat canal infections or on teat canal infections by other organisms.

Acta Odontol Scand, 1990 Feb, 48(1), 45 - 53
Oral adhesion of yeasts; Olsen I; Oral adhesion of yeasts probably occurs by interaction between yeast cell adhesins and oral epithelial cell receptors . In Candida albicans mannoprotein, glucan, chitin, cell wall proteins, and lipids are possible adhesins . Mannoprotein appears as a fibrillar or floccular outermost layer in stationary-phase cells grown in sugar-rich medium . Preincubation of buccal epithelial cells (BECs) with concanavalin A inhibits adhesion, as does suppression of mannoprotein production by tunicamycin . Germ tubes adhere more easily to BECs and plastic than do blastospores . Methyl-alpha-D-mannoside may be analogous to the yeast adhesin or epithelial cell receptor because it inhibits adhesion of C . albicans to BECs . L-Fucose, N-acetyl-D-glucosamine, or D-mannose, having the same effect, may also function as epithelial cell receptors . Other factors affecting yeast adhesion may be fibronectin, hydrophobicity, s-IgA, and indigenous bacteria . Growth of yeasts to stationary phase in sugar-rich media promotes adhesion to acrylic, as do divalent cations and serum . Saliva, chlorhexidine, and Streptococcus salivarius inhibit adhesion of yeasts.

J Dent Res, 1990 Feb, 69 Spec No, 676 - 81; discussion 682-3
The antimicrobial action of fluoride and its role in caries inhibition; Van Loveren C; Despite a considerable amount of literature on the effects of fluoride in dental plaque, several urgent questions remain unanswered, such as: Does the inhibiting effect of fluoride on dental plaque metabolism contribute to caries prevention? Does adaptation of plaque to fluoride affect its cariogenicity? Single applications of fluoride directly to dental plaque reduced acid production . Also, fluoride dissolving from topically treated enamel reduced the acid production in covering layers of oral bacteria in vitro . The effects of both treatments were only of short duration and may not be relevant to caries prevention in vivo . In contrast, daily applications of fluoride resulted in a reduction of the acidogenicity of dental plaque even 8-12 h after the treatment . Such a reduction is likely to contribute to caries prevention . But it has to be realized that when plaque reaches saturation with respect to fluoridated calcium (phosphate) precipitates, enamel becomes insoluble and any antimicrobial effect becomes irrelevant . Still lacking are data on the antimicrobial effects of fluoride regimens normally used in home care, in weekly rinsing programs in schools, or treatments applied professionally every six months . Adaptation of Streptococcus mutans to fluoride has been suggested to reduce the cariogenic potential of the cells . In vitro-induced fluoride-resistant strains were less cariogenic in rats, and the velocity of acid production in vitro was reduced at constant pH greater than 5.5 . Despite the ability of oral bacteria to adapt to fluoride, evidence of adaptation in dental plaque of normal subjects resulting in a reduced cariogenic potential has not yet been demonstrated.

J Dent Res, 1990 Feb, 69 Spec No, 653 - 9; discussion 682-3
Effects of fluoride on the microbial ecology of dental plaque; Bowden GH; In order to survive in a community such as dental plaque, bacteria must be able to resist changes in the environment . These changes may be the result of differences in the host or the activities of the bacteria within the community . Bacteria which cannot resist these environmental pressures may cease metabolism but survive, or be eliminated from the community . Fluoride is only one of numerous environmental pressures which impact on oral bacterial communities, yet its beneficial effect on caries is such that it could be proposed that in addition to its effects on enamel and remineralization, fluoride would affect the bacteria . It has been shown on many occasions that fluoride can affect bacterial carbohydrate fermentation; however, are there other effects of fluoride on the bacteriology of dental plaque? Although very high levels of fluoride (0.16-0.3 mol/L) will kill bacteria, there is little evidence that fluoride causes dramatic changes in the number of species found in plaque or their relative concentrations . The survival of the populations in the plaque community in the presence of fluoride could result from: (1) the fact that all the organisms are unaffected, (2) selection of mutant strains resistant to fluoride, or (3) adaptation of strains to fluoride resistance . Examples of these phenomena can be found among members of the oral flora . Some species are unaffected (Veillonella), but Streptococcus can be mutated to fluoride resistance and also adapt phenotypically to increasing levels of fluoride in the environment . Which of these mechanisms operates in vivo, and does resistance, mutation, or phenotypic adaptation of these bacteria reduce the effectiveness of fluoride, in controlling caries?(ABSTRACT TRUNCATED AT 250 WORDS)

Jpn J Cancer Res, 1990 Feb, 81(2), 169 - 75
Active oxygen-mediated cytotoxic and antitumor actions of streptococcal cytotoxic protein; Higuchi Y et al.; Streptococcal cytotoxic protein (SCP), obtained from the cell-free extract of Streptococcus pyogenes, inhibited the uptake of {methyl-3H}thymidine by Ehrlich ascites carcinoma cells depending on the concentration of fetal calf serum (FCS) added to the culture medium . The same results were found using sera from different animals . The inhibitory activity of SCP was completely suppressed by catalase but not by hydroxyl radical scavengers or superoxide dismutase . The antitumor activity of SCP in tumor-bearing mice was inhibited by administration of catalase together with SCP . SCP enzymatically produced hydrogen peroxide in the presence of FCS as detected by the 2,2'-azino-di{3-ethyl-benzothiazoline-(6)-sulfonic acid}/horseradish peroxidase method . The kinetic parameters, Km and Vmax, for hydrogen peroxide production of SCP were 2.13% FCS and 0.53 nmol/min/micrograms SCP, respectively . These results indicate that SCP is an enzyme which produces hydrogen peroxide and exerts potent cytotoxic and antitumor effects using an active oxygen species, hydrogen peroxide, produced by the enzymatic reaction of SCP with an unknown substrate contained in FCS or sera from various animals and molecular oxygen.

J Dent Res, 1990 Feb, 69 Spec No, 672 - 5; discussion 682-3
Diminished acid tolerance of plaque bacteria caused by fluoride; Marquis RE; Fluoride acts to reduce acid tolerances of plaque bacteria by upsetting normal proton currents across cell membranes . Streptococcus mutans was found to be unusually sensitive to fluoride, in part because its F1F0, proton-translocating ATPase is directly inhibited by fluoride at plaque levels . Thus, not only does fluoride serve in the HF form to bring extruded protons back into the cell, but it also reduces the capacity of the cell to extrude protons . Reductions in acid tolerance caused by fluoride would be expected to result in concomitant reductions in cariogenic potential.

Infect Immun, 1990 Feb, 58(2), 543 - 9
Inhibition of Streptococcus mutans by the antibiotic streptozotocin: mechanisms of uptake and the selection of carbohydrate-negative mutants; Jacobson GR et al.; The antibiotic streptozotocin {2-deoxy-2-(3-methyl-3-nitrosoureido)-D-glucopyranoside}, an analog of N-acetylglucosamine (NAG), has been shown to be useful for the selection of carbohydrate-negative and auxotrophic bacterial mutants . We have adapted this method for use with the oral pathogen Streptococcus mutans, a gram-positive, aerotolerant anaerobe that uses predominantly carbohydrates as carbon sources for growth . Streptozotocin selectively kills growing cells of S . mutans GS-5, and under appropriate conditions it can reduce the number of viable cells in actively growing cultures by a factor of 10(3) to 10(4) . However, unlike in enteric bacteria, which take up this antibiotic by a single NAG-specific transport system, streptozotocin appears to be taken up in S . mutans by both a NAG-specific system and a relatively nonspecific system that is also involved in glucose, fructose, and mannose uptake . Combining streptozotocin selection and a screening procedure involving indicator plates containing triphenyl-tetrazolium chloride, we developed a general method for the isolation of carbohydrate-negative and auxotrophic mutants of S . mutans . A preliminary characterization of both pleiotropic and specific carbohydrate-negative mutants isolated by using this procedure is presented.

Shika Kiso Igakkai Zasshi, 1990 Feb, 32(1), 10 - 9
{Effects of oxygen on growth of Streptococcus mutans}; Shimamoto T et al.; Effects of oxygen on growth of Streptococcus mutans Ingbritt (serotype c) were examined . The strain could be passaged under aerobic conditions at 37 degrees C in a peptone/yeast extract medium containing 0.2% glucose . Although the growth rate was slightly retarded under aerobic conditions (the doubling time, 60 min; 45 min under anaerobic conditions), the increment of cellular dry weight change was 35 g per mole of glucose under both conditions . To investigate such aerotolerance in growth as indicated by these results, oxygen metabolism was compared between aerobically and anaerobically grown cells . No difference was observed in the apparent rate of superoxide production or superoxide dismutation . However, aerobically grown cells showed a higher activity of hydrogen peroxide reduction with glucose as substrate and accumulated a lower level of hydrogen peroxide when incubated with glucose under aerobic conditions . In addition, hydrogen peroxide added to the medium was less inhibitory to anaerobic growth when aerobic cells were used as the inoculum . These results indicate that aerotolerance of S . mutans Ingbritt can be ascribed at least in part to its hydrogen peroxide reducing activity which is elevated under aerobic conditions.

Antimicrob Agents Chemother, 1990 Feb, 34(2), 321 - 5
Tolerance and efficacy of parenterally administered penicillin-streptomycin and orally administered amoxicillin or penicillin V for prophylaxis of experimentally induced streptococcal endocarditis; Pujadas R et al.; A regimen of a single intramuscular dose of penicillin G-streptomycin was compared with regimens of three oral doses of amoxicillin and two oral doses of penicillin V to prevent Streptococcus sanguis endocarditis in rabbits with experimentally induced valvular heart lesions . Challenge doses of 10(4), 10(6), and 10(8) CFU of a strain of S . sanguis highly tolerant to penicillin and amoxicillin were used . The combination of penicillin and streptomycin was the only regimen tested that provided full protection even against the highest inoculum concentration . A single oral dose of penicillin V (36 mg/kg) or amoxicillin (50 mg/kg), two oral doses of penicillin V (36 and 18 mg/kg with a 7-h interval between doses), or six oral doses of amoxicillin (50 mg/kg followed by 8.5 mg/kg at 8-h intervals) protected recipients of the lowest inoculum concentration; protection diminished with increasing inocula . In contrast, administration of two high oral doses of amoxicillin (50 mg/kg) with a 10-h interval between doses provided full protection against challenge doses of 10(4) and 10(6) CFU, preventing endocarditis in 10 (66%) of 15 recipients of 10(8) CFU . All regimens evaluated were highly effective in preventing endocarditis when rabbits were challenged with 10(4) CFU . The combination of penicillin and streptomycin was the best regimen tested . Administration of two high oral doses of amoxicillin (50 mg/kg) with a 10-h interval between doses led to significantly fewer infections when compared with the other oral regimens when rabbits were challenged with 10(6) and 10(8) CFU.

Eur J Clin Microbiol Infect Dis, 1990 Feb, 9(2), 75 - 9
Recent taxonomic changes in the genus Enterococcus; Ruoff KL; Recent taxonomic changes among the catalase-negative gram-positive cocci have led to the recognition of a separate genus for bacteria previously considered to be members of the genus Streptococcus . Presently, a total of 12 species of the genus Enterococcus have been described . The characteristics, taxonomy and nomenclature of these species, along with the possible clinical implications of revised enterococcal taxonomy, are discussed.

J Clin Invest, 1990 Feb, 85(2), 577 - 81
Loss of cerebrovascular autoregulation in experimental meningitis in rabbits; Tureen JH et al.; The present study was designed to determine whether cerebrovascular autoregulation is intact in experimental meningitis and to examine the relationship between fluctuations in cerebral blood flow (CBF) and increased intracranial pressure (ICP) . Measurements of CBF were determined by the radionuclide microsphere technique in rabbits with experimental Streptococcus pneumoniae meningitis with simultaneous ICP monitoring via an implanted epidural catheter . CBF and ICP measurements were determined at baseline and when mean arterial blood pressure (MABP) was artificially manipulated by either pharmacologic or mechanical means . CBF was pressure passive with MABP through a range of 30-120 torr, and ICP directly correlated with CBF . These findings indicate that autoregulation of the cerebral circulation is lost during bacterial meningitis, resulting in a critical dependency of cerebral perfusion on systemic blood pressure, and that the parallel changes in ICP and in CBF suggest that fluctuations in CBF may influence intracranial hypertension in this disease.

Oral Microbiol Immunol, 1990 Feb, 5(1), 19 - 23
Primary reservoirs of Streptococcus mutans and their relationship to caries experience in adults with good oral hygiene; Keene HJ et al.; Primary reservoirs of Streptococcus mutans were identified in a group of 21 adults with intact dentitions and good oral hygiene by obtaining multiple plaque samples from all available tooth surfaces . Routine cultural methods and a rapid plate scoring method employing a 7-point ordinal scale were used to assess S . mutans levels . Oral hygiene status (DI-S) and caries experience (DMFT and DMFS) were determined clinically . Primary S . mutans reservoirs (high scores) were restricted essentially to the posterior interproximal areas and occasionally in the occlusal pits and fissures of partially erupted mandibular third molars . An anterior to posterior gradient of increasing S . mutans scores was observed for interproximal sites . Oral hygiene scores correlated poorly with DMFT, DMFS and the S . mutans scores obtained for different anatomic locations.

J Hosp Infect, 1990 Feb, 15(2), 173 - 6
Streptococcus pyogenes: an outbreak on a burns unit; Burnett IA et al.; An outbreak of infection with Streptococcus pyogenes (Group A beta-haemolytic streptococcus) on a burns unit described . The control measures taken are outlined, and the route of spread of infection is discussed along with possible preventative measures.

Vaccine, 1990 Feb, 8(1), 35 - 40
Polyvalent synthetic vaccines: relationship between T epitopes and immunogenicity; Jolivet M et al.; Three different synthetic polyvalent vaccines have been constructed by conjugating four synthetic peptides without any carrier protein . The peptides were copy fragments of two bacterial antigens (Streptococcus pyogenes M protein and diphtheria toxin), two parasitic antigens (circumsporozoite protein of Plasmodium falciparum and Plasmodium knowlesi), and one viral antigen (hepatitis B surface antigen) . Outbred guinea-pigs immunized with polyvalent vaccine containing streptococcal, diphtheric, P . knowlesi and hepatitis peptides raised high specific antibody response against the four specificities . Individual T cell analysis demonstrated that hepatitis peptide bears T dominant epitope . A similar immune response was obtained with a second polyvalent vaccine where the P . knowlesi peptide had been replaced by the P . falciparum peptide . In both experiments the malarial peptides behave like pure B epitopes . Prediction of immunodominant helper T-cell antigenic sites were performed with the five peptides using computer algorithm . Hepatitis and diphtheric peptides were selected whereas the streptococcal peptide was rejected although it can experimentally contain a T epitope . To confirm this result animals were immunized with a third polyvalent vaccine which does not contain the hepatitis peptide . No T cell proliferation or antipeptide antibodies were detected . These results demonstrate that the cooperative immune response requires a certain degree of antigenic complexity for the induction of antibody response.

Immunology, 1990 Feb, 69(2), 177 - 83
The reactivity of naturally sensitized human CD4 cells and IgG antibodies to synthetic peptides derived from the amino terminal sequences of a 3800 MW Streptococcus mutans antigen; Childerstone A et al.; Natural immunity to synthetic peptides (SP) derived from the sequences of a 3800 MW streptococcal antigen (SA) was found in human subjects . Significant serum IgG antibodies were detected both to the native SA and to peptides consisting of residues 3-13, 1-15 and 1-20 . Inhibition studies confirmed cross-reactivity between the native SA and SP . A series of short peptides with deletions at the amino and carboxy termini were then tested to determine the sequence of B-cell epitopes . Residues 8-13 and 1-6 bound significant serum IgG antibodies, but residues 8-13 were more effective and consistent in inhibiting human antibodies than residues 1-6 . These results suggest that residues 8-13 constitute a major B-cell epitope but that residues 1-6 may represent a minor B-cell epitope . The human CD4 subset of T cells was then examined by stimulating the cells with SA or SP and measuring the uptake of {3H}thymidine {( 3H}TdR) . The cells were found to be sensitized in vivo to both the native SA and the SP and cross-reactivity between the SA and SP was shown by enrichment and depletion experiments on antigen-coated monocytes . As with the B-cell epitope, the series of short peptides was used to stimulate CD4 cells, in order to determine the T-cell epitope . Residues 6-15 were the shortest SP which stimulated significant {3H}TdR uptake and this peptide was designated as a T-cell epitope . The results suggest that natural oral immunization with Streptococcus mutans induces serum antibodies and T-cell sensitization to a peptide in which a T-cell epitope (residues 6-15) overlaps with a B-cell epitope (residues 8-13) . Furthermore, a comparison between linear and cycled peptides suggests that unlike immunogenicity which is commonly enhanced by the more rigid cyclized peptides, antigenicity is favoured by linear peptides . This was evident not only for antibodies but also for T-cell proliferative responses.

Gene, 1990 Jan 31, 86(1), 81 - 8
Modular organization of the lytic enzymes of Streptococcus pneumoniae and its bacteriophages; Garcia P et al.; The nucleotide sequences of genes cpl7 and cpl9 of the Streptococcus pneumoniae bacteriophages Cp-7 and Cp-9, encoding the muramidases CPL-7 and CPL-9, respectively, have been determined . The N-terminal domains of CPL-7 and CPL-9 were virtually identical to that previously reported for the CPL-1 muramidase . The C-terminal domain of the CPL-7 muramidase, however, was different from those of the host amidase and the phage Cp-1 and Cp-9 lysozymes . Whereas all enzymes studied are characterized by repeated sequences at their C termini, the repeat-unit lengths are 20 amino acids (aa) in CPL-1, CPL-9 and in the host amidase, but 48 aa in CPL-7 . Six repeated sequences represent the C-terminal domains of CPL-1, CPL-9 and the host amidase, and 2.8 perfect tandem repetitions that of CPL-7 . The peculiar characteristics of the structure of CPL-7 muramidase correlate with its biochemical and biological properties . Whereas CPL-1, CPL-9 and the pneumococcal amidase strictly depend on the presence of choline-containing cell walls for activity, CPL-7 is able to degrade cell walls containing either choline or ethanolamine . These results support the previously postulated role for the C-terminal domain of these lytic enzymes in substrate recognition and provide further experimental evidence supporting the notion that the proteins have evolved by an exchange of modular units.

Gene, 1990 Jan 31, 86(1), 71 - 9
Comparative expression of the pC194 cat gene in Streptococcus pneumoniae, Bacillus subtilis and Escherichia coli; Ballester S et al.; The expression of the cat gene of the staphylococcal plasmid pC194 present in the pLS1-pC194 composite plasmid pJS37 was lower in Streptococcus pneumoniae and Escherichia coli than in Bacillus subtilis . Different transcription start points (and, by inference, different promoter utilization) of the cat mRNA synthesized in S . pneumoniae or B . subtilis were detected . Plasmid pJS37 is prone to deletion formation when host cells are grown in the presence of chloramphenicol (Cm) . The analysis of the expression of the cat gene carried by the deleted derivatives of pJS37 has shown that a new promoter for the synthesis of cat mRNA is involved in the selective advantage conferred to the host by those deleted plasmids . Characterization of either in vivo or in vitro deleted plasmids has shown that the nucleotide sequence that could encode for a putative leader peptide is required for the Cm-induced pC194 cat gene expression.

Biochim Biophys Acta, 1990 Jan 29, 1033(1), 91 - 5
Characterization of glucan involved in the reduction of dental caries in rats; Takada K et al.; Culture supernatant fluids (SF) of mutant 108 obtained from Streptococcus sobrinus 6715, when incubated with sucrose, produce large amounts of water-soluble glucans . Mainly, two water-soluble glucan synthesizing glucosyltransferases (GTases) were found in culture SF by isoelectric focusing . These two GTases had higher activities than those from the parent strain . The GTase which synthesizes water-insoluble glucan totally lacked the mutant . When the glucan preparation synthesized by the SF was subjected to gel filtration, a major large molecular weight fraction (designated glucan A) and a small molecular weight fraction (designated glucan B) were obtained . Glucan A yielded a smaller molecular weight glucan after treatment with dextranase . Glucan B was not hydrolyzed by the same enzyme.

J Immunol Methods, 1990 Jan 24, 126(1), 79 - 87
Measurement of the humoral immune response against Streptococcus pneumoniae type 14-derived antigens by an ELISA and ELISPOT assay based on biotin-avidin technology; Verheul AF et al.; A Streptococcus pneumoniae type 14-specific ELISA and ELISPOT assay have been developed based on the use of biotinylated type 14 capsular polysaccharide (S14PS-biotin) . A major advantage of this application over other methods is the use of 10-100-fold less antigen than that reported in the literature for other similar assays . Moreover, the prepared biotinylated polysaccharides are very stable and it is possible to use the same procedures for other pneumococcal polysaccharide antigens (e.g., S6BPS) with no major changes necessary in the ELISA and ELISPOT protocols . Furthermore, a simple thin layer chromatography method has been developed as a method for quality control of the biotinylated polysaccharide . Immunization with the thymus-independent antigen S14PS resulted in the induction of IgM spot-forming cells (SFC) and antibodies while S14PS-protein conjugates induced a thymus-dependent response . The immune response to the conjugates was enhanced by the addition of the adjuvant Quil A resulting in high levels of both IgG SFC and antibodies at day 14 after immunization . The developed assays are reliable and reproducible tools for studying the humoral immune response against Streptococcus pneumoniae type 14 capsular polysaccharide derived antigens.

Tidsskr Nor Laegeforen, 1990 Jan 20, 110(2), 213 - 6
{Streptococcus viridans and respiratory failure in acute leukemia}; Dybedal I et al.; Through the last 18 months, five of our patients with acute leukaemia have developed septicaemia caused by Streptococcus viridans, followed by acute respiratory failure . Two patients had to be placed in a respirator . In patients with acute leukaemia treated with cytostatic drugs, close clinical observation, including repeated blood gas analysis, is very important if they develop septicaemia caused by Streptococcus viridans . Early administration of high doses of corticosteroids seems to be important in order to prevent serious respiratory failure.

Am J Gastroenterol, 1990 Jan, 85(1), 78 - 80
Streptococcus bovis brain abscess associated with an occult colonic villous adenoma; Emiliani VJ et al.; Streptococcus bovis is now recognized as a common cause of bacterial endocarditis . However, infection of the central nervous system by this organism is very rare . Recent studies have demonstrated the association between Streptococcus bovis infections and colonic neoplasms.

Prev Assist Dent, 1990 Jan-Feb, 16(1), 11 - 5
{Prevalence of Streptococcus mutans in a school group}; Brambilla E et al.; In the present study, S . mutans colony morphotypes has been investigated in salivary specimens obtained from 67 schoolchildren . Prevalence of these bacteria has been matched with DMFS in order to obtain information on cariogenicity of single morphotypes . Our data seems to suggest a correlation between total count of S . mutans colonies and caries experience, with major evidence for two colony morphotypes.

Gerontology, 1990, 36(1), 2 - 11
In vitro assessment of chemotaxis by peripheral blood neutrophils from adult and senescent C57BL/6 mice: correlation with in vivo responses to pulmonary infection with type 3 Streptococcus pneumoniae; Esposito AL et al.; To assess the effects of advanced age on the ability of circulating neutrophils to respond to biologically relevant chemoattractants, cells were isolated from the peripheral blood of pathogen and disease-free C57BL/6 mice and evaluated in a microchemotaxis chamber . The responses of granulocytes obtained from senescent mice (26-28 months) to the chemotactic peptide, FMLP, and to leukotriene B4 were similar to those found with cells from the younger animals (8-10 months) . In contrast, the migration of neutrophils in response to sonicated type 3 Streptococcus pneumoniae was significantly greater with cells from the older animals . Similarly, the chemotactic response of neutrophils to zymosan-activated serum was greater with cells and serum from the senescent animals; however, the enhanced chemotaxis exhibited by granulocytes from the aged mice was a consequence of serum factors . Following the deposition of viable type 3 S . pneumoniae into the lower respiratory tract, the neutrophil influx at 24 h after challenge was significantly greater in the senescent mice; however, age-related differences in survival rates and LD50 were not detected . Thus, in the C57BL/6 mouse, senescence is not associated with deficiencies in the response of neutrophils in vitro to chemoattractants that contribute to lung host defense against the pneumococcus; further, in this murine strain, advanced age does not result in an attenuation of the pulmonary inflammatory reaction to infection with type 3 S . pneumoniae.

Arch Oral Biol, 1990, 35(6), 483 - 6
Gingival overgrowth induced by cyclosporin A in rats; Kitamura K et al.; Gingival overgrowth, which is one of the major side-effects of this immunosuppressive agent, was studied in specific pathogen-free Fischer rats fed diet No . 2000 containing 56% sucrose . Marked macroscopic overgrowth was noted in mandibular gingiva of all the rats fed this diet containing cyclosporin A . The overgrowth was more severe in buccal than in lingual gingiva . Rats fed the cyclosporin-containing diet and infected with Streptococcus sobrinus 6715 had the most gingival overgrowth . Histopathological examination revealed that the bulk of the enlargement consisted of fibrous connective tissue without a marked increase in the number of fibroblasts or inflammatory cells.

Arch Oral Biol, 1990, 35(6), 475 - 7
Intranasal immunization of mice with recombinant protein antigen of serotype c Streptococcus mutans and cholera toxin B subunit; Takahashi I et al.; The cholera toxin subunit and the recombinant cell-surface antigen (molecular mass of 190,000 Da) were administered intranasally to BALB/c mice . After 30 days, the mice were immunized intranasally with the recombinant protein antigen alone . High serum IgG and salivary IgA responses to the protein antigen were induced by the intranasal immunization.

Microbios, 1990, 62(251), 101 - 12
Isolation and some properties of extracellular glucan-producing strains of human oral Streptococcus salivarius; Sato S et al.; A total of eighteen strains of Streptococcus salivarius, which formed rough gelatinous, rough mucoid or smooth mucoid colonies on sucrose agar media, were isolated from the saliva and tongue dorsum of adults . All of the isolates produced glucans as well as fructans from sucrose . The bulk of the glucans was synthesized by the extracellular enzyme fraction and was water insoluble, whereas most of the fructans were synthesized by the cell-associated enzyme fraction and were water soluble . All strains formed microbial deposits on wire and glass surfaces when cultured in sucrose broth, but their sucrose-dependent adhesion was apparently looser than that produced by a cariogenic S . sobrinus strain . The rough gelatinous colony forming strains possessed a greater ability to synthesize water-insoluble glucans and produced heavier deposits with higher cohesion . Preliminary studies showed that the S . salivarius of such characteristic forms of colony were detected primarily in the saliva and tongue dorsum: the smooth mucoid colony formers appeared to predominate in the tongue coat and the rough mucoid and rough gelatinous colony formers were prominent in saliva . Isolation of these S . salivarius from dental plaques was low.

Caries Res, 1990, 24(3), 189 - 97
Interactions of micromolar concentrations of fluoride with Streptococcus rattus FA-1; Psarros N et al.; Inhibition of the metabolic activities of bacteria by trace amounts of fluoride is manifested phenomenologically as changes in the pH gradient and/or the electrical potential between the cellular interior and the surrounding medium . These data were obtained from the intracellular/extracellular distribution of radioactivity labelled fluoride (18F), 5,5-dimethyloxazolidine-2,4-dione (14C), and tetraphenylphosphonium chloride (14C) . When taken up from acidic media, trace concentrations of fluoride (1-100 microM) reduce the intracellular/extracellular pH gradient and affect the electrical potential across the cell membrane . The chromatographic fractionation of fluoride-charged bacterial homogenates showed that fluoride is attached to many proteins of the cytoplasm, the cell membrane, and to nonproteinaceous components of the cell wall . Lysozyme treatment synergistically affects the vulnerability of the bacteria to micromolar concentrations of fluoride.

Scand J Infect Dis, 1990, 22(2), 221 - 2
Necrotizing pneumonitis and empyema caused by Streptococcus cremoris from milk; Torre D et al.; A 24-year-old heterosexual male, HIV-infected intravenous drug addict, with necrotizing pneumonitis and empyema due to Streptococcus cremoris is presented . The patient had fever, severe dyspnea and chest pain . Chest roentgenogram demonstrated pleural effusion on the left side . A thoracocentesis revealed purulent exudate and S . cremoris was isolated . Fever and pleural effusion disappeared with penicillin and clindamycin therapy . The most likely source of the infection was ingestion of unpasteurized milk and cheese.

Caries Res, 1990, 24(2), 113 - 6
Antiplaque activity of some antimicrobial agents using a simple in vitro method; Murata Y et al.; Some antimicrobial compounds were tested for their antiplaque activity by a simple method involving measurement of the weight of Streptococcus sobrinus plaque on a glass surface . Chlorhexidine, cetylpyridinium chloride, and n-tetradecylamine reduced the weight of plaque produced by S . sobrinus in vitro; some N-palmityl and palmitoyl derivatives of polymethylenediamines were also found to possess antiplaque activity . The results suggest that an antiplaque effect does not necessarily depend on high bactericidal activity.

Microb Pathog, 1990 Jan, 8(1), 61 - 9
Variation in the molecular weight of PspA (pneumococcal surface protein A) among Streptococcus pneumoniae; Waltman WD et al.; Pneumococcal surface protein A (PspA) has been shown to be a virulence factor of pneumococci and to elicit protective anti-pneumococcal antibodies in mice . PspAs from different pneumococcal isolates have been shown to exhibit antigenic variability . In previous studies with three strains, two different apparent molecular weights of PspA were observed . In this report we have studied the variation in molecular weight of PspA from 43 pneumococcal strains reactive with anti-PspA monoclonal antibodies, Xi64 and/or Xi126 . The relative molecular mass (Mr) of the major PspA band ranged from 67 k to 99 k in the different strains . Variations in Mr of PspA were observed even within strains of the same capsular type . The molecular size of PspA from strain Rx1 was not affected by treatment with a variety of chemical, enzymatic, and physical procedures, suggesting that the differences in Mr of PspA among different strains, was not due to uncontrolled variations in PspA preparation . The Mr of PspA of a given strain was found to be stable both in vivo and in vitro . As a result variations in the Mr of PspA from clinical isolates, should allow discrimination between strains within a given capsular type in epidemiologic studies.

Diagn Microbiol Infect Dis, 1990 Jan-Feb, 13(1), 63 - 6
Optochin-resistant variants of Streptococcus pneumoniae; Munoz R et al.; Ten Streptococcus pneumoniae clinical isolates, possessing physiologically typical pneumococcal characteristics, showed optochin-susceptible and optochin-resistant colonies around the optochin disk, when tested for optochin susceptibility . Equivocal optochin disk test results should be confirmed by bile solubility, agglutination tests, or both.

Eye, 1990, 4 ( Pt 1), 74 - 8
Microbial keratitis after penetrating keratoplasty; Bates AK et al.; Thirty cases of microbial keratitis after penetrating keratoplasty were reviewed to examine the associated risk factors, the spectrum of pathogens and the prognosis for graft survival and visual outcome . The indications for keratoplasty in this group differed markedly from those for all corneal grafts performed with a much higher incidence of previous microbial keratitis and of herpes simplex keratitis . A positive culture was obtained in 93% of cases and in contrast to microbial keratitis overall, Gram positive organisms predominated particularly streptococcus pneumoniae and staphylococcus aureus . Risk factors identified were loose or broken sutures, graft decompensation and a poor ocular surface environment . There was a poor prognosis for graft survival with only 23% of cases retaining a clear graft . Overall 53% of cases were regrafted.

J Antimicrob Chemother, 1990 Jan, 25(1), 103 - 9
Differential response to benzylpenicillin in vivo of tolerant and non-tolerant variants of Streptococcus sanguis II; Meeson J et al.; A variant that was highly tolerant to benzylpenicillin was obtained from a non-tolerant clinical isolate of Streptococcus sanguis II by repeated exposure to penicillin . The rabbit model of endocarditis was used to investigate the efficacy of a high dose regimen of benzylpenicillin (250 mg/kg; peak serum concentration c . 25 mg/l) in the prophylaxis and treatment of endocarditis during challenge or infection with the non-tolerant parent strain or its tolerant variant . The two strains exhibited a similar capacity to initiate infection . A single dose of penicillin administered 0.5 h before bacterial challenge protected six of nine rabbits infected with the non-tolerant parent strain, but none of nine infected with the tolerant variant . Treatment of established infection with penicillin administered twice daily for four days cured eight of 13 (61%) rabbits infected with the non-tolerant parent strain, but only one of 14 (7%) rabbits infected with the tolerant variant . These results support the view that tolerance to penicillin has therapeutic implications.

Microbios, 1990, 61(246), 39 - 48
Isolation of acid producing sorbitol-adapted bacteria from dental plaque using selective agar media; Linke HA et al.; Acidogenic bacteria metabolizing sorbitol were isolated and identified from dental plaque of twenty nine volunteers, claiming to be users (sixteen) and non-users (thirteen) of sorbitol-containing chewing gum and candy . Sixty bacterial strains were isolated, using improved selective agar media . The taxonomy of twenty strains, all Gram-positive cocci, was determined employing a customized BBL MinitekR system and other biochemical reactions . The majority of these strains represented Streptococcus sanguis and Streptococcus acidominimus . Although sorbitol-metabolizing bacteria were found in plaque specimens of most persons tested, a larger number of acidogenic sorbitol degrading bacteria was detected in the plaque of the volunteer group claiming to use sorbitol-containing sweets . Bacteriological results indicate that frequent consumption of sorbitol-containing products will lead to a shift in oral ecology, numerically favouring sorbitol-metabolizing bacteria . These sorbitol adapted bacteria appear to be as acidogenic as Streptococcus mutans in the presence of ordinary sugars.

Curr Surg, 1990 Jan-Feb, 47(1), 4 - 7
Perineal necrotizing infection; Artigas V et al.; Perineal necrotizing infection is a severe disease that ever since its first description by Fournier in 1883 has been referred to by many names prompted by its protean nature in terms of location and suspected etiology . We treated nine patients with PNI . The infection began as a perineal abscess of long evolution (7 days +/- 2 SD) in eight patients . The ninth patient had had an inguinal herniorrhaphy 3 days before . The cultures of the exudates and tissues always yielded aerobic and anaerobic mixed flora of colorectal origin, except in one instance, in which S . aureus and hemolytic streptococcus A were identified . The treatment was medical support and wide surgical debridement of the infected tissues . In six patients a left transverse colostomy was performed . Only one patient died, of septic shock . On the basis of the results in our series and on a review of the literature, it is our opinion that PNI is a mixed bacterial infection that despite its origin, clinical appearance and microbiologic findings, is highly uniform in terms of clinical course and treatment . Therapy is based on radical surgical debridement with excision of all necrotic tissue . The current plethora of terms seems impractical and confusing . We propose a rather comprehensive term perineal necrotizing infection for the sake of clarity.

Clin Exp Dermatol, 1990 Jan, 15(1), 39 - 43
Hypothesis--the natural selection of psoriasis; McFadden JP; The high genetic frequency of some inherited disorders may in part be related to a survival advantage conferred against an environmental hazard . Psoriasis is an inherited disorder which is common amongst populations of northern latitudes . Cutaneous delayed-type hypersensitivity response to streptococcal antigen is altered in such patients with a decrease in induration and erythema . Scarlet fever has until recently been associated with a high childhood mortality, the pathogenesis of which is related to interdependent primary toxicity and secondary toxicity (including delayed-type hypersensitivity) to streptococcal antigen (erythrogenic toxin), leading to cellular damage and potentially lethal shock . Streptococcal infection, usually presenting as pharyngitis, is a classical trigger for both scarlet fever and psoriasis . Individual susceptibility to scarlet fever has been clinically assessed in the past by the Dick test--an intradermal injection of the filtrate of a broth culture of scarlatina-producing strains of Streptococcus giving an erythematous reaction at 24-48 h (Dick-positive) . The degree of reaction is directly related to susceptibility to scarlet fever . The severity of and mortality from scarlet fever may be ameliorated by immunological mechanisms also found in psoriatic patients . The high prevalence of psoriasis amongst some populations today may be related to such a protective factor.

Rev Infect Dis, 1990 Jan-Feb, 12(1), 118 - 24
Meningitis due to penicillin-resistant Streptococcus pneumoniae in adults; Weingarten RD et al.; A 33-year-old woman with quiescent systemic lupus erythematosus developed meningitis due to a penicillin-resistant strain of Streptococcus pneumoniae . After an initial failure of penicillin therapy, the patient responded to cefotaxime . The meningitis was complicated by total neurosensory hearing loss . Howell-Jolly bodies noted on peripheral blood smear led to a radionuclide spleen scan, which documented functional asplenia . This woman is the second patient in the United States with meningitis caused by a strain of S . pneumoniae moderately resistant to penicillin G (minimal inhibitory concentration, 1.0 microgram/mL) . The resistant isolate displayed resistance to penicillin that was not of enzymatic origin but rather was due to an alteration of penicillin-binding proteins . This experience illustrates the importance of testing the in vitro susceptibility of the pneumococcus to penicillin G.

Res Vet Sci, 1990 Jan, 48(1), 23 - 7
Immunisation of pigs with killed cultures of Streptococcus suis type 2; Holt ME et al.; Ten intravenous inoculations of 10(10) formalin-killed pathogenic Streptococcus suis type 2 stimulated detectable levels of opsonic antibody and a strong protective response against intravenous challenge with 10(9) viable S suis type 2 of the same strain . Heat-killed organisms did not stimulate a protective response, even though the type-specific antigen was intact and opsonic antibodies were induced . When the number of formalin-killed organisms in the inoculum was increased 10-fold, one inoculation was insufficient to stimulate a protective response, but two inoculations protected pigs against intravenous challenge with live, pathogenic organisms . Four-hour and overnight cultures were equally immunogenic, and the response was not enhanced by either Freund's incomplete adjuvant or aluminium hydroxide gel adjuvant.

J Pediatr Surg, 1990 Jan, 25(1), 125 - 9
Postoperative wound infection in pediatric surgical patients: a study of 676 infants and children; Bhattacharyya N et al.; We conducted an epidemiologic study of postoperative wound infection in pediatric patients . Over a 14-month period, 676 patients who received an operative incision on the Pediatric Surgical service were entered . Demographic, nutritional, clinical, and laboratory data were collected . The patients were followed for development of postoperative wound infection . Cultures were taken from wounds to identify the offending organisms . Of the 676 patients, 137 were neonates, 197 infants, and 342 older children . Wound infection occurred in 17 patients (2.5%): 1 neonate (0.7%), 8 infants (4.1%), and 8 older children (2.3%) . Infection rates according to wound classification were: clean 1.0%, clean-contaminated 2.9%, contaminated 7.9%, and dirty 6.3% . Heavily contaminated or dirty wounds were packed open in one third of cases, and allowed to heal by granulation . The largest group of wound infections followed operations on the gastrointestinal tract (10 patients, 267 operations, 3.7%) . Staphylococcus aureus, Escherichia coli, and alpha hemolytic streptococcus were the most common wound pathogens . An increased rate of wound infection was associated with operative procedures longer than 1 hour, with the presence of an associated illness, and with emergency operations . Age, sex, nutritional status, and duration of preoperative hospital stay did not significantly alter the wound infection rate . It could be concluded that the incidence of wound infection was lower among pediatric surgical patients than the reported incidence in adult surgical patients . The greatest risk factors were those associated with local contamination of the surgical wound.

J Oral Rehabil, 1990 Jan, 17(1), 61 - 6
The effect of sustained release application of chlorhexidine on salivary levels of Streptococcus mutans in partial denture wearers; Zyskind D et al.; The effect of a slow-releasing dosage (SRD) coating of chlorhexidine on the salivary levels of Streptococcus mutans and on plaque index scores in patients with removable partial dentures (RPD) was tested . The SRD proved to be effective in maintaining a low level of S . mutans counts after mechanical cleaning, as compared to a baseline established during the control period . Plaque index scores were lower following the treatment and correlated with the microbiological results . Our findings indicate that a single application of sustained-release chlorhexidine to removable partial dentures effectively maintains S . mutans levels as well as reducing the plaque score for a minimum period of 1 week.

J Infect, 1990 Jan, 20(1), 59 - 63
Early-onset neonatal pneumococcal sepsis in siblings; Wright ED et al.; The case of a woman who in two successive pregnancies produced premature infants affected by early-onset Streptococcus pneumoniae type 8 sepsis is described . Low maternal levels of pneumococcal IgG antibodies were demonstrated after the second delivery, and vaccination with 'Pneumovax' produced a rise in antibody levels . Attention is drawn to the similarity between early-onset pneumococcal neonatal sepsis and group B streptococcal sepsis . Mothers of infants affected by early-onset pneumococcal sepsis who have low pneumococcal antibody levels run the risk of subsequent babies being similarly affected and vaccination should be considered to prevent recurrence.

Cornea, 1990 Jan, 9(1), 77 - 80
Infectious crystalline keratopathy associated with topical anesthetic abuse; Kintner JC et al.; Two patients with infectious crystalline keratopathy associated with topical anesthetic abuse are described . No previously reported predisposing factors existed, including topical corticosteroid use during active Herpes simplex or Acanthamoeba keratitis, or following penetrating keratoplasty . Cultures from corneal biopsies of both patients grew Streptococcus viridans . Both infections resulted in corneal scarring with vascularization . Ultimately, corneal transplantation was performed in one case.

Infect Immun, 1990 Jan, 58(1), 163 - 8
Cellular coaggregation of oral Streptococcus milleri with actinomyces; Eifuku H et al.; Oral isolates of Streptococcus milleri were examined for their ability to coaggregate with actinomyces . Of the 68 S . milleri strains tested, including 3 reference strains, 40 strains coaggregated with Actinomyces naeslundii WVU45 (actinomyces coaggregation group B) and 36 strains coaggregated with Actinomyces viscosus T14V (actinomyces coaggregation group A) . All S . milleri strains of serotypes b (4 strains), e (2 strains), and f (24 strains) coaggregated with both of the actinomyces . The coaggregation reactions between the S . milleri cells and A . naeslundii WVU45 cells were optimal at about pH 7.0 and were Ca2+ or Mg2+ dependent, but they were not inhibited by the presence of simple sugars or amino sugars, including lactose (up to 0.5 M) . Treatment of the S . milleri cells with heat (100 degrees C, 3 min) or proteases (trypsin, 1.0 mg/ml; pronase, 0.25 mg/ml; 37 degrees C; 3 h) and of the actinomyces cells with periodate (0.01 M, 4 degrees C, 16 h) destroyed their coaggregating abilities . The coaggregations between cells of the S . milleri strains, we well as cells of the Streptococcus sanguis H1 (reference strain for streptococcus coaggregation group 2) and the actinomyces strains (WVU45 and T14V), were inhibited by AFH1 (a carbohydrate receptor on T14V cells for a lectin on H1 cells) . These interactions were also inhibited by anti-AFH1 immunoglobulin G (IgG) and by anti-b, anti-e, and anti-f S . milleri IgG or anti-f IgG Fab fragments . These results suggest that S . milleri, at least strains of serotypes b, e, and f, belongs to streptococcus coaggregation group 2.

J Fr Ophtalmol, 1990, 13(6-7), 327 - 31
{Endogenous bacterial endophthalmitis . Report of 3 cases}; Riss JM et al.; Since the antibiotic era, endophthalmitis has been a rare complication of bacterial septicemia . The authors report hereby 3 cases of endogenous bacterial endophthalmitis . Both eyes were involved in one case . Causative bacteria were identified in blood . Cultures were positive respectively for Streptococcus pneumoniae, Staphylococcus aureus and Klebsiella pneumoniae . All patients received intravenous antibiotherapy, once intravitreal antibiotic was injected . Clinical manifestations were three times panophthalmitis with dramatic course . In one case, only the anterior segment was involved . The course became complicated with a cataract, but the patient finally recovered . Although several clinical types with distinct prognoses can be defined, endogenous bacterial endophthalmitis remains a devastating situation . Treatment is controversial because of the uncertainty about the value of intravitreal antibiotics and vitreous surgery.

Child Nephrol Urol, 1990, 10(3), 158 - 60
Cat-scratch bacillus and Streptococcus pneumoniae causing submandibular suppurative adenitis and acute glomerulonephritis; Wolach B et al.; Acute cervical adenitis is a frequent problem in pediatrics . It is occasionally followed by acute postinfectious glomerulonephritis, which has a well-defined set of clinical and histological manifestations . We present two rare cases of acute postinfectious glomerulonephritis, one associated with Streptococcus pneumoniae and the second with cat-scratch disease . Cultures of material from the lymph nodes yielded S . pneumoniae type 15 in case 1 . A pleomorphic gram-negative micro-organism, identified by silver stain as cat-scratch bacillus, was found in case 2.

Mikrobiyol Bul, 1990 Jan, 24(1), 71 - 8
{Evaluation of conjunctival cultures in various eye infections}; Yildirim N et al.; 1550 conjunctival cultures taken between 1985-1988 were evaluated retrospectively . Among 455 cultures with positive growth, bacterial agents seen in their order of occurrence were Staphylococcus epidermidis (35.82%), Streptococcus pneumonia (19.34%) and Staphylococcus aureus (18.46%), respectively . Moreover, the distribution of agents in 185 cases with complete clinical records were discussed in the light of data found in the literature.

Eur Arch Otorhinolaryngol, 1990, 248(2), 113 - 8
Uptake of horseradish peroxidase by the middle ear mucosa in experimentally induced otitis media; Sakagami M et al.; Electron microscopy was used to study the characteristics of uptake of the protein tracer, horseradish peroxidase (HRP), by the middle ear mucosa of chinchillas . Two types of experimental otitis media were used: serous otitis media (SOM) produced by eustachian tube obstruction and purulent otitis media (POM) produced by inoculation of Streptococcus pneumoniae type 7F . HRP was placed in each tympanic bulla for either 1 min or 10 min . In the 1-min installation of HRP, the degree of HRP uptake was higher in SOM and POM animals than in control animals . Following the 10-min installation of HRP, the degree of HRP uptake was higher in SOM and POM animals than in control animals . Following the 10-min installation of HRP, the degree of tracer uptake was almost the same as among the control, SOM and POM animals . The mechanism of uptake was pinocytosis . In another experiment, 5-hydroxydopamine (mol . wt . 256) was used as a small tracer placed into the bulla to examine the permeability of epithelial tight junctions . No labelling of reaction product was observed in the tight junctions of the control, SOM or POM animals . These findings suggest that otitis media increases the uptake of HRP by pinocytosis and that epithelial tight junctions remain intact in inflammation of the middle ear cavity.

Caries Res, 1990, 24(4), 248 - 53
Accumulation of enamel constituents in Streptococcus mutans plaque during intraoral demineralization; Kashket S et al.; Studies were carried out with an intraoral demineralizing system in order to determine whether calcium and inorganic phosphate (Pi) accumulate in plaque during active demineralization of enamel . Blocks of bovine enamel were coated with Streptococcus mutans and were carried in palatal appliances worn by human volunteers . Demineralization was determined as changes in the iodide penetrability (delta Ip) of the enamel surfaces . Ca and Pi were determined in the extracellular spaces of the synthetic plaque . Delta Ip increased with time after administration of rinses containing 5% (w/v) sucrose, while plaque pH dropped and then returned toward neutrality . Ca increased to 10.9 +/- 2.8 mmol/l at 30 min, while Ca2+ and Pi rose to 3.0 +/- 2.1 and 9.5 +/- 3.1 mmol/l, respectively . The Ca:Pi ratio was 1.15 . Rinses with 10% (w/v) sucrose gave similar results . Concentrations of Ca and Pi were considerably higher than those in saliva . Accumulation of the mineral constituents was shown to be dependent on metabolic activity of the S . mutans plaque, and experiments in which enamel blocks were replaced with blocks made of acrylic plastic gave Ca and Pi concentrations of 2.5 +/- 0.6 and 6.6 +/- 2.4 mmol/l, respectively, demonstrating that most of the Ca and about one-third of the Pi were derived from enamel . The data suggested, furthermore, that Ca and Pi were partially bound to complex macromolecules, and that part eventually recrystallized as mineral within the plaque.

Swed Dent J Suppl, 1990, 73, 1 - 41
Studies on posterior composite resins with special reference to class II restorations; Lundin SA; Longevity, clinical performance and some related factors of posterior composite resin restorations were investigated through clinical follow-up and laboratory studies in vivo and in vitro . Class I and Class II restorations using two experimental posterior composite resin materials were followed clinically for a four-year period . USPHS evaluation criteria were used . Assessments of wear were also made indirectly using the Leinfelder method . Marginal leakage of bacteria (in vivo) and of dye (in vitro) were studied on modified loaded Class II composite resin restorations lined with GlumaR and LifeR . The grade of conversion (cure) of the posterior composite resin material and the colonization of bacteria at proximal tooth surfaces restored with posterior composite resins were evaluated . Seven per cent of the restorations were evaluated as failures and had to be replaced during a 4-year period . The failures were mainly due to fractures and postoperative sensitivity . The calculated occlusal wear rate was 34-40 microns/year . Occlusal loading of Class II restorations in vitro resulted in a higher frequency of restorations with marginal leakage . The marginal leakage for occlusally-loaded Class II restorations in vivo and in vitro could be reduced if dentine bonding was utilized . The grade of conversion (cure) was increased in the in vivo situation compared to the in vitro . Bacterial colonization of strepococcus mutans on the proximal surfaces of posterior composite restorations showed higher frequencies compared to that on sound tooth surfaces . From the results of these studies, it may be concluded that the tested posterior composite resin materials can be used in Class I and II restorations with a good prognosis for at least 4 years . When posterior composite resins are used as restorative for posterior teeth, the following conditions should be considered: The occlusal loading should be minimal, dentin bonding should be used, the increased risk of colonization of streptococcus mutans should be acted on and regular clinical and radiographical follow-up should be performed.

Caries Res, 1990, 24(5), 306 - 11
Interactions of selenium and fluoride on growth, glycolysis and survival of Streptococcus mutans GS-5; Eisenberg AD et al.; The effects of low concentrations (1.0 mmol/l of selenite and seleno-dl-cystine were tested alone, or in combination with NaF, on growth, glycolysis, and survival of Streptococcus mutans GS-5 . In batch culture, both selenium-containing compounds (1.0 mmol/l) inhibited the growth rate and final cell yield by 92% or greater; glycolysis, however, was not affected . The observed bactericidal action of selenite at 0.1 mmol/l was pH-dependent . Fluoride reduced the killing effect of SeO3 in the culture medium and in a lactate-acetate buffer system at pH 6.5, 5.0 and 4.0 . These data indicate that selenium-containing compounds exert an antibacterial action on cells of S . mutans in a manner which leaves glycolysis unaffected.

Rev Inst Med Trop Sao Paulo, 1990 Jan-Feb, 32(1), 11 - 5
{Serotypes of Streptococcus pneumoniae isolated from cerebrospinal fluid in 1977-1988 in São Paulo City, Brazil}; Taunay AE et al.; Since 1977, the Instituto Adolfo Lutz (IAL) is having interest in the serotyping of S . pneumoniae or pneumococcus from infections caused by this bacteria . The isolated strains have been sent to the WHO Pneumococcal Reference Center, Pennsylvania, U.S.A. . From 1977 to 1988, 1.000 pneumococcus strains isolated from cerebrospinal fluid were typed, according to Danish nomenclature, and 60 serotypes were identified . The most frequent serotypes were 1, 6B, 18C, 14, 5, 3, 6A, 23F, 19F, and 38 . Among different age groups, they showed a variable incidence, with serotype 6B in the ages of zero to almost 2 years old, serotype 1 in the age group of 2 to 50 years old, and serotype 3 in the ages over 50 . During the 12 years study, 25 serotypes showed some uniformity in the frequency, the same as with the seasonal fluctuations . Concerning the severity of the pneumococcal infections, chiefly meningitis, and the few information related to pneumococcus serotypes which occur in the area, it was considered of high relevance to have the information of serotypes, once polysaccharide vaccines have been employed with success to prevent these infections.

Child Nephrol Urol, 1990, 10(2), 112 - 4
Acute poststreptococcal glomerulonephritis and acute rheumatic fever: occurrence in the same patient; Matsell DG et al.; Group A streptococcus can cause both acute glomerulonephritis and acute rheumatic fever . The occurrence of characteristic acute poststreptococcal glomerulonephritis and acute rheumatic fever in the same patient is rare . We describe a 10-year-old girl with acute rheumatic fever who presented with the typical clinical and biopsy findings of acute poststreptococcal glomerulonephritis.

Beitr Gerichtl Med, 1990, 48, 229 - 31
{Waterhouse-Friderichsen syndrome in adults}; Varchmin-Schultheiss K et al.; Only a minority of published cases of Waterhouse-Friderichsen-syndrome occurred in adults (Harms et al., 1973) . At the autopsy of a 23 years old woman there were found sugillations of the eyelid, of the peri- and epicard, of the serosa of the small intestine and of the lung . In the region of the adrenal gland a brownish-red mass was detectable . Histologically an adrenal apoplexy with necrosis and in liver, spleen and lung a lot of neutrophils were seen . Streptococcus viridans was pointed out in the blood.

Przegl Lek, 1990, 47(3), 348 - 52
{Clinical analysis of 53 cases of septicemia caused by Streptococcus viridans in children}; Szymborski J et al.; The clinical analysis has been performed in 53 cases of sepsis induced by Streptococcus viridans . Among children with diagnosis of sepsis majority of cases in group of older infant and children up to 2 year age was due to above infection . The S . viridans strain isolated form the blood were in 90% percentage resistant to cloxacillin , the resistance to penicillin, ampicillin and gentamicin was equal to 70%, 50% and 34% respectively . The main symptoms of the S . viridans sepsis was most frequently localized in lung . Laboratory findings most frequently revealed anemia and toxic granulation in neutrophils . Four children died due to the infection (mortality index to 7.5%).

Pediatr Pathol, 1990, 10(5), 757 - 68
Clinicopathological differences between early-onset and late-onset sepsis and pneumonia in very low birth weight infants; Itoh K et al.; We performed clinicopathological studies on early-onset sepsis (5 infants, less than 72 hours of life, EOS) and late-onset sepsis (15 infants, greater than 72 hours, LOS) of very low birth weight, less than 1500 g (VLBW) . In EOS, the clinical features mimic the respiratory distress syndrome and hematological changes were not observed . The lungs showed slight interstitial pneumonia with structural immaturity, hyaline membranes, hemorrhage, and minimal infiltration by polymorphonuclear neutrophils (PMNs) . The pathogen was group B streptococcus or weakly gram-negative bacilli . In LOS, pneumonia proceeded to sepsis and neutropenia with elevated numbers of circulating immature neutrophils, and increased levels of C-reactive protein were observed at the onset of sepsis . Severe pneumonia with infiltration of numerous PMNs and bacterial colonies and polymicrobial infection by nosocomial pathogens such as Staphylococcus aureus and Pseudomonas aeruginosa were common . The thymus and spleen weights varied but retained normal structure in EOS . The thymus was depleted of lymphocytes, and the spleen was hypertrophic but poorly reactive against infection in LOS . The pathogenesis of EOS is regarded as being more closely correlated with lung immaturity and circulatory disorder in early life, whereas that of LOS is associated with immunological defenses of the host, potency of the pathogens, and terminal multiple organ failure.

Scand J Infect Dis, 1990, 22(4), 493 - 7
Neonatal sepsis due to Streptococcus pneumoniae; Jacobs J et al.; A 20-year-old primigravida in the 33rd week of gestation was delivered of a girl weighing 1,790 g 23 h after spontaneous rupture of the membranes . 13 h after birth, the child showed signs of shock . Cultures of blood, conjunctiva and nasopharyngeal aspirate grew Streptococcus pneumoniae of serotype 11 . Cultures from the mother's cervix and from the placenta and membranes also grew S . pneumoniae of the same serotype . The infant responded well to ampicillin and netilmicin . The early-onset pneumococcal septicemic cases reported over the last 20 years are reviewed.

Jpn J Med, 1990 Jan-Feb, 29(1), 89 - 90
Overwhelming pneumococcal pneumonia in a patient receiving ofloxacin for antimicrobial prophylaxis; Saito H et al.; A case of severe bacteremic pneumococcal pneumonia which developed in a patient with lung cancer, who was taking ofloxacin for chemoprophylaxis, is presented . Pneumonia resolved well with intravenous penicillin G . Infection by and colonization with Streptococcus pneumoniae might become a problem with increasing use of the fluoroquinolones.

Biotherapy, 1990, 2(3), 235 - 45
Changes in immunological parameters in lung cancer patients undergoing immunotherapy with streptococcal preparation OK-432; Watanabe Y et al.; We have studied the immunological status of patients treated with streptococcal preparation OK-432 . Two KE of OK-432 was injected intramuscularly once every week for more than three years unless the patients died . The natural killer (NK) activity in those patients who underwent curative surgery for lung cancer and had no sign of recurrence was significantly increased (P less than 0.01) during the OK-432 treatment . However, the NK activity in the patients who had persistent disease (non-resected cases, incompletely resected cases or recurrent cases) was not significantly increased in comparison with that before the immunotherapy . Also, in the cases with no clinical symptoms of recurrence, both the lymphoblastogenetic reactions to the mitogens and the IL-2 production were significantly enhanced (P less than 0.01) during the administration of OK-432 . Reactions in the SU-PS (polysaccharide taken from the cell-wall fraction of the Streptococcus pyogenes SU strain and containing 7.2% of protein) skin-test appeared to significantly correlate with the immunological status of the patients under OK-432 therapy, but the PHA and PPD skin reactions showed no definitive enhancement . The survival rate of the patients whose SU-PS skin tests were positive during the OK-432 immunotherapy was significantly higher (P less than 0.01) than that of the patients with negative reactions.

Czech Med, 1990, 13(1), 38 - 42
Eikenella corrodens infection of the oral cavity as a cause of bacterial endocarditis; Bigl P et al.; The authors describe the case of a 24-year-old woman with valve disease . After a bout of respiratory tract infection, she was diagnosed to have bacterial endocarditis associated with mitral valve disease . The causative agents isolated included Eikenella corrodens, Streptococcus intermedius, Bacteroides oralis and Bacteroides bivius . At the same time, the patient was found to have developed IgA immunodeficiency . A complication accompanying the cardiac disease was spontaneous pneumothorax . Since antibiotic therapy had failed, the mitral valve was replaced by a prosthetic one . After the procedure, the patient had her teeth examined . The examination revealed complete destruction of tooth 36, thick layers of calculus and chronic gingivitis . E . corrodens was isolated also after microbiological examination of the patient's oral cavity . The reason for reporting on what we regard as an interesting case is that bacterial endocarditis with E . corrodens implicated as the causative agent is relatively rare; to date, polymicrobial endocarditis due to E . corrodens and other microorganisms has been described in intravenous drug addicts only.

Neurosurg Rev, 1990, 13(2), 103 - 7
Brain abscess in Saudi Arabia; Ibrahim AW et al.; There are significant variations among countries in the incidence of brain abscess . We report here 26 cases of brain abscess treated at the Neurosurgery Department of King Faisal University and Dammam Central Hospital Saudi Arabia over a six year period (1982-1988) . This is 2.3% of total admissions to the two neurosurgery departments serving a population of approximately 1.2 million in the same period . Young males were most often affected (M/F ratio 3.3:1; 31% were less than 15 years old, 46% aged between 15-39 years, and 23% older than 40 years) . Streptococcus was found to be the most common microorganism (38.4%) . Mixed infection was seen in 15.3%, and sterile abscesses were found in 11.5% of the patients after aerobic and anaerobic cultures of the pus . Chronic otitis media and paranasal sinusitis predisposed the patients to abscess formation in 57.6% of the cases . The temporo-parietal area was the commonest site . Epilepsy was a complication in 30.7% of our patients, and the mortality rate was 15.3%.

Med Microbiol Immunol (Berl), 1990, 179(1), 13 - 23
Immunopathological investigations during the course of arthritis induced in rats by Streptococcus agalactiae; Abd AH et al.; A large single intraperitoneal injection of sonicated cells of Streptococcus agalactiae O90R induced polyarthritis in Wistar rats . The arthritis reaction score was monitored according to redness, edema, severity and deformity of rat ankle and wrist joints . The inflammation of joints was confirmed by radiology and histology . Acute arthritis was initiated within 48 h and the chronic form continued for more than 30 days . Although serum immunoglobulin was elevated within 48 h, anti-streptococcal antibody was detected only at later times (by enzyme-linked immunosorbent assay and Arthus-type hypersensitivity reactions) and neither serum nor splenocytes of arthritic rats were able to transfer disease to susceptible, normal rats . From these observations and the finding of streptococcal antigen in joint macrophages (by immunogold labelling) we conclude that arthritis is related to persistent streptococcal fragments rather than to antibody or immune complexes.

Vet Immunol Immunopathol, 1990 Jan, 24(1), 79 - 89
The opsonic antibody response of female rats to type III group B streptococcal immunization: a model for maternal immunity; Heiman HS et al.; Group B streptococcus (GBS) remains a major cause of neonatal infection . Maternal immunization-induced GBS antibody may protect neonates from GBS disease . Since the opsonophagocytosis assay correlates well with survival in GBS infected suckling rats, we sought to determine an immunization schedule which would induce type III GBS opsonic antibody in rat dams above a predetermined level of 10 dilution-1 (dil-1) . This schedule could then be used for future studies of maternal-fetal immunity . Wistar rat dams (n = 12) were given killed GBS type III using three immunization schedules (primary injection, initial booster at 7, 14 or 22 days and then weekly boosters) . Opsonic GBS type III antibody and total immunoglobulin (IgG) were measured . Only the schedule with a 7-day initial booster resulted in GBS type-specific opsonic antibody consistently above 10 dil-1 . The IgG (467 +/- 83 mg/100 ml) remained constant while the opsonic antibody increased significantly to 50 and 63 dil-1 (P less than 0.01 compared to day 0) after boosters on day 7 and 14 respectively . Eight pregnant dams, who received a primary immunization and boosters at 7 and 14 days, developed GBS type III opsonic antibody titers (72 dil-1) similar to non-pregnant dams and potentially adequate to protect suckling rats from GBS disease . This model may now be used to study other adjuvants, immunogens, and maternal-fetal immunity using established suckling rat models of GBS disease.

Acta Clin Belg, 1990, 45(4), 264 - 8
Interest of gallium hepatic scintigraphy in hepatic abscess: a case study; Daumerie C et al.; The interest of 67Ga-citrate scintigraphy in the diagnosis of hepatic abscess is illustrated by a study of a 56-year-old man, who was admitted to the hospital for upper abdominal pain . Ultrasound (US) and X-ray CT scan examinations suggested the presence of a liquid mass, the origin of which was unclear . Liver scintigraphy with 67Ga-citrate disclosed a lacunar zone surrounded by a rim of increased uptake, an image strongly suggestive of abscess or necrotic tumor . A US-guided needle aspiration of the hepatic mass yielded a purulent liquid, from which Streptococcus milleri were grown . This observation suggests that, despite the development of other diagnostic procedures, hepatic gallium scintigraphy still remains sometimes useful for the investigation of poorly characterized hepatic masses.

Pediatrie, 1990, 45(1), 29 - 33
{Circumscribed spinal myositis ossificans of infections origin}; Sijelmassi R et al.; A case of paravertebral, non-traumatic myositis ossificans in a 4.5 year-old boy is reported . Infectious spondylitis and osteosarcoma were considered before the diagnosis was established on the basis of histological examinations of a biopsy performed during excision . A group G beta hemolytic streptococcus was isolated from the biopsy, suggesting an infectious etiology which has rarely been reported . The child appears to be completely cured one year after excision.

Arch Oral Biol, 1990, 35(9), 753 - 8
Phenytoin-induced gingival overgrowth in rats infected with Streptococcus sobrinus 6715; Morisaki I et al.; Inbred Fischer rats were fed a high sucrose diet (No . 2000) containing phenytoin (5,5-diphenyl-hydantoin) for 52 days, which produced serum and salivary PHT levels of 13-14 and 2.6-2.7 micrograms/ml, respectively . Gingival overgrowth was induced in the molar region of all PHT-treated rats but was more severe in Streptococcus sobrinus 6715-infected rats than in non-infected rats, which had lower plaque scores . No significant overgrowth was found in rats infected with Strep . sobrinus and fed the same diet without PHT . Thus dental plaque accumulation enhanced, but was not essential for the development of the PHT-induced gingival overgrowth . Histological examination showed that the density of fibroblasts and connective tissue fibres was similar in all groups . This experimental model could serve as a useful means of understanding the pathogenesis of PHT-induced gingival overgrowth.

Scand J Infect Dis Suppl, 1990, 72, 20 - 5
The bactericidal activity of vancomycin and teicoplanin against Streptococcus pneumoniae; Felmingham D et al.; The in vitro inhibitory and bactericidal activity of vancomycin and teicoplanin against clinical isolates of Streptococcus pneumoniae was investigated . Minimum inhibitory concentrations (MICs) were determined using an agar incorporation technique . Vancomycin (MIC range 0.12-0.25 mg/l) and teicoplanin (MIC range 0.03-0.12 mg/l) were both very active against the isolates examined . Single-time-point minimum bactericidal concentrations (MBCs) were determined using a macrobroth incorporation technique . Both antimicrobials brought about a 99.9% reduction in viability of the original inocula during 24 hours' exposure at concentrations of 4-8 times the MIC for vancomycin and 2-4 times the MIC for teicoplanin . Time-kill curves of vancomycin, teicoplanin and penicillin against a penicillin-susceptible and a penicillin-resistant strain of S . pneumoniae showed a greater than 3.0 log10 cfu/ml reduction in viability of cultures within 6 hours of exposure to all three of the antimicrobials at a concentration equal to eight times the MIC . The results suggest that clinical trials of the efficacy of teicoplanin in the treatment of infections caused by S . pneumoniae are warranted.

Zahn Mund Kieferheilkd Zentralbl, 1990, 78(6), 483 - 7
{The phagocytic activity of the blood neutrophilic granulocytes in patients with marginal periodontitis}; Brachmann P et al.; The ingestion of opsonized zymosan particles by neutrophil blood granulocytes and the chemiluminescence in samples of whole blood, induced by zymosan, Streptococcus mutans as well as phorbol myristate acetate, as a measure of the generation of reactive oxygene species were studied in patients with various forms of marginal periodontitis . Compared to a control group the phagocytic activity was found to be enhanced in progressive adult periodontitis and diminished in juvenile periodontitis whereas no differences to controls were found in chronic nonprogressive or postjuvenile periodontitis . With respect to the height of the chemiluminescence signals increased values were only measured in chronic nonprogressive periodontitis after stimulation by phorbol myristate acetate . The results indicate that impairment of blood granulocyte functions may be a pathogenetic factor for the development and the progression of marginal periodontitis.

Caries Res, 1990, 24(6), 446 - 51
Effect of experimental hyposalivation on the induction of dental caries in rats infected with Streptococcus mutans; Ooshima T et al.; The effects of hyposalivation on the induction of dental caries were examined in specific pathogen-free Sprague-Dawley rats infected with Streptococcus mutans MT8148R and fed the caries-inducing diet 2000 . Hyposalivation was induced by either irradiation or surgical removal of salivary glands in 30-day-old rats . After either procedure, severe dental caries was induced in the rats when examined at 84 days of age, and a statistically significant correlation was found between caries scores and flow rates of saliva . However, the recovery of strain MT8148R from hyposalivated rats was not always high, and it is possible that microorganisms other than the inoculated S . mutans strain MT8148R may have played a role in promoting dental caries.

Rev Chir Orthop Reparatrice Appar Mot, 1990, 76(5), 321 - 8
{Early reoperation for infection in orthopedic surgery of the leg (arthroplasties and hip surgical procedures excluded)}; Lortat-Jacob A et al.; The authors report 32 cases of post-operative infections reoperated before the first month of which 12 articular fractures of the tibia . 6 tibial osteotomies of valgisation, 6 tibial diaphyseal fractures, 2 fractures of the lower extremity of the femur, 2 bimalleolar fractures, 1 serious knee sprain, 1 patellar fracture, 1 calcaneum fracture and an arthroscopic arthrolysis of the knee . Twelve of them had an articular infection . Globally, they have obtained 22 satisfactory results (very good or good) and 10 non satisfactory results out of which 2 deaths and 1 amputation . The bad results were due either to a particularly aggressive germ (streptococcus and gas gangrene), or to an articular infection insufficiently controlled: 5 out of the 10 arthrites on infected articular fractures have had a non satisfactory result . As for metaphyseal infections, a simple cleaning has given 4 very good results out of 6, the 2 excluded being very serious and special cases . For the 6 diaphyseal leg infections after osteosynthesis, the early reoperation has not avoided a secundary graft in a picture of infected pseudoarthrosis . In view of this series, the authors propose to adapt the cleaning operation to the localisation and to the presence or not of an articular infection.

Chemotherapy, 1990, 36(4), 287 - 93
Protective role of complement in the development of experimental pneumococcal pneumonia in mice; Nakajima R et al.; To evaluate the role of complement in the lung defense against Streptococcus pneumoniae, mice decomplemented with multiple injections of cobra venom factor were challenged with type 3 pneumococci by inhalation . Without injection of cobra venom factor, the organisms were eliminated rapidly from the lungs in the majority of mice, accompanied by a significant but transient decrease in the serum C3 level . Focal pneumonia developed occasionally in some mice retaining the organisms in the lungs . By decomplementation with cobra venom factor, on the other hand, pneumococci were not eliminated completely from the lungs during the early stage of infection and afterward proliferated extensively . Consequently, the mice developed typical pneumococcal pneumonia with attendant bacteremia, while the serum C3 level has recovered compensatory during the course of infection . Thus, the complement was indicated to play an important role in the lung defense against pneumococci in mice, especially during the early stage of infection.

Acta Otorhinolaryngol Belg, 1990, 44(1), 37 - 41
{Deafness-blindness caused by Streptococcus suis meningitis--epidemiology and rehabilitation}; Cammaert T et al.; A case of blind-deafness due to Streptococcus suis meningitis is described . The high incidence of blind-deafness in this disease is emphasized . Rehabilitation problems are discussed . Special attention is given to the Lorm writing as an ideal way of revalidation in this particular patient.

J Gen Microbiol, 1990 Jan, 136 ( Pt 1), 165 - 9
Secretion of fructosyltransferase by Streptococcus salivarius involves the sucrose-dependent release of the cell-bound form; Milward CP et al.; Three strains of Streptococcus salivarius including a recent clinical isolate were found to possess Ca2(+)-dependent fructosyltransferase (FTF) activity . The extracellular FTF activity of cells grown on sucrose increased as much as 9-fold compared with cells grown on either glucose, fructose or galactose . This increase in activity was due not to induction of FTF by sucrose, but to the release of the cell-bound form of the enzyme . Studies with washed cells of S . salivarius ATCC 25975 showed that the extent of release of the cell-bound FTF activity was dependent upon the sucrose concentration up to 4 mM, at which concentration maximum release (95%) of cell-bound FTF occurred . Several lines of evidence suggested that either substrate binding or de novo synthesis of fructan is required for the release of the cell-bound FTF activity.

Arch Microbiol, 1990, 153(4), 378 - 83
ATPase-dependent energy spilling by the ruminal bacterium, Streptococcus bovis; Russell JB et al.; When the ruminal bacterium Streptococcus bovis was grown in batch culture with glucose as the energy source, the doubling time was approximately 21 min and the rate of bacterial heat production was proportional to the optical density (1.72 microW/micrograms protein) . If exponentially growing cultures were treated with chloramphenicol, there was a decline in heat production, but the rate was greater than 0.30 microW/micrograms protein even after growth ceased . Since there was no heat production after glucose depletion, this growth-independent energy dissipation (spilling) was not simply due to endogenous metabolism . Stationary cells which were washed and incubated in nitrogen-free medium containing an excess of glucose produced heat at a rate of 0.17 microW/micrograms protein . Monensin and tetrachlorosalicylanilide (TCS), compounds which facilitate an influx of protons, caused a more than 2-fold increase in heat production . Dicyclohexylcarbodiimide (DCCD) virtually eliminated growth-independent heat production regardless of the mode of growth inhibition . Because DCCD had little effect on the glucose phosphotransferase system, it appeared that the combined action of proton influx and the membrane bound F1F0 proton ATPase was responsible for energy spilling.

G Batteriol Virol Immunol, 1990 Jan-Dec, 83(1-12), 108 - 17
{Streptococcus mutans and dental caries: microbiological aspects}; Zucca M et al.; The central role of Streptococcus mutans in the pathogenesis of caries is universally recognized . In this article we discuss bacterial metabolism relevant to plaque formation and enamel destruction, and review current methods and new prospects in caries prophylaxis: the use of fluorine, possible substitutes for sucrose, active and passive immunoprophylaxis, teeth colonization with non-cariogenic strains of S . mutans . No one of these methods can be considered a definitive solution for every caries problem, but short term major achievements can be reasonably attained by ongoing field research.

Reg Immunol, 1990-91, 3(6), 289 - 96
Mucosal and systemic responses to an oral liposome-Streptococcus mutans carbohydrate vaccine in humans; Childers NK et al.; Purified polysaccharide antigens are often poorly immunogenic, especially when given by the oral route . However, it has been shown in experimental animals that liposomes can greatly increase the immunogenicity of certain polysaccharide antigens . Here we report the induction of immune responses in humans to an oral vaccine consisting of liposomes containing purified serotype carbohydrate antigen of Streptococcus mutans, the primary etiological agent of dental caries . Four volunteer subjects swallowed enteric coated gelatin capsules containing liposomal-antigen for seven consecutive days . Pre- and post-immunization samples of saliva and plasma were analyzed for antibody activity to S . mutans carbohydrate by ELISA . Salivary anticarbohydrate IgA responses were detected in all four subjects between day 21 and day 32 . Upon second and third immunizations, subjects experienced salivary responses earlier than following the first immunization . Early (day 4-7) plasma IgA responses to the carbohydrate were found in three subjects which consisted of both polymeric and monomeric forms . Variable levels of plasma IgG anti-carbohydrate antibody activity were seen in three individuals . These results show that orally administered liposomal-S . mutans serotype carbohydrate antigen induces a salivary IgA response in humans and provides evidence for the efficacy of liposomal antigen delivery system in the induction of a protective mucosal immune response against microbial pathogens.

Ann Pharm Fr, 1990, 48(6), 295 - 305
{In vitro evaluation of antimicrobial activity of fusafungine}; German-Fattal M et al.; Fusafungine is an antibiotic extracted from the fungus Fusarium laterium WR strain 437 . The antimicrobial activity of fusafungine was determined on strains from laboratory collections and clinical isolates; since fusafungine is not soluble in the classical media, the usual techniques had to be modified . MICs for all the Gram-positive cocci and bacteria tested, aerobic, or anaerobic, were below 30 mcg/ml . The antimicrobial activity included Mycoplasma pneumoniae (MIC less than 18 mcg/ml) and Streptococcus mutans (MIC less than 30 mcg/ml) . An antifungal activity was shown for most of the Candida albicans tested (MIC less than 32 mcg/ml) and for different Nocardia sp . (MIC less than 13 mcg/ml) . Moreover, fusafungine induced neither acquired resistance nor cross-resistance towards the antibiotics classically used in therapy.

Probl Tuberk, 1990, (9), 58 - 60
{Dependence of sensitization to specific and nonspecific antigens on the individual type of immune reaction in patients with pulmonary tuberculosis}; Ginda SS; Study of cellular sensitization and antibody formation in 317 patients with pulmonary tuberculosis (both concurrent and not concurrent with nonspecific lung diseases) to antigens of M . tuberculosis, staphylococcus, streptococcus and pneumococcus revealed their various interaction in relation to the type of immune reaction . It was noted that with a normergic type of immune reaction, the levels of cellular sensitization and antibody formation to M . tuberculosis antigens were consistent with a hyperergic type, a higher level of cellular sensitization inhibited antibody formation; and with a hypoergic type, the inhibition of cellular sensitization level was accompanied by hyperproduction of antibodies . With an anergic type of immune reaction, inhibition of cellular sensitization and antibody formation to M . tuberculosis antigens was recorded.

Arch Oral Biol, 1990, 35(10), 839 - 44
Influence of sweetening agents in solution on dental caries in desalivated rats; Bowen WH et al.; Sucralose (trichlorogalactosucrose), sorbitol and aspartame in drinking water induced little or no caries in desalivated rats infected with Streptococcus sobrinus and Actinomyces viscosus and receiving their essential nutrition by gastric gavage . In contrast, sucrose and fructose induced extensive decay . Only sucrose could sustain implantation of Strep . sobrinus in these animals . The populations of A . viscosus were sparse (0.3-0.5%) in the animals given fructose and sucrose . Large populations of A . viscosus occurred in the controls and in those given sucralose, sorbitol and aspartame . In a second experiment, where animals were also desalivated and receive diet 2000 ad libitum, sucrose in solution promoted caries whereas sucralose, aspartame and saccharin were without effect . Addition of 10 parts/10(6) F overcame the caries-promoting effect of sucrose in solution . There was no interaction between fluoride and other sweetening agents that affected the incidence of caries.

Acta Haematol, 1990, 84(2), 95 - 7
Group B streptococcal polyarthritis complicating hemophilia B; Hartmann LC et al.; We report a case of polyarticular group B streptococcal infection in an HIV-negative 46-year-old alcoholic with factor IX deficiency . Septic arthritis occurs infrequently in the hemophilic population despite their chronic joint disease; indications for diagnostic arthrocentesis in these individuals are discussed . The group B streptococcus often behaves as an opportunist in adults.

Biotherapy, 1990, 2(1), 13 - 20
Immunohistochemical analysis of inflammatory infiltrates around the injection site of a streptococcal preparation, OK-432, in rat tongue; Niimi A et al.; On the assumption that neutrophils around the injection site of OK-432, a heat- and penicillin-treated lyophilized preparation of the Su strain of Streptococcus pyogenes, enhance immunologic response through the production of Interleukin-1 (IL-1), OK-432 was injected into rat tongue, and specimens from the tongue were immunohistochemically investigated at various intervals after the injection, to clarify the process of inflammatory and immune responses at the injection site . Neutrophils and mononuclear cells appeared around the OK-432 injection site after 1 hour, increased to their maximum level at 24 hours, and then decreased from the 3rd to the 7th day . IL-1 was detected on neutrophils 3 hours after the injection, and OX-08-positive cells (suppressor/cytotoxic T cells and the majority of natural killer cells) remarkably increased . OX-39-positive cells (IL-2 receptor) appeared after 12 hours . These results suggest that neutrophils around the injection site of OK-432 at early phases of inflammation play a role in the expression of BRM function through IL-1.

Arch Oral Biol, 1990, 35(1), 43 - 8
Chemiluminescence of neutrophils from patients with Behçet's disease and its correlation with an increased proportion of uncommon serotypes of Streptococcus sanguis in the oral flora; Isogai E et al.; Zymosan-induced chemiluminescence was investigated in whole blood and in neutrophils: in both, the peak count was frequently elevated in Behcet's disease, and was significantly higher than in healthy controls; similarly the peak time was shorter . There were more uncommon serotypes of Streptococcus sanguis in the oral flora of patients with Behcet's disease . Common serotypes were present in the flora of healthy controls, but not in patients with the disease . The percentage of Strep . sanguis in the oral flora was significantly correlated with the level of chemiluminescence response . Thus infection with uncommon serotypes of Strep . sanguis may play a role in the aetiology of Behcet's disease.

Stat Med, 1990 Jan-Feb, 9(1-2), 45 - 9; discussion 49-51
Sickle cell anaemia trial; Gaston MH et al.; The major cause of death in sickle cell anaemia is from infection, especially infection caused by Streptococcus pneumoniae . Meningitis, pneumonia and septicaemia caused by this organism are the primary types of infection leading to death . Children under three years of age are at highest risk . We have known for over twenty years that approximately 30 per cent of the infants born with sickle cell anaemia will become infected in the first three years of life and one-third can be expected to die from the infection . These data were the reason that we conducted the Prophylactic Penicillin Study (PROPS), a trial to investigate the effectiveness of oral prophylactic penicillin in preventing severe infection due to S . pneumoniae . This investigation was a very efficient, cost effective study because of its timeliness and its conduct within the framework of an ongoing study . Moreover, the question being answered was simple and focused with up-to-date data that permitted accurate estimates of sample size and incidence.

Microbiol Immunol, 1990, 34(2), 211 - 9
Serogrouping of oral Streptococcus intermedius; Osano E et al.; Employing twenty fresh oral isolates of Streptococcus intermedius, studies were carried out to characterize serological relations among the isolates and also between the isolates and the strains of bacterial species closely related to S . intermedius . The Rantz-Randall extracts from the cells were used as antigens . The anti-rabbit serum raised against S . intermedius ATCC 27335T reacted with the cell extracts from only three strains of the isolates, which were designated serogroup I strains . The other isolates were classified into four serogroups, I, III, IV, and V, which specifically reacted with the cell extracts from the homologous serogroup strains . However, the serogroup II antiserum formed in immunodiffusion a common precipitin line between the extracts from the cells of serogroups II and I . The serogroups I, III, IV, and V antisera reacted with none of the extracts from the bacterial cells closely related to S . intermedius, which included Streptococcus anginosus ATCC 33397T, Streptococcus constellatus ATCC 27823T, three NCTC strains of "Streptococcus milleri," and three ATCC strains of Streptococcus MG . The precipitin line formed by the homologous reaction of the serogroup II antiserum was found to be a reaction of identity with that formed by the extract from "S . milleri" NCTC 10708 . Conversely, the antiserum against NCTC 10708 strain did not react with the cell extracts of serogroup II.

Arch Mal Coeur Vaiss, 1990 Jan, 83(1), 101 - 3
{Infected false aneurysm at the level of an aortotomy cicatrix 5 years after mechanical replacement of the aortic valve}; Richaud M et al.; The authors report the case of Streptococcus Bovis Infection of a pseudoaneurysm which developed in the aortotomy suture line five years after aortic valve replacement with a Bjork-Shiley prosthesis . This was an isolated lesion without involvement of the prosthesis or aortic ring and was an operative finding.

Ankara Univ Hekim Fak Derg, 1990 Jan, 17(1), 83 - 6
{In vivo adhesion of Streptococcus mutans on amalgam and composite restorative materials}; Gunyakti N et al.; The adherence of cariogenic S . mutans, to dental restorative materials in vitro has been reported previously . The purpose of this study was to evaluate the ability of S . mutans, to colonize on metallic and nonmetallic composite restorative materials in vivo . A total of 30 plaque samples from patients with metallic restorations, and 30 plaque samples from the patients with nonmetallic restorations obtained . This study indicates that, composite restorative materials and unpolished surfaces tend to be more highly colonized by S . mutans, than metallic and polished surfaces.

Hum Antibodies Hybridomas, 1990, 1(3), 132 - 6
Immunodominant antigens of Streptococcus mutans in dental caries-resistant subjects; Gregory RL et al.; Previously, we reported that dental caries-resistant subjects, who have significantly fewer Streptococcus mutans in whole saliva than caries-susceptible patients, have significantly higher levels of naturally occurring binding and neutralizing parotid salivary immunoglobulin A and serum immunoglobulin G antibodies to native S . mutans antigens than caries-susceptible patients . Recent animal studies indicated that the immunogenicity of swallowed S . mutans may be altered by either saliva-coating or stomach acid-denaturation . These results suggest a difference not only in the quantity of antibody to S . mutans, but also in the antigenic epitopes that caries-resistant subjects synthesize antibody to as compared with caries-susceptible patients . In the present report, sodium dodecyl sulfate-polyacrylamide gel electrophoresis/immunoblotting studies indicate that caries-resistant subjects produce salivary immunoglobulin A and serum immunoglobulin G antibodies to several different (molecular weight: 94, 80, 40, and 35 kilodaltons) as well as several similar (molecular weight: 67, 55, and 30 kilodaltons) S . mutans epitopes as compared to caries-susceptible patients . This provides additional confirmation for our previous binding and functional antibody studies, indicating that caries-resistant subjects synthesize antibodies of different specificities than caries-susceptible patients . This study supports the concept of immune regulation of dental caries by naturally occurring antibodies induced by swallowing S . mutans antigens in saliva.

Drugs Exp Clin Res, 1990, 16(11), 565 - 8
In vitro antibacterial activity of cefotaxime and desacetylcefotaxime, alone or in combination, against gram-positive cocci; Cruciani M et al.; The in vitro activity of cefotaxime and desacetylcefotaxime against Staphylococcus aureus, Staph . epidermidis and Streptococcus pyogenes was investigated . Synergy studies were performed using time-kill curves and the chequerboard test . The time-kill curves were performed on five strains each of Staph . aureus, Staph . epidermidis and Strep . pyogenes; cefotaxime and desacetylcefotaxime were tested alone or in combination at MIC and sub-MIC values . The chequerboard test was performed in microtitre plates on ten strains each of Staph . aureus, Staph . epidermidis and Strep . pyogenes: the results were interpreted by the fractional inhibitory concentration index . In some cases both methods showed synergistic interaction against the staphylococci tested . Indifference was observed against Strep . pyogenes.

Respiration, 1990, 57(4), 229 - 32
Oral immunization with bacterial lysate against infection with Streptococcus pneumoniae in mice; van Daal GJ et al.; The protective effect of oral immunization against infection with Streptococcus pneumoniae was investigated in mice . Two bacterial lysates, one with an additional lysate of Candida albicans, were investigated . Intranasal inoculation of adult Balb-C mice with a S . pneumoniae type I strain resulted in a lethal infection, with deaths occurring from the 2nd until the 6th day after infection . Oral immunization resulted in a significant decrease in mortality rate (18-48% reduction) . No significant difference in mortality rates was observed between the groups immunized with different lysates in the same concentrations.

Arch Oral Biol, 1990, 35 Suppl, 47S - 52S
Cloning of the amino terminal nucleotides of the antigen I/II of Streptococcus sobrinus and the immune responses to the corresponding synthetic peptides; Staffileno LK et al.; A portion of the antigen I/II (spaA, B, P1) gene of Streptococcus sobrinus 6715, containing the coding sequence for the amino terminal 684 amino acids of the protein, was cloned in bacteriophage lambda GT10 . Selection was by immunological detection using a polyclonal antiserum to the antigen I/II from Strep . mutans . From the amino acid sequence, peptides were synthesized, 15 amino acids in length, that covered the entire sequence . In total, 260 synthetic peptides were synthesized and evaluated for their immunogenicity in Balb/C mice . Thirty-nine peptides were immunogenic, without carrier, and the antisera generated were tested for their ability to bind cells of Strep . mutans and Strep . sobrinus in a solid-phase assay . Antisera corresponding to peptides from five regions on the I/II molecule bound cells of both bacterial species . These peptides were then evaluated for their ability to stimulate in vitro murine lymphocyte proliferation, after in vivo immunization with Strep . sobrinus cells . Two of the peptides were capable of stimulating proliferation, as determined by incorporation of {3H}-thymidine into murine lymph node cells . The sequences of these 5 peptides were then compared to sequences found in the antigen I/II from Strep . mutans (Kelly et al., 1989) . As expected, there was considerable homology between the cross-reactive peptides synthesized and the analogous region from Strep . mutans . This homology was not usually contiguous and suggests that the antibodies bind a face of antigen I/II that is in an alpha-helical conformation.(ABSTRACT TRUNCATED AT 250 WORDS)

Arch Oral Biol, 1990, 35 Suppl, 169S - 172S
Characterization of a Streptococcus mutans serotype e plasmid pJEB110; Bergmann JE et al.; A search for extrachromosomal elements in 300 mutans streptococcal strains, isolated from dental plaque, yielded one 5.7 kb plasmid (pJEB110) in a serotype e strain (JEB110) . The strain was distinguished from a plasmid-free (B2) and a plasmid-carrying (LM7) serotype e strain, by the presence of a prominent protein band of Mr 70 K on electrophoretograms of buffer-extracted denatured cell protein . Restriction enzyme site mapping indicated that pJEB110 was more closely related to pAM7, the plasmid endogenous to LM7, than to the other Strep . mutans plasmids harboured by serotype c or f strains.

Arch Oral Biol, 1990, 35 Suppl, 15S - 23S
Cloning and inactivation of the gene responsible for a major surface antigen on Streptococcus mutans; Bleiweis AS et al.; To understand more fully the biological function(s) and investigate the reported cross-reactivity with heart tissue of antigen P1 (I/II) of Streptococcus mutans (serotype c), this molecular biological study of the responsible gene, spaP, was undertaken . A 5.2 kb Hin dIII fragment of strain NG5 was cloned into Escherichia coli JM109 by a shotgun procedure with pUC18 as the vector . Recombinant SM2949 expressed a P1 fusion protein under the control of the streptococcal promoter . Southern analysis revealed hybridization of pSM2949 with DNA from Strep . mutans (serotypes c, e, f), Strep . cricetus (a) and Strep . sobrinus (d), but not Strep . sobrinus (g), Strep . rattus (b) or Strep . downei (h) . Recombinant (r) antigen was detected in E . coli periplasm, indicating the presence of a signal sequence . This product (of Mr 155K) showed partial identity to the native streptococcal P1 antigen by Ouchterlony double-diffusion analysis . The N-terminal 28 amino acid residues of rP1 were determined by Edman degradation analysis and an end-labelled oligonucleotide probe corresponding to residues 8-13 was used to determine the 5'-3' orientation of spaP by Southern hybridization with restriction enzyme digests of pSM2949 . Rabbit antisera made against native and rP1 did not cross-react with human heart tissue . Isogenic mutants of strain NG8 were isolated after transformation with insertionally inactivated spaP . Each mutant was non-reactive with anti-P1 antisera . Selected mutants were shown to have a defective spaP gene incorporated into their chromosomal DNA.(ABSTRACT TRUNCATED AT 250 WORDS)

Arch Oral Biol, 1990, 35 Suppl, 115S - 122S
Prevention of colonization of Streptococcus mutans by topical application of monoclonal antibodies in human subjects; Ma JK et al.; Topical application of Streptococcus mutans-specific MAbs was examined as a means of preventing colonization in the mouth . The MAbs recognize the cell surface antigen (SA I/II) of Strep . mutans and also bind to the intact bacterial cell . In experiments with implantation of an exogenous Strep . mutans strain, specific MAb significantly reduced the levels of implantation when compared with that in controls given a non-specific MAb . In a second investigation, the effect of MAb on recolonization by indigenous Strep . mutans was studied in subjects after treatment with a topical antibacterial mouthwash (chlorhexidine), which had decreased Strep . mutans to undetectable levels . In control subjects, the indigenous Strep . mutans started to recolonize within days, but those receiving MAb remained free of Strep . mutans for up to 2 yr . By using different Strep . mutans-specific MAbs, it was found that the serotype and epitope specificities of the IgG MAb were essential, but that the IgG sub-class may not be important . No clinical side-effects were detected in any of the subjects receiving MAb and there was no evidence of serum, salivary or gingival fluid antibody responses against the antibody . Local passive immunization with MAbs is a safe method for preventing colonization of Strep . mutans in the mouth.

Cell Signal, 1990, 2(6), 521 - 30
Differential signal requirements in T-cell activation by mitogen and superantigen; Majumdar G et al.; The requirement for co-stimulatory molecules in T-cell stimulation by mitogens and superantigens in the absence of antigen-presenting cells (APC) was investigated . Phytohemagglutinin (PHA) induced interleukin (IL)-2 receptor (IL-2R) expression on purified T-cells, but proliferation occurred only when exogenous IL-2 was added . In contrast, the proliferative response to a pepsin-extracted type 5 M-protein from Streptococcus pyogenes (pep M5), a recently identified superantigen, required signals provided by phorbol 12-myristate 13-acetate (PMA), IL-1 and IL-6 . pep M5 alone did not induce IL-2R expression; however, when combined with PMA, IL-1 and IL-6, IL-2R was expressed . Differences were also observed in the response of the leukemic T-cell line, Jurkat, to PHA and pep M5 . Soluble PHA, but not pep M5, induced IL-2 production by these cells in the presence of PMA . Cross-linking by its specific antibody or adsorption of pep M5 to microtiter plates was required to activate Jurkat cells . Both PHA and pep M5 induced Ca2+ mobilization in Jurkat cells; however, only PHA induced a rise in intracellular Ca2+ in purified T-cells, whereas pep M5 was unable to induce this activity unless IL-1, IL-6 and PMA were added . Our data provide biochemical evidence that mitogenic and superantigenic stimulation of T-cells is different.

Arch Oral Biol, 1990, 35 Suppl, 33S - 38S
Sequencing and characterization of the 185 kDa cell surface antigen of Streptococcus mutans; Kelly C et al.; The gene spa P (formerly designated as spa P1) encoding the Mr 185,000 surface antigen I/II of Streptococcus mutans, serotype c (strain NG5) has been sequenced . The deduced amino acid sequence of antigen I/II (1561 residues) includes a putative signal peptide (residues 1-38), as well as a transmembrane region (residues 1537-1556) . The N-terminal part of the protein (residues 39-550) is particularly rich in alanine and includes three tandem repeats of a sequence of 82 residues . This region is predicted to be alpha-helical, adopting a coiled-coil formation, and may account for the cell surface hydrophobicity associated with expression of antigen I/II . In contrast the C-terminal region (residues 800-1549) is proline-rich, favouring an extended conformation . Comparison with the sequence determined from Strep . mutans strain MT8148 showed that antigen I/II is highly conserved with the exception of a short central region (residues 750-805) . N-terminal sequencing of purified antigens I and II components indicated that antigen I extends from the amino-terminus of the intact Mr 185,000 surface antigen while antigen II extends from residue 996.

Int Immunol, 1990, 2(8), 775 - 85
Induction of human TCR gamma delta + and TCR gamma delta-CD2+CD3- double negative lymphocytes by bacterial stimulation; Abo T et al.; When human blood mononuclear cells (MNC) were incubated with heat-killed bacteria, proliferation of MNC was observed 5 days after stimulation, showing a peak on day 7 . Interestingly, the bioassay of the culture supernatant and Northern blot analysis of mRNA demonstrated that no IL-2 production was associated with these proliferative responses . The induced lymphoblasts consisted predominantly of TCR gamma delta + (22.4 +/- 9.3%) and TCR gamma delta-CD2+CD3-(33.2 +/- 11.8%) double negative lymphocytes (n = 10), which were initially minor populations (less than 10%) in freshly isolated MNC . The prominent induction of TCR gamma delta + cells was confirmed by Northern blot analysis . TCR gamma delta + cells induced by bacterial stimulation seemed to generate from lymphocytes lacking the apparent expression of gamma delta TCR . The inducing capability for double negative cells is present in a large number of species of bacteria, especially Gram-positive bacteria . Gel filtration analysis of ultrasonicated filtrates of Staphylococcus aureus and Streptococcus pyogenes revealed that a substance with an Mr of 25-26 kd could be substituted for whole bacterial particles in the cell proliferative responses . In contrast to the purified protein derivative (PPD)-induced response, the response described here was inducible in the cord blood of neonates who had not yet been exposed to the corresponding bacterial infection . The physicochemical properties of the sonicated filtrates were different from those of PPD . These results suggested that the present phenomenon may be nonspecific, polyclonal (or oligoclonal) activation of TCR gamma delta + and TCR gamma delta -CD2+CD3- cells by bacterial stimulation.

Virchows Arch B Cell Pathol Incl Mol Pathol, 1990, 59(6), 343 - 7
Atypical differentiation of bronchiolar epithelial cells following experimental pneumonia; Rhodes GC et al.; In the bronchiolar and alveolar epithelial responses to experimentally induced organizing pneumonia in the rat evoked by Streptococcus pneumoniae type 25, the appearance of lamellar body-containing bronchiolar cells is reported . Such cells, which are interspersed among proliferating type 2 pneumocytes in the form of intraalveolar and bronchiolar buds, also stain immunohistochemically with antisera to alveolyn, a surfactant-associated protein . We believe this phenomenon supports an hypothesis that in response to specific stimuli, proliferation of a common precursor cell of both the bronchiolar Clara cell and the type 2 pneumocyte occurs, with varying expression of a latent or precursor capacity for surfactant secretion.

Vet Res Commun, 1990, 14(3), 181 - 91
Factors influencing the adherence of strains of Streptococcus bovis and Escherichia coli isolated from ruminal epithelium; Semjen G et al.; Two strains of Streptococcus bovis (A1 and A5) and one strain of Escherichia coli (0141:H28) isolated from the surface of bovine ruminal mucous epithelium were examined for adherence to isolated and cultured ruminal epithelial cells . The E . coli adhered to the target cell by means of fimbriae, which had several common properties with type 1 common fimbriae and caused mannose-sensitive haemagglutination . The A1 strain of S . bovis was devoid of fimbriae and its adherence to the epithelial surface was not inhibited by treatment with sugars or phenol-treated bacterial membrane from the same organism . It was therefore postulated that the bacterial glycocalyx of the S . bovis organisms acted as ligand . The extent of bacterial adherence depended on the state of differentiation of the target cell in both the isolated and the cultured ruminal cell systems . The receptors for both adherent bacterial species were in all probability associated with the glycocalyx of the target cells.

FEMS Microbiol Lett, 1990 Jan 1, 54(1-3), 317 - 22
Autolysins are direct involved in the bactericidal effect caused by penicillin in wild type and in tolerant pneumococci; Lopez R et al.; The two pneumococcal autolytic enzymes (an N-acetylmuramoyl-L-alanine amidase and an endo-beta-1,4-N-acetylglucosaminidase) are directly involved in the penicillin-induced killing of Streptococcus pneumoniae . The activity of these lytic enzymes was efficiently controlled in tolerant mutants under physiological conditions.

J Virol, 1990 Jan, 64(1), 137 - 42
Characterization of the pneumococcal bacteriophage HB-3 amidase: cloning and expression in Escherichia coli; Romero A et al.; HB-3, a temperate bacteriophage of Streptococcus pneumoniae, synthesizes its own murein hydrolase activity when multiplying on cultures of pneumococcus . The enzyme (HBL) was purified and biochemically characterized as an N-acetylmuramoyl-L-alanine amidase of 36,000 daltons, and a 2.1-kilobase DraI fragment containing the lysin gene (hbl) was cloned and expressed in Escherichia coli . Our results demonstrated that the primary product of the hbl gene is a form with low enzyme activity that can be converted to a more active form under conditions similar to those previously described for the major pneumococcal autolysin (E . Garcia, J.L . Garcia, C . Ronda, P . Garcia, and R . Lopez, Mol . Gen . Genet . 201:225-230, 1985) . The phage-encoded amidase requires the presence of choline in the teichoic acids of the pneumococcal cell walls for in vivo and in vitro activity . Comparative biochemical and immunological tests of the phage-encoded and host amidases revealed a remarkable similarity between these enzymes, although analyses of their N-terminal amino acid sequences allowed us to conclude that the amidases are similar but not identical . This appears to be the first description of the cloning of a phage-encoded amidase in gram-positive bacteria.

Arkh Patol, 1990, 52(12), 19 - 24
{Pathology of generalized Streptococcus infection}; Khodasevich LS; 7 cases of the generalized streptococcus infection in children aged from 1 year 8 months to 12 years are analyzed . The course of the disease was in all cases extremely rapid and terminated by death within 3-4 days . Results of the autopsy material investigation allowed to conclude that the pathology of the generalized streptococcus infection at present does not differ from that described in classical text-books . The attention is drawn to the connection between the generalized streptococcus infection and herpes-like infections since in all cases studied herpes stomatitis, genital herpes, varicella were noted clinically . The presence of herpes-like infections was confirmed morphologically in some cases.

Arch Oral Biol, 1990, 35 Suppl, 137S - 140S
Modulation of bacterial binding to salivary pellicle by treatment with hydrophilizing compounds; Olsson J et al.; Two hydrophilizing agents, a branched polyethylene glycol derivative and a non-ionic cellulose ether (EHEC) bind to buffer-treated hydroxyapatite and prevent attachment of Streptococcus mutans . EHEC gives a more efficient surface modification, presumably due to a more complete surface coverage . Neither of the 2 hydrophilizing agents were effective on hydroxyapatite which had been pre-treated with saliva . In a small clinical trial, EHEC was found to be moderately effective in preventing plaque formation.

Arch Oral Biol, 1990, 35 Suppl, 39S - 45S
Identification of T- and B-cell epitopes in synthetic peptides derived from a Streptococcus mutans protein and characterization of their antigenicity and immunogenicity; Lehner T et al.; Natural immunity to synthetic peptides (SP) derived from the sequences of a 3800 Mr Streptococcus mutans antigen was found in human subjects . Significant serum IgG antibodies were detected both to the native streptococcal antigen and to the SP17, containing essentially residues 1-15 . A series of short peptides with deletions at the amino- and carboxy-termini were then tested to identify the B-cell epitopes . Residues 8-13 and 1-6 bound significant serum IgG antibodies but only the former consistently inhibited human antibodies, suggesting that residues 8-13 constitute a major B-cell epitope . The human CD4 subset of T-cells was then examined and this showed a significant uptake of {3H}-thymidine when stimulated with both the native streptococcal antigen and the SP17 . The series of short peptides was then used to stimulate CD4 cells, in order to determine the T-cell epitope . The synthetic peptide with residues 6-15 was the shortest peptide that stimulated significant {3H}-thymidine uptake and this peptide was designated as a T-cell epitope . The immunogenicity and antigenicity of SP17 was also investigated in macaques . Immunization of monkeys with the free SP17 failed to elicit serum antibodies or T-cell responses . However, immunization with SP17 linked to tetanus toxoid as a carrier elicited serum antibodies and proliferative responses of lymphocytes, not only to the synthetic peptide but also to the native streptococcal antigen . As in the human studies a B-cell epitope was found in residues 8-13, whereas an overlapping T-cell epitope was located in residues 7-15.(ABSTRACT TRUNCATED AT 250 WORDS)

Lab Delo, 1990, (11), 72 - 4
{Preparation of immune sera to group A streptococcus lipoteichoic acid}; Dmitrieva NF et al.; A method is described for the preparation of sera highly active in reactions with Group A Streptococcus lipoteichoic acid . Ultrasound-destroyed biomass of Streptomyces levoris K-3053 strain is used as the antigen . This strain was isolated in studies of soil Streptomyces; it contains sufficient amounts of nonglycosylated glycerolteichoic acid of the first-third types, that is identical in structure to polyglycerophosphate skeleton of Group A Streptococcus lipoteichoic acid.

Lab Delo . 1990;(6):68.
{An improved method of differentiating pneumococcus from alpha-hemolytic streptococcus}; Savinkov VA; An improved method for differentiation between pneumococcus and alpha-hemolytic streptococcus by the microcolonies morphology is suggested . The method is simple and time-saving, its diagnostic value is higher than that of the original technique, this recommending it for wide use at clinical and field bacteriologic laboratories.

Cytometry, 1990, 11(6), 667 - 75
Flow cytometric identification of microorganisms by dual staining with FITC and PI; Miller JS et al.; The identification of microorganisms by flow cytometry was evaluated by using a double staining technique with propidium iodide and fluorescein isothiocyanate and a two dimensional analysis . A diverse group of 19 different species and strains of microorganisms was tested to determine if they could be differentiated by flow cytometry . The organisms tested displayed characteristic and distinct two dimensional fluorescent patterns which allowed ready grouping and differentiation into subsets of organisms . The slopes and correlation coefficients of the histograms and the ratio of red to green signals expressed these differences quantitatively and allowed organisms to be placed into one of three groups based on these values . In some instances, as with Streptococcus pneumoniae and pyogenes and Staphylococcus aureus and epidermidis, it was possible to distinguish between species of bacteria from the same genus . The use of dual dye labeling and flow cytometry provided a rapid method of identifying selected microorganisms and may be broadly applicable for the detection and identification of many bacteria and fungi.

Sov Med, 1990, (1), 3 - 6
{Immunologic reactions with group-specific antigens of group A Streptococcus in rheumatic fever}; Zborovskii AB et al.; The levels of Group A streptococcal antigens, characterized by group specificity, incorporated in the immune complexes, were measured by enzyme immunoassay, and antibodies to group-specific polysaccharide were titered in patients with rheumatic fever of the minimal activity, running a protracted course . A statistically significant rise of these parameters was revealed in rheumatic patients as against normal subjects or patients with chronic tonsillitis with tonsillogenic cardiopathy . The diagnostic informativeness of these methods was found higher than that of antistreptolysin-O determination . The authors make a conclusion that signs of streptococcal infection persist in cases with the minimal activity of the rheumatic process and discuss rational antibiotic therapy of such patients . The described methods are recommended for the diagnosis and differential diagnosis of rheumatic fever of low activity.

Infect Immun, 1990 Jan, 58(1), 70 - 9
Cholera toxin B-subunit gene fusion: structural and functional analysis of the chimeric protein; Dertzbaugh MT et al.; A synthetic peptide, encoding amino acid residues 345 to 359 of the glucosyltransferase B enzyme of Streptococcus mutans GS-5, was genetically fused to the N-terminal end of the B-subunit gene of cholera toxin . The protein was overexpressed in Escherichia coli and retained the antigenicity associated with cholera toxin B subunit (CTB) as well as that associated with glucosyltransferase B . The addition of 15 amino acids to the N-terminal end of CTB did not appear to affect the gross structure of the protein significantly . The chimeric protein monomers assembled into a functional oligomer which exhibited only minor conformational differences from native CTB as measured by circular dichroism . The chimera bound to GM1 ganglioside and thus retained the biological activity of CTB . These results demonstrate that genetic fusion of small peptides to the N terminus of CTB has only a minimal effect on the structure and function of the protein . Furthermore, the chimera was shown to be immunogenic when fed to mice . This work has important implications in the construction of CTB chimeras for use as oral vaccines.

J Biotechnol, 1990 Jan, 13(1), 83 - 96
Expression and characterization of a tripartite fusion protein consisting of chimeric IgG-binding receptors and beta-galactosidase; Strandberg L et al.; Using protein engineering, a tripartite fusion protein was constructed consisting of five IgG-binding regions of protein A from Staphylococcus aureus, two IgG-binding regions of protein G from Streptococcus strain G148 and beta-galactosidase from Escherichia coli . The resulting protein lacks the serum albumin binding regions of native protein G . The fusion protein, which is a tetramer of approximately 660 kDa, was designed as a tool for immunological assays taking advantage of its broad spectrum of antibody affinity . The gene was placed under control of two promoters, the PR promoter and the lac UV5 promoter and the expression from the two promoters was studied in a bioreactor . Induction of the PR promoter gave an intracellular product concentration corresponding to 20% of the cell dry weight . By utilizing the properties of beta-galactosidase, the protein was purified by extraction in an aqueous two-phase system . The fusion protein was not proteolytically degraded during the cultivation and purification steps . The biological activity of all three parts of the protein was demonstrated with a competitive ELISA.

Aust J Biotechnol, 1990 Jan, 4(1), 38 - 43
Hyaluronic acid--a versatile biopolymer; Tan SW et al.; Since its discovery from bovine synovial fluid, hyaluronic acid has found application in several diverse areas . It is now extensively used in ophthalmic surgery, in the treatment of lameness in racehorses and as an ingredient in cosmetics . It can also be used in drug delivery, orthopedics, cardiovascular aids and in wound healing . Even so, its potential as a therapeutic agent is yet to be fulfilled . New improved products, formed by crosslinking hyaluronic acid with itself or other chemicals, are being produced . Hyaluronic acid is clearly a most valuable therapeutic biopolymer . This article reviews the properties of hyaluronic acid, its biosynthetic pathway and its methods of commercial production, and provides an estimation of its current and future world demand . Experiments designed to improve production economics have been performed in our laboratory . These involved control of glucose and yeast extract concentrations and fermentation pH . Hyaluronic acid production by Streptococcus zooepidemicus was found to be lower at pH 6.5 than at pH 7.1 . A new method of extending the production of hyaluronic acid by S . zooepidemicus into the stationary phase has also been achieved.

Carbohydr Res, 1989 Dec 21, 195(1), 75 - 86
Synthesis of a selectively protected trisaccharide building block of the capsular polysaccharide of Streptococcus pneumoniae types 6A and 6B; Slaghek TM et al.; 4-Methoxybenzyl 2,4-di-O-benzyl-3-O-{2,4,6-tri-O-benzyl-3-O-(3,4,6-tri-O-benzyl-alpha-D- galactopyranosyl)-alpha-D-glucopyranosyl}-alpha-L-rhamnopyranoside (22), a building block for the alpha-D-Galp-(1----3)-alpha-D-Glcp-(1----3)-alpha-L-Rhap fragment of the capsular polysaccharides of Streptococcus pneumoniae types 6A and 6B {----2)-alpha-D-Galp-(1----3)-alpha-D-Glcp-(1----3)-alpha-L-Rhap-( 1----X)-D- RibOH-(5-P----}n (6A, X = 3; 6B, X = 4) has been synthesised . Ethyl 3-O-allyl-2,4,6-tri-O-benzyl-1-thio-beta-D-glucopyranoside was coupled with 4-methoxybenzyl 2,4-di-O-benzyl-alpha-L-rhamnopyranoside in ether, using methyl triflate as promoter . The resulting alpha-D-Glcp-(1----3)-alpha-L-Rhap derivative was deallylated with KOBut in N,N-dimethylformamide followed by 0.1M HCl in 9:1 acetone-water . The product was coupled with 3,4,6-tri-O-acetyl-2-O-allyl-alpha,beta-D-galactopyranosyl trichloroacetimidate in ether, using trimethylsilyl triflate, to yield 19 . Deacetylation, benzylation, and deallylation then gave 22.

J Immunol, 1989 Dec 15, 143(12), 4061 - 8
Sequence and fine specificity analysis of primary 511 anti-phosphorylcholine antibodies; Feeney AJ et al.; The primary antibody response of mice to phosphorylcholine (PC) is dominated by antibodies using the T15 L chain . Anti-PC antibodies using the 511 L chain are prominent only in secondary responses to PC coupled to proteins, are somatically mutated, and all have an extra amino acid at the Vh-D junction, compared with T15 antibodies . The aim of the experiments reported here was to determine if the extra junctional amino acid alone was sufficient to generate a 511 PC-binding antibody, or if somatic mutation or other junctional changes were also necessary . We also wished to determine if unmutated 511 antibodies had sufficient affinity for PC to appear in the primary response . To increase the frequency of primary 511 antibodies, we generated a series of hybridomas from M167 L chain transgenic mice immunized 4 days earlier with either Streptococcus pneumonia R36a or PC-keyhole limpet hemocyanin (KLH) . We determined the relative affinity of the antibodies, and sequenced their H chain V regions . The results showed that: 1) somatic mutations are not required for 511 antibodies to bind PC; 2) primary 511 antibodies all had lower relative affinities for PC than T15 while having similar affinities to T15 for TNP-aminophenyl PC, and higher affinities for the PC analogs nitrophenyl PC and choline; 3) all antibodies had the 511-specific insertion of an extra amino acid, usually Ala, at the VhD junction, compared with T15; 4) immunization with R36a, but not PC-hemocyanin, elicited antibodies with a specific Tyr----Asp substitution in the D region, indicating Ag selection based on fine specificity differences; 5) the total length of CDR3 was conserved in most anti-PC-hemocyanin antibodies, whereas the anti-R36a antibodies predominantly had longer CDR3 sequences; and 6) there were unique substitutions in most antibodies, including significant sequence heterogeneity in the D-Jh junction . We conclude that Ag selection on the basis of affinity for PC biases the primary anti-PC response in favor of T15, and that 511 precursors with their alternative fine specificities contribute the precursors that are expanded in the secondary anti-PC-KLH responses.

Vet Rec, 1989 Dec 9, 125(24), 591 - 3
An economic justification of "blitz" therapy to eradicate Streptococcus agalactiae from a dairy herd; Edmondson PW; Streptococcus agalactiae was identified as the cause of mastitis in a 240-cow dairy herd . Forty-five per cent of the herd had cell counts over 500,000/ml, and 28 per cent had cell counts over 1,000,000/ml . Dry cow therapy was used regularly but teat dipping had not been used for three years . The procedures at milking were modified, teat dipping was introduced, and the herd was divided into two according to cell count . The 120 cows with higher cell counts were treated with 300 mg erythromycin (Erythrocin intramammary; Sanofi Animal Health) preparation per quarter at two consecutive milkings . Towards the end of lactation, all the 90 lactating cows in the herd were again treated with erythromycin . Milk samples were collected from all the cows in the herd 12 months after the initial treatment, and S agalactiae was isolated from only one replacement heifer which had been purchased after the treatments with erythromycin . The butterfat and protein levels in the milk were compared with those of a similar, but untreated, herd for 12 months before and after therapy . The butterfat levels rose sharply after treatment, and financial assessment showed a 41 per cent return on investment in the 12 months following the treatment.

Orv Hetil, 1989 Dec 3, 130(49), 2615 - 20
{Incidence and characteristics of childhood suppurative meningitis in Hungary in 1983-87}; Nyerges G et al.; Data of 1208 infants and children hospitalized for purulent meningitis were analysed . The incidence of the disease was closely age related: morbidity calculated for 100,000 children was found 97.5 under one year of age; 15.6 in 1 to 5 and 2.2 in 6 to 14 years of age . Incidence of newborn meningitis cases was 3.7 per 10,000 live-borns . The disease was caused by N . meningitidis in 278 (23%), H . influenzae in 171 (14%), S . pneumoniae in 157 (13%), E . coli in 74 (6%), B-group streptococcus in 61 (5%), other bacteria (altogether 17 species) in 107 (9%) cases, while in 360 cases (30%) the etiology remained unknown . Overall case fatality was 19.6 per cent . When compared to international data mortality was especially high among the newborns (53%) and in meningitis cases due to S . pneumoniae (29%), E . coli (48%), B-group streptococcus (37%) and "other bacteria" (41%) . Neurologic sequelae were found in 17 per cent of the patients at discharge however, in newborns it was 54 per cent . Since the antibacterial therapy was appropriate in all cases, authors try to reveal the possible causes of the relatively high mortality and make recommendations for reducing it.

Infect Immun, 1989 Dec, 57(12), 3702 - 7
A human salivary protein which promotes adhesion of Streptococcus mutans serotype c strains to hydroxyapatite; Kishimoto E et al.; The aim of this study was to investigate the nature of one of the factors in human submandibular-sublingual (SMSL) saliva which promotes the adhesion of Streptococcus mutans serotype c strains to hydroxyapatite (HA) surfaces . Gel filtration chromatography of SMSL saliva on Trisacryl GF2000 gave a void volume peak which contained the major fraction of adhesion-promoting activity for S . mutans JBP to HA . Maximum adhesion-promoting activity, however, eluted slightly later than the maximum 220-nm absorbance of the void volume peak . Gel filtration of the void volume material after treatment with sodium dodecyl sulfate (SDS) gave an early-eluting larger peak followed by a smaller peak with which the adhesion-promoting activity was associated . SDS-polyacrylamide gel electrophoresis (SDS-PAGE) showed the presence of relatively slowly migrating material associated with the larger inactive peak, presumably mucin, and a faster-migrating band(s) associated with the smaller active peak . SDS-PAGE indicated molecular weights in the range of 300,000 to 350,000 by extrapolation from size standards . Comparison of SMSL from five individuals showed the presence of single bands or double bands associated with adhesion-promoting activity, indicating genetic polymorphism . The active material did not resemble either secretory immunoglobulin A, based on SDS-PAGE and immunoassay, or fibronectin, based on SDS-PAGE, and also differed in molecular weight from salivary mucins and salivary constituents previously reported to promote aggregation of certain oral bacteria, but a relationship to these materials cannot be excluded . This adhesion-promoting material may play a significant role in the initial colonization of tooth surfaces by S . mutans strains.

Oral Microbiol Immunol, 1989 Dec, 4(4), 233 - 5
Immunolocalization of Streptococcus mutans sr gene product in recombinant Escherichia coli; Cuisinier FJ et al.; A direct post-embedding immunogold method was used to determine the subcellular localization of the expression product of Streptococcus mutans sr gene in Escherichia coli cells . Immunolabelling was principally localized in the cytoplasm and was absent in the periplasmic space and extracellular compartment . We observed no difference in the localization of the labelling between bacteria originated from solid or liquid cultures . No difference in saliva binding could be observed between recombinant E . coli or control E . coli cells . These results showed that the cloned SR protein was not accessible at the surface of the host cell.

Jpn J Antibiot, 1989 Dec, 42(12), 2617 - 26
{Bacteriological and clinical evaluations of cefmenoxime in neonates and premature infants}; Sunakawa K et al.; The antimicrobial activity of cefmenoxime (CMX) against B group Streptococcus was investigated . The clinical efficacy of CMX was determined in neonates and premature infants . The results are summarized below . 1 . MIC's of CMX against 39 strains of B group Streptococcus obtained from the pregnant vagina were below 0.05 micrograms/ml . 2 . CMX was given in a dose of 20 mg/kg by intravenous bolus injection to 3 neonates with birth weight over 2,500 grams . Peak serum concentrations ranged from 54.0 to 199 micrograms/ml and the mean half-life was 1.8 hours . 3 . Efficacies of CMX were good to excellent in 5 cases administered for treatment and in 4 cases for prophylaxis . As abnormal laboratory parameters, elevation of GOT and eosinophilia were observed in each 2 cases . 4 . Examinations on intestinal bacteria in 2 cases revealed that CMX gave as much influences to the flora as other third-generation cephems . 5 . The vitamin K deficiency were observed in 2 out of 6 cases examined.

FEMS Microbiol Lett, 1989 Dec, 53(3), 275 - 8
Presence of a small plasmid in clinical isolates of Streptococcus pneumoniae; Berry AM et al.; We have detected the presence of a small (2.95 kb) plasmid in a clinical isolate of Streptococcus pneumoniae . A restriction map was constructed for this plasmid and for pDP1 (the only previously reported pneumococcal plasmid); no apparent differences were observed and the two plasmids hybridized strongly to each other . Portions of pDP1 were then cloned into Escherichia coli K-12, using the vector pUC19, and the pneumococcal DNA insert was used as a probe to screen 500 clinical isolates of S . pneumoniae for pDP1 sequences . The plasmid was detected in a total of 8 isolates . These were of various serotypes and no correlation could be found between the presence of the plasmid and the geographical location from which it came, the type of infection, or with resistance to antibacterial drugs . Although no function has yet been assigned to pDP1, it may form the basis of a useful vector for cloning in S . pneumoniae, as it contains at least seven unique restriction sites.

Epidemiol Infect, 1989 Dec, 103(3), 465 - 74
The effect of pre-enrichment on recovery of Streptococcus agalactiae, Staphylococcus aureus and mycoplasma from bovine milk; Thurmond MC et al.; The study was conducted to determine whether pre-enrichment would increase sensitivity of detecting Streptococcus (Str.) agalactiae, Staphylococcus (S.) aureus, and mycoplasma in bovine milk . Two procedures were followed, one involving direct inoculation of milk on bovine blood agar, and the other involving preenrichment in broth followed by inoculation on agar . Logistic regression was used to predict the probability of isolation as a function of culture procedure and two additional covariates, the California Mastitis Test (CMT) score of the milk and the type of sample (indicating sample storage temperature and herd mastitis status) . A total of 13778 milk samples was cultured for each of the three bacteria . By using results of both direct inoculation and pre-enrichment, the probability of isolation compared to use of direct inoculation only and adjusted for effects of other variables was increased 3.6-fold for Str . agalactiae, 1.6-fold for S . aureus and 1.7-fold for mycoplasma . The probability of isolation for all three bacteria increased as the CMT score increased . For Str . agalactiae, there was a statistical interaction predicting that enrichment improved the odds of isolation more from milk with high CMT scores than from milk with low scores . Results indicate that pre-enrichment can substantially increase the sensitivity of bacteriological screening of dairy cows for mastitis caused by Str . agalactiae, S . aureus, and mycoplasma.

J Med Microbiol, 1989 Dec, 30(4), 273 - 8
Epidemiological typing of Streptococcus pyogenes by pyrolysis mass spectrometry; Magee JT et al.; Strains of Streptococcus pyogenes from an outbreak of infection on a burns unit (15), a collection of routine isolates from another hospital(12) and isolates from a national survey of throat infections in children in the community(4) were examined blind by pyrolysis-mass spectrometry (Py-MS) . The outbreak strains (M22 T12) previously found to give identical typing results in conventional tests, formed a closely similar cluster and were distinct from other hospital and community strains . One hospital and one community strain were loosely associated with this cluster . Another cluster comprised six antibiotic-susceptible strains and two community strains . Six strains did not fall within the clusters; four were antibiotic-resistant strains isolated in hospital, one an antibiotic-resistant strain isolated in the community, and one a susceptible hospital strain . Results show that Py-MS is a potentially valuable method for rapid comparison of strains in studies of infection.

Proc Natl Acad Sci U S A, 1989 Dec, 86(23), 9223 - 7
DpnA, a methylase for single-strand DNA in the Dpn II restriction system, and its biological function; Cerritelli S et al.; The two DNA-adenine methylases encoded by the Dpn II restriction gene cassette were purified, and their activities were compared on various DNA substrates . DpnA was able to methylate single-strand DNA and double-strand DNA, whereas DpnM methylated only double-strand DNA . Although both enzymes act at 5'-GATC-3' in DNA, DpnA can also methylate sequences altered in the guanine position, but at a lower rate . A deletion mutation in the dpnA gene was constructed and transferred to the chromosome . Transmission by way of the transformation pathway of methylated and unmethylated plasmids to dpnA mutant and wild-type recipients was examined . The mutant cells restricted unmethylated donor plasmid establishment much more strongly than did wild-type cells . In the wild type, the single strands of donor plasmid DNA that enter by the transformation pathway are apparently methylated by DpnA prior to conversion of the plasmid to a double-strand form, in which the plasmid would be susceptible to the Dpn II endonuclease . The biological function of DpnA may, therefore, be the enhancement of plasmid transfer to Dpn II-containing strains of Streptococcus pneumoniae.

J Clin Microbiol, 1989 Dec, 27(12), 2767 - 71
Screening of type Ia and Ib Streptococcus agalactiae strains with high sialic acid levels by determination of susceptibility to tetracyclines; Nagano Y et al.; The type-specific capsular polysaccharide antigen of Streptococcus agalactiae is recognized to be an antiphagocytic factor in strains having large amounts of it . In the present study, it was indicated that vaginal isolates of types Ia and Ib could be classified into two groups on the basis of both their levels of the sialic acid, which occupies the terminal side chains of the polysaccharide, and their susceptibility to tetracyclines: one group comprised strains with low sialic acid levels (less than 9 micrograms/mg of cell dry weight) as well as with susceptibility to tetracyclines (MIC, less than or equal to 0.5 micrograms/ml), and the other comprised strains with higher sialic acid levels (greater than or equal to 9 micrograms/mg) and resistance to tetracyclines (MIC, greater than or equal to 8 micrograms/ml) . A few isolates were found to have low levels of sialic acid and to be resistant to tetracyclines, but no isolates that were both relatively high in sialic acid and susceptible to tetracyclines were ever detected . Among strains of those serotypes, the MICs of tetracyclines were not in proportion to the sialic acid levels and were not affected when the sialic acid levels of each strain were altered by using Todd-Hewitt broth with various concentrations of Na2HPO4 and glucose . It was, therefore, apparent that the correlation of sialic acid levels with susceptibility to tetracyclines was not related directly to the sialic acid content or to the amount of the capsular polysaccharide . Since no plasmid DNAs were detected among representative strains that were tetracycline resistant, it was apparent that at least for the strains tested, resistance was chromosomal gene associated . In strains of S . agalactiae of types of Ia and Ib, the determination of susceptibility to tetracyclines was considered to be useful for screening strains with higher sialic acid levels.

Infect Immun, 1989 Dec, 57(12), 3834 - 40
Purification of a Streptococcus mutans protein that binds to heart tissue and glycosaminoglycans; Choi SH et al.; Proteins of Streptococcus mutans MT703 were isolated by differential filtration from chemically defined culture medium following growth of the bacteria . Incubation of this preparation with cryostat-cut sections of fresh rabbit cardiac muscle resulted in deposition of streptococcal components on basement membranes of sarcolemmal sheaths and capillary walls, as indicated by indirect immunofluorescence assay . Binding of radioiodinated streptococcal proteins to heart in vitro was time dependent and saturable . Unlabeled S . mutans proteins competitively inhibited 72% of heart binding by the radiolabeled proteins, indicating a high level of binding specificity . A selection of components common to tissue basement membranes was tested for their abilities to inhibit the binding of streptococcal proteins to heart tissue . Of the glycosaminoglycans, heparin was the most effective inhibitor, followed by heparan sulfate and chondroitin sulfate . Hyaluronic acid was not inhibitory . Of the glycoproteins tested, laminin and collagen type IV were weakly inhibitory, whereas fibronectin was ineffective . A single polypeptide was purified to homogeneity by affinity chromatography on a column of heparin-agarose . Gel filtration chromatography of the purified protein under nondissociating conditions showed a single component at 31 kilodaltons (kDa), whereas in sodium dodecyl sulfate-polyacrylamide gel electrophoresis one band appeared at 8 kDa . This indicates that the tissue-binding protein may either be a linear polypeptide or be released into the environment by the bacterium as a tetramer of the 8-kDa polypeptide . The purified protein had an isoelectric point of 9.5 and showed binding activity for basement membranes in thin sections of heart . Chemical analyses of the purified binding protein showed it to have high contents of lysine and alanine and to be devoid of half-cystine, methionine, tyrosine, histidine, and both neutral and amino sugars.

Cesk Epidemiol Mikrobiol Imunol, 1989 Dec, 38(6), 342 - 7
{The incidence of Streptococcus pneumonia strains with resistance to penicillin}; Janeckova V et al.; In the submitted paper the authors give an account of the incidence of 10 strains of Streptococcus pneumoniae resistant to penicillin and other antibacterial substances in children under one year . In the majority otitis media was involved (8 x), in one instance with septic manifestations and detection of pneumococci also from the haemoculture . From a total number of 580 strains of Streptococcus pneumoniae isolated from the end of 1986 to the first half of 1988 the ratio of penicillin resistant strains was 1.72% . The values of penicillin resistance varied within the range of MIC from 1 mg/l to more than 16 mg/l . The strains were also resistant to ampicillin, oxacillin, cephalotine and tetracycline . One strain was moreover resistant also to erythromycin and lincomycin . There was also one strain resistant to cotrimoxazole with a MIC of 64 mg/ml.

Bratisl Lek Listy, 1989 Dec, 90(12), 907 - 10
{The in vitro effects of josamycin on various strains of bacteria}; Milosovic P et al.; The minimal inhibitory concentration of josamycin was studied by the dilution plate method on the strains Staphylococcus aureus, plasmacoagulase negative staphylococci, Streptococcus pyogenes, Streptococcus agalactiae, and enterococci . The effect of josamycin was compared with that of erythromycin, penicillin, ampicillin, oxacillin, tetracycline, chloramphenicol, cotrimoxazol, and furantion . Of the series of 572 strains tested, josamycin was most effective in the strains Staphylococcus aureus, Streptococcus pyogenes, and Streptococcus agalactiae . All the strains tested were susceptible to josamycin, including the Staphylococcus aureus strains resistant to erythromycin . Of the plasmacoagulase negative staphylococci 2.6% resistant strains and 86.3% strains with decreased susceptibility were found . Of the enterococci 41.2% of the strains were resistant to josamycin . In these strains the most effective antibiotics were ampicillin and furantoin.

Pediatr Infect Dis J, 1989 Dec, 8(12), 848 - 51
Dexamethasone treatment for bacterial meningitis in children and adults; Girgis NI et al.; Four hundred twenty-nine patients with bacterial meningitis were assigned on a nonselective alternating basis into one of two therapeutic regimens . Patients in Group I received dexamethasone in addition to standard antibacterial chemotherapy of ampicillin and chloramphenicol whereas those in Group II received antibacterial chemotherapy alone . Dexamethasone was given intramuscularly (8 mg to children younger than 12 years and 12 mg to adults every 12 hours for 3 days) . Both treatment groups were comparable with regard to age, sex, duration of symptoms and state of consciousness at the time of hospitalization . A significant reduction in the case fatality rate (P less than 0.01) was observed in patients with pneumococcal meningitis receiving dexamethasone; only 7 of 52 patients died compared with 22 of 54 patients not receiving dexamethasone . A reduction in the overall neurologic sequelae (hearing impairment and paresis) was observed in patients receiving dexamethasone . This reduction was significant only in patients with Streptococcus pneumoniae meningitis; none of the 45 surviving patients receiving steroids had hearing loss whereas 4 of 32 patients not receiving dexamethasone had severe hearing loss (P less than 0.05) . No significant difference was observed between the two groups with regard to time for patients to become afebrile or to regain consciousness or in the mean admission and 24- to 36-hour cerebrospinal fluid leukocyte count, glucose or protein content.

Int J Pediatr Otorhinolaryngol, 1989 Dec, 18(2), 119 - 27
Diagnostic flexible bronchoscopy in human immunodeficiency virus (HIV)-positive children; Sculerati N et al.; Twelve children with laboratory evidence of human immunodeficiency virus (HIV) infection underwent diagnostic flexible bronchoscopy with washings or bronchoalveolar lavage at Bellevue Hospital Center from October 1987 to April 1989 . The patients included 7 boys and 5 girls ranging from age 3.5 months to 10 years 5 months . Indications for bronchoscopy included respiratory distress with or without focal changes on chest radiograph in 11 patients, and persistent but asymptomatic right middle lobe collapse in one child . The etiology of pneumonia was diagnosed in 7 children and included Pneumocystis carinii, (PCP) (17%), Streptococcus viridans (17%), mechanical obstruction (17%) and cytomegalovirus (CMV) (8%) . Bronchoscopy was non-diagnostic in 5 cases . Techniques for maximal yield of information using flexible bronchoscopy in HIV-positive children are discussed.

Ann Pediatr (Paris), 1989 Dec, 36(10), 685 - 8
{Neonatal pneumococcal septicemia}; Barbeau C et al.; We report two cases of neonatal pneumococcal septicemia, including one fatal case in a 32-week-gestational-age premature infant . Neonatal pneumococcal septicemias account for less than 1% of all neonatal infections . Diagnosis is provided by simple and rapid methods for identifying pneumococci . Clinical features have little specificity (respiratory distress) and resemble those found in B streptococcus infections . The mother rarely exhibits symptoms at delivery . The severity of the prognosis is not related to resistance to the antimicrobial agents currently used in neonatal infections but to the infectivity of the organism itself and to the specific immunologic characteristics of premature neonates . The current use of amoxicillin and aminoglycosides in neonatal infections does not therefore need to be revised.

Rev Esp Cardiol, 1989 Dec, 42(10), 638 - 44
{Endocarditis with Ionescu-Shiley's bioprosthesis . Long-term results}; Gonzalez-Juanatey JR et al.; With the aim to attesting the ability of treated pericardial tissue to resist infection we analyzed the incidence of prosthetic valve endocarditis in 541 operative survivors with the Ionescu-Shiley (I-S) valve since January 1977 . A total of 580 valves were available for the study, 21 (3.8%) sustained I-S endocarditis or 0.65% patients/annum . The mean age was 53.2 years; male/female ratio was 16/5 . Native endocarditis was present in 20 cases (3.6%) . There were 13 aortic endocarditis (2 in cases of multiple replacement) and eight mitral . The interval between insertion and endocarditis ranged from 2 weeks to 108 months (means 31); 8 cases were early I-S endocarditis (38%) and 13 late endocarditis (62%) . The organisms isolated were: Staphylococcus (epidermidis, aureus) in 10 cases . Streptococcus (viridans, fecalis) in 7 cases, gram negative in three and no organism was cultured in 3 cases . The outcome was as follows: specific medical treatment in 4 cases (one early), valve re-replacement in 11 (four early) from whom eight survived, and 6 patients died with unspecific medical treatment . The total mortality rate 9/21 (43%), in early endocarditis 5/8 (62.5%) and in late endocarditis 5/13 (38%) . Operative and necropsy findings in 12/21 showed always periprosthetic abscess but no leaflet perforations . The rate of I-S valve endocarditis compares favourably with other valve substitutes . Early re-replacement combined with adequate antibiotic treatment is mandatory according to our experience.

Eur J Clin Microbiol Infect Dis, 1989 Dec, 8(12), 1019 - 23
Serum levels of ciprofloxacin after single oral doses in patients with septicemia; D'Espine M et al.; Ciprofloxacin serum levels were measured after administration of the drug to 36 patients with septicemia (at least one positive blood culture) who were able to take oral medication . Patients were randomly allocated to receive ciprofloxacin 500 mg p.o . (n = 21) or 200 mg i.v . over 30 min (n = 15) . A first dose was administered 18-30 h after the last positive blood culture (day 1), and a second dose four days later (day 5) in some patients . In addition to ciprofloxacin, standard antibiotics were administered . Organisms isolated were Escherichia coli (15), other gram-negative bacteria (6), Streptococcus pneumoniae (7), Staphylococcus aureus (2), and other gram-positive bacteria (6) . None of the patients vomited . Ciprofloxacin serum concentrations 1 h after oral administration were in the range 0.09-2.32 mg/l, and 2 h after administration in the range 0.5-7.27 mg/l . The average terminal half-life was 8.6 h . In individual patients serum concentrations and area-under-the-curve values were compared . Poor correlation was found between values measured on day 1 and day 5 after oral administration, whereas the correlation was excellent after i.v . administration . Serum levels 2 h after oral administration were 30-900 times the MICs for the gram-negative organisms, but were in the range of the MICs for the gram-positive organisms in some cases . In conclusion, ciprofloxacin serum levels are difficult to predict in septicemia patients after oral administration, but probably suffice to treat infections caused by gram-negative organisms.

Carbohydr Res, 1989 Dec 1, 194, 247 - 60
Production and partial characterization of the extracellular polysaccharides from oral Streptococcus salivarius; Eifuku H et al.; The production of polysaccharides from sucrose by extracellular enzymes from oral Streptococcus salivarius isolates and the physico-chemical properties of water-insoluble products (IPs) were investigated . Extracellular enzymes from all the 18 strains tested produced insoluble alpha-D-glucans (IGs) as well as soluble beta-D-fructans, and formed adhering deposits on glass . Generally, the IPs (mostly IGs) of S . salivarius strains differed from the S . sobrinus IPs by (a) containing significant proportions of alpha-D-(1----4)-, in addition to alpha-D-(1----3)- and alpha-D-(1----6)-glucosyl linkages, and much higher proportions of alpha-D-(1----3) than alpha-D-(1----6) linkages, (b) being more susceptible to hydrolysis by mutanase than by dextranase, (c) possessing low or no streptococcal cell-agglutinating ability, and (d) showing weaker adhesion to a glass surface . The degree of the polysaccharide adherence differed greatly among the S . salivarius strains and, therefore, they were divided into three groups of adherence producers; heavy, moderate, and slight . The IPs of the three groups contained, generally in descending order, a higher proportion of higher-molecular-weight fractions, and consisted of higher proportions of IG containing higher proportions of -(1----6)-alpha-D and -(1----4)-alpha-D glucosyl linkages and (1----3,6) branches, but showed higher susceptibility to hydrolysis by mutanase as well as dextranase . Thus, the production and the properties of extracellular insoluble alpha-D-glucans from sucrose differ considerably between oral S . salivarius and cariogenic S . sobrinus.

Scand J Dent Res, 1989 Dec, 97(6), 511 - 9
Uptake and expulsion of 14C-xylitol by xylitol-cultured Streptococcus mutans ATCC 25175 in vitro; Soderling E et al.; The effect of successive cultivations in the presence of 6% xylitol on the uptake and expulsion of 14C-xylitol was studied using the cells of Streptococcus mutans 25175 . Three sequential cultivations did not alter the growth inhibition percentage (approximately 50%) observed in the presence of 6% xylitol . The 14C-xylitol uptake experiments performed with growing and resting cells showed that both the uptake and the expulsion of xylitol were enhanced by xylitol-culturing . Both xylitol-cultured and resting control cells contained only one major labeled compound which was identified as 14C-xylitol 5-phosphate . The label subsequently was expelled from the cells as 14C-xylitol . These results indicate that S . mutans possesses an intracellular xylitol cycle and this cycle is regulated by adding xylitol to the growth medium.

J Ethnopharmacol, 1989 Dec, 27(3), 285 - 95
Screening of Taiwanese crude drugs for antibacterial activity against Streptococcus mutans; Chen CP et al.; Preliminary antibacterial screening of local crude drugs was carried out using the cariogenic bacterium, Streptococcus mutans . Of 79 aqueous extracts tested, 6 crude drugs were shown to have significant antibacterial activity with minimal inhibitory concentration equal to or lower than 7.8 mg/ml (expressed in terms of dry starting material) . Of these effective crude drugs, Morus australis, Ludwigia octovalvis and Thuja orientalis were very effective in inhibiting the growth of serotypes c and d of S . mutans (MIC less than or equal to 2.0-7.8 mg/ml) . Elephantopus scaber, Artemisia vulgaris, Mosla chinensis and Orthosiphon aristatus also exhibited considerable antibacterial activity (MIC = 7.8-23.4 mg/ml) against both serotypes . In the presence of 5% sucrose, the antibacterial potency of the majority of the extracts did not change for type c, while the potency decreased about one-half for type d.

Am Rev Respir Dis, 1989 Dec, 140(6), 1590 - 4
The cardiac glycoside digoxin disrupts host defense in experimental pneumococcal pneumonia by impairing neutrophil mobilization; Esposito AL et al.; Normal CD-1 mice were administered digoxin (4 micrograms/kg/24 h) and infected with type 3 Streptococcus pneumoniae in order to assess the effects of the cardiac glycoside on the chemotactic responsiveness of peripheral blood neutrophils and the mobilization of granulocytes from storage pools . The chemotactic responses to autologous zymosan-activated serum (C5a) by neutrophils obtained from uninfected digoxin-treated and control animals were similar; comparable observations were made with circulating granulocytes isolated from animals at 24 or 48 h after intratracheal challenge with 5 x 10(5) colony-forming units (cfu) of bacteria . However, at 4 and 6 h after intratracheal pneumococcal challenge, the number of immature neutrophils in the peripheral blood was significantly lower in the glycoside-treated animals versus controls; at 24 and 48 h, these differences were not apparent . Following the intravenous inoculation of pneumococci, the number of circulating immature neutrophils was also found to be significantly lower at 4 and 24 h in animals given the cardiac glycoside versus controls . We conclude that digoxin disrupts host defense in experimental pneumococcal pneumonia and bacteremia by impairing the mobilization of neutrophils.

J Dent Res, 1989 Dec, 68(12), 1786 - 9
Effects of varnishes containing chlorhexidine on the human dental plaque flora; Schaeken MJ et al.; This study describes the effects of varnishes containing 0%, 10%, 20%, or 40% chlorhexidine diacetate on the microflora of human fissure dental plaque . Sandarac, a natural resin, was used as the varnish base . Ten subjects, each with at least four sound fissures harboring high levels of Streptococcus mutans, participated in the study . The fissures in each of the individuals were randomly assigned to four experimental groups, in each of which one of the varnishes was tested . The varnish treatment consisted of a single application of a small amount of varnish onto the fissures . Apart from the selected fissures, the rest of the dentition was left untreated . All chlorhexidine-containing varnishes selectively suppressed S . mutans in fissure plaque, and had no effect on total viable counts or on the numbers of Actinomyces viscosus/naeslundii and Streptococcus sanguis beyond one week . The extent of the suppression depended upon the concentration of chlorhexidine in the varnish, 40% chlorhexidine varnish giving the greatest suppression of S . mutans . At 22 weeks, after a single treatment with varnish containing 40% chlorhexidine, mean S . mutans counts were more than ten times lower than in the control or 10%-chlorhexidine varnish group . At that time, S . mutans was still undetectable in five out of ten experimental fissures in this group . The results suggested that sandarac varnishes containing high concentrations of chlorhexidine can be used successfully for long-term suppression of S . mutans in dental fissures.

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