J Immunol, 1989 Jul 15, 143(2), 565 - 70 The Fc binding site for streptococcal protein G is in the C gamma 2-C gamma 3 interface region of IgG and is related to the sites that bind staphylococcal protein A and human rheumatoid factors; Stone GC et al.; The isolated 35 kDa fragment of protein G obtained by papain digestion of group G streptococci was found to bind solid phase intact IgG, Fc (2C gamma 2 + 2C gamma 3 domains), F(ab')2 and F(acb)2 (F(ab')2 + 2C gamma 2 domains) fragments but not pFc' (2C gamma 3 domains) fragments . The level of binding to rabbit F(acb)2 and rabbit F(ab')2 fragments was similar . Protein G binding to solid phase Fc fragments was inhibited by IgG, Fc, staphylococcal protein A and its monovalent fragment D, but was enhanced by F(ab')2 fragments . Chemical modification of tyrosine but not histidine residues of IgG abrogated its ability to inhibit the binding of protein G to solid phase Fc fragments . Protein G was found to strongly inhibit the binding of a monoclonal and a polyclonal human rheumatoid factor to IgG . These findings indicate that protein G binds with separate sites to the Fc and F(ab')2 fragments of IgG, that the interaction with the Fc fragment occurs at the C gamma 2-C gamma 3 domain interface region and that tyrosine but not histidine residues in this area are likely involved . The relationship of the Fc fragment-binding site specificity of protein G to that of other microbial IgG binding proteins and human rheumatoid factors is discussed. FEMS Microbiol Lett, 1989 Jul 15, 51(1), 179 - 82 A lysozyme isolated from rainbow trout acts on mastitis pathogens; Grinde B; The antibacterial effects of two lysozymes purified from rainbow trout kidney (type I and II) were tested on eight bacterial strains isolated from cases of clinical mastitis (staphylococci, streptococci and coliforms) . Three other lytic agents were included in the experiments as controls: hen egg-white lysozyme, lysostaphin and mutanolysin . Proliferating bacteria were incubated with the various lytic agents, either in hearts infusion broth or in milk . The type II rainbow trout lysozyme decreased the number of live bacteria (colony forming units) of all the strains tested, but was most efficient against staphylococci . The other two lysozymes had little effect. Thromb Res, 1989 Jul 15, 55(2), 187 - 93 Group A streptococci bind human plasmin but not other structurally related proteins; DesJardin LE et al.; Certain group A streptococci are known to possess a receptor for the human enzyme plasmin . Plasmin is a member of a super gene family that includes other serine proteases and kringle containing proteins . In this study we have examined the interaction of a group A streptococcus with structurally related proteins, including plasmin, glu-plasminogen, tissue plasminogen activator, kallikrein, factor XII, prothrombin, thrombin, trypsin, and urokinase . Our studies indicate that only the key fibrinolytic enzyme, plasmin, demonstrates significant binding activity to the group A streptococcus. N Engl J Med, 1989 Jul 6, 321(1), 1 - 7 Severe group A streptococcal infections associated with a toxic shock-like syndrome and scarlet fever toxin A; Stevens DL et al.; There is concern that group A streptococci, which have caused less serious infections in developed countries in recent decades, may be acquiring greater virulence . We describe 20 patients from the Rocky Mountain region who had group A streptococcal infections from 1986 to 1988 that were remarkable for the severity of local tissue destruction and life-threatening systemic toxicity . Among the 20 patients (median age, 36), necrotizing fasciitis with or without myositis was the most common soft-tissue infection (55 percent) . Nineteen patients (95 percent) had shock, 16 (80 percent) had renal impairment, and 11 (55 percent) had acute respiratory distress syndrome . The mortality rate was 30 percent . All patients but 1 had positive tissue cultures for Streptococcus pyogenes; 12 had positive blood cultures . Most of the patients had no underlying disease; 2 used intravenous drugs . Strains of group A beta-hemolytic streptococci isolated from 10 patients were not of a single M or T type; however, 8 of the 10 strains produced pyrogenic exotoxin A (scarlet fever toxin A, a classic erythrogenic toxin), which has rarely been observed in recent years . From our study of this cluster of severe streptococcal infections with a toxic shock-like syndrome, we conclude that in our region, more virulent group A streptococci have reappeared that produce the pyrogenic toxin A associated with scarlet fever. Indian J Med Res, 1989 Jul, 89, 261 - 4 Bacteriology of pyoderma including anaerobes; Kishore J et al.; Of 100 pus samples cultured from pyodermal lesions, 99 yielded positive cultures . Staphylococcus aureus alone (45%) or with beta-haemolytic streptococci (BHS, 32%) was the commonest isolate . Antimicrobial sensitivity of 71 Staph . aureus strains tested showed high degree of resistance to erythromycin (38.3%) . BHS was the second common pathogen encountered . T-agglutination patterns studied in BHS group A could type 85.7 per cent of the isolates . Non-group A BHS isolated were of group G (3) and group D (1) . Five pus specimens yielded obligate anaerobes mixed with aerobes . Bacteroides melaninogenicus/asacchrolyticus was isolated in 4 of 5 samples. Infection, 1989 Jul-Aug, 17(4), 240 - 4 Prevention of bacteremia caused by alpha-hemolytic streptococci by roxithromycin (RU-28 965) in granulocytopenic patients receiving ciprofloxacin; Rozenberg-Arska M et al.; We previously demonstrated that ciprofloxacin prevents infections caused by gram-negative bacilli in patients with granulocytopenia . However, in patients with intensive cytotoxic treatment leading to severe mucosal damage a high incidence of bacteremias caused by alpha-hemolytic streptococci was seen . In the present study 45 consecutive patients undergoing intensive cytotoxic treatment received a short course of roxithromycin (10 days) in addition to ciprofloxacin for prevention of bacteremias caused by alpha-hemolytic streptococci . The results of this study were compared with the results obtained in previous comparable patients receiving ciprofloxacin alone . During the days with addition of roxithromycin no infections caused by alpha-hemolytic streptococci occurred, while in the control group of 80 patients 16 bacteremias (20%) were seen . Although roxithromycin was shown to antagonize bactericidal action of ciprofloxacin on gram-negative bacilli in vitro, in vivo study based on serum bactericidal titers and on results of surveillance cultures showed no antagonistic interactions. Ala Med, 1989 Jul, 59(1), 13 - 7 Viridans streptococcal endocarditis; Harris LF; Although responsible for a declining proportion of cases of infective endocarditis, viridans streptococci remain the commonest cause and accounted for 30% of our cases seen in Huntsville, Alabama . Usually viridans streptococcal endocarditis is associated with dental manipulation or infection and underlying heart disease but both conditions were not common in our series . Similar to the experience of other investigators, our patients exhibited a subacute course with fever, dyspnea, weight loss and heart murmur . Echocardiography, reported useful in detecting vegetations in one series, was not a sensitive diagnostic tool in our patients . We confirmed the low relapse rate and mortality rate associated with earlier reports of viridans streptococcal endocarditis but observed a high rate of complications, as noted in a recent series. Int J Cardiol, 1989 Jul, 24(1), 47 - 54 Prognostic index in prediction of mortality from infective endocarditis; Woo KS et al.; Out of 176 patients with infective endocarditis complicating rheumatic (120) and congenital heart disease (38), mortality occurred in 35 patients (19.9%) . Presence of leukocytosis, heart failure, major embolisation and isolation of certain organisms including Staphylococci, beta-haemolytic Streptococci, Pseudomonas and Klebsiella were ominous with higher mortality rates compared with those when they were absent (P less than 0.02) . Stepwise logistic multiple regression was then applied and the four most important independent variables were identified . A prognostic index for the prediction of mortality for infective endocarditis was then constructed by the summation of the regression coefficients . By applying this index, patients with infective endocarditis could be divided into subgroups with increasing proportional mortality from 5.8 to 83.3% . It provides an objective assessment of the risk patients with infective endocarditis, and a more reliable evaluation of benefit of any new treatment regimen, including cardiac surgery, during the acute stage. J Med Microbiol, 1989 Jul, 29(3), 207 - 19 Outbreaks of human infection caused by pyogenic streptococci of Lancefield groups C and G; Efstratiou A; Within a collection of 749 strains of group C streptococci (Streptococcus equisimilis) and 2348 of group G, isolated over a period of 6 years, there were clusters from 63 probable outbreaks of infection . These occurred in burns and maternity units, hospital wards, outpatient clinics, army camps and religious communities . Overall, it was possible to identify T-protein antigens in 88% of the group C strains and in 82% of group G . Serotyping by the identification of T-protein antigens was a useful method for the subdivision of these strains. Am J Dis Child, 1989 Jul, 143(7), 794 - 7 Non-group A streptococci in the pharynx . Pathogens or innocent bystanders? Hayden GF, Murphy TF, Hendley JO. OBJECTIVE: To determine whether beta-hemolytic streptococci from groups other than A are an important cause of sporadic pharyngitis in children . DESIGN: Cross-sectional, case-referent survey . SETTING: General pediatric clinic at a military base in Ohio . PARTICIPANTS: One hundred fifty children with symptomatic pharyngitis and 150 controls matched for age and time of presentation over a 20-month study period . INTERVENTIONS: None . MEASUREMENTS/MAIN RESULTS: Anaerobic culture technique was used to improve isolation of beta-hemolytic streptococci . Group A beta-hemolytic streptococci were detected significantly more often among the ill children than among the controls (39% vs 16%, respectively) . In contrast, non-group A beta-hemolytic streptococci were isolated in similar frequency from the ill and control children (17% vs 21%, respectively) . Non-group A beta-hemolytic streptococci from groups B, C, F, and G were each isolated in similar frequency among the ill and control children . The isolation rate of non-group A organisms increased with age among both patients and controls . CONCLUSIONS: Non-group A beta-hemolytic streptococci seemed not to be an important cause of sporadic pharyngitis in this pediatric population. Zh Mikrobiol Epidemiol Immunobiol, 1989 Jul, (7), 7 - 12 {The role of fibronectin in the streptococcal adhesion process}; Lyzlova LV et al.; The work shows that fibronectin obtained from human plasma is capable of binding with streptococci of different groups with almost equal effectiveness . Fibronectin bound to bacterial cells inhibits the adhesion of group A streptococci onto vaginal cells, but it produces no effect on the adhesion of group B streptococci . The binding constant of fibronectin 125I is equal to 10(6) -M-1, which indicates that the level of the specificity of interaction is not sufficiently high. J Dairy Sci, 1989 Jul, 72(7), 1900 - 6 Effect of freezing on bacteriologic culturing of mastitis milk samples; Schukken YH et al.; The objective was to determine the effect of freezing and length of freezing in a commercial freezer on the qualitative results of bacteriologic culturing of milk collected from glands of cows with clinical or subclinical intramammary infections . A total of 182 milk samples from cows with clinical mastitis and 55 milk samples of cows with subclinical mastitis were taken from four problem herds . Samples were split into four equal sub-samples . Three of these were frozen immediately at -20 degrees C and 1 was submitted fresh for bacteriologic analysis . At 4, 8, and 16 wk after collection, samples were thawed and submitted for bacteriologic culturing . Freezing and increased length of storage resulted in 1) a decrease in the number of samples that had cultures of Escherichia coli or Actinomyces pyogenes; and 2) an increase in the number of samples that had cultures of coagulase-negative staphylococci . Freezing had no effect on streptococci and Staphylococcus aureus. Rev Infect Dis, 1989 Jul-Aug, 11 Suppl 5, S1231 - 6 Prevention of infections in granulocytopenic patients by fluorinated quinolones; Rozenberg-Arska M et al.; Despite the dramatic decline in the infection-associated death rate as a result of advances in antimicrobial therapy, extensive diagnostic procedures, and better supportive care, morbidity from infectious disease in granulocytopenic patients remains a problem . Several approaches are used for infection prevention . The new oral fluorinated quinolones seem promising for the prevention of infections caused by gram-negative bacilli . Results from different studies showed that these compounds are more efficacious and better tolerated than are other prophylactic regimens . Prophylactic use of quinolones leads to trends in bacteriologically documented infections toward gram-positive microorganisms associated either with the presence of central intravenous catheters (Staphylococcus epidermidis) or with chemotherapy-induced mucositis (alpha-hemolytic streptococci) . These changes suggest a need for the inclusion of an antibiotic effective against gram-positive organisms in the initial therapeutic regimen. J Clin Microbiol, 1989 Jul, 27(7), 1657 - 8 Evaluation of the pacific biotech CARDS STREP A test for detecting group A streptococci from cases of pharyngitis; Manasse RJ; The Pacific Biotech CARD STREP A test for rapid screening of throat specimens for group A streptococci was evaluated . Relative to conventional culture, this assay had a sensitivity of 76.1% (108 of 142) and a specificity of 98.7% (392 of 397) . The relatively low sensitivity of the test makes it of questionable value as a screening procedure. Clin Microbiol Rev, 1989 Jul, 2(3), 315 - 28 Classification and identification of the viridans streptococci; Coykendall AL; This review traces the history of the human, nonhemolytic, or viridans, streptococci and describes improvements in their taxonomy wrought by study of their biochemical profiles and analysis of their nucleic acids . The goal was to define species on the basis of genetic relationships and to describe these species by their phenotypic characteristics so that they can be easily identified . This method has resulted in the division of some species . Streptococcus mutans has been divided into four species, two of which are common in humans . Three more mutans group species are indigenous to animals . Conversely, S . constellatus, S . intermedius, and "S . milleri" have been combined under S . anginosus . S . mitis (or "S . mitior") can be well-defined and includes S . sanguis II . There is genetic heterogeneity within S . sanguis, but the species is usually easy to identify . There is also some heterogeneity in S . bovis, but most human isolates are genetically related . Discussions of the taxonomy of these species are accompanied by descriptions of the characteristics by which these streptococci can be identified . Among these species are potential pathogens which should be suspected in cases of endocarditis and purulent infections of liver, brain, and other tissues. DICP, 1989 Jul-Aug, 23(7-8 Suppl), S21 - 6 Developmental pharmacology: relationship to drug use; Reed MD; The pharmacodynamics of drugs in children have been poorly understood, and only recently have technological advances permitted the issue to be studied . Factors that affect drug use in infants include absorption, distribution, protein binding, metabolism, renal elimination, and volume of distribution . Selection of antibiotics in this patient population should reflect commonly isolated organisms, such as staphylococci, group B streptococci, Escherichia coli, and gram-negative bacteria . An antibiotic must also have good penetration into the central nervous system . Displacement of bilirubin from its albumin-binding sites by drugs or endogenous substrates can lead to kernicterus, or bilirubin encephalopathy . The free bilirubin, rather than total concentration, appears to be only partly responsible for the development of kernicterus. J Am Vet Med Assoc, 1989 Jul 1, 195(1), 69 - 72 Clinical, ultrasonographic, and surgical findings in foals with umbilical remnant infections; Reef VB et al.; Infection of umbilical arteries, umbilical vein, and/or urachus was diagnosed ultrasonographically in 33 foals 1 to 90 days old (mean, 17.7 +/- 17.3 days) . In these foals, the most common initial problems were umbilical abnormalities, septic arthritis, and/or neonatal septicemia . In 16 foals, abnormalities of the external umbilical stalk were noticed on admission . Abnormalities of the internal umbilical structures were identified when enlargement and echogenic material (fluid and/or gas) were imaged ultrasonographically within these structures . Multiple structures were affected in 23 foals, with the urachus the most commonly affected structure . Surgical findings confirmed ultrasonographic identification of infected umbilical structures in 23 foals . Twenty-two samples from affected umbilical remnants submitted for culture at surgery were positive for bacterial growth . Multiple organisms were isolated in 15 cultures . Escherichia coli and beta-hemolytic streptococci were the most common isolates . Two foals died of late complications associated with surgical resection, 1 foal treated surgically and 3 foals treated medically died or were euthanatized because of other complications, and the remaining 27 foals lived. Ethiop Med J, 1989 Jul, 27(3), 115 - 9 Colonization of pregnant women and their newborn infants with group B streptococci in the Gondar College of Medical Sciences; Schmidt J et al.; In a study of Group B streptococcal carriage, 200 postpartum women and 80 newborn infants were investigated in the Gondar College of Medical Sciences from January to April 1987, using swabs from the vagina and rectum, and from the throat and external ear, respectively . We found a colonization rate of 9% (18/200) in the mothers and 5% (4/80) in the neonates . The serological typing of the 25 isolated strains showed 60% (15/25) to be Type Ib/c and 16% (4/25) to be Type Ia strains . Therefore, in newborn infants with infections, diagnostic and bacteriological procedures should include a search for Group B Streptococci. South Med J, 1989 Jul, 82(7), 900 - 2 Spontaneous streptococcal gangrenous myositis: survival with early debridement; Doebbeling BN et al.; Spontaneous gangrenous myositis caused by Streptococcus pyogenes is usually fatal, but no longer uniformly so . There appears to be a spectrum of disease due to beta-hemolytic streptococci, from necrotizing fasciitis to pyomyositis to spontaneous gangrenous myositis . Survival is possible with early surgical debridement, reexploration at 24 to 36 hours, and intensive supportive care. Infect Immun, 1989 Jul, 57(7), 2050 - 6 Cloning and expression of a cohemolysin, the CAMP factor of Actinobacillus pleuropneumoniae; Frey J et al.; The genetic determinant of the cohemolysin which is responsible for the CAMP phenomenon, a cohemolysis, of Actinobacillus pleuropneumoniae was cloned in Escherichia coli . Total DNA from the A . pleuropneumoniae serotype 1 type strain 4074 was used to construct a gene library in plasmid pUC18 in E . coli JM83 . A total of 10,500 clones containing recombinant plasmids have been screened for hemolysis on blood plates . Fifty-five clones which showed a weak hemolytic response after 24 to 48 h of incubation were screened for the CAMP reaction with Staphylococcus aureus . This led to the identification of one clone which showed a positive CAMP reaction . Immunoblot analysis revealed that the recombinant strain expressed a protein with a molecular mass of 27,000 daltons, similar in size to the CAMP protein of the group B streptococci . Rabbit antibodies against the CAMP+ clone neutralized the CAMP reaction mediated by the E . coli strain containing the cloned CAMP gene as well as that of A . pleuropneumoniae . Antibodies raised against the cloned CAMP cohemolysin cross-reacted with Streptococcus agalactiae protein B . We designate the 27,000-dalton molecule CAMP factor protein and name its corresponding gene cfp. J Dent Res, 1989 Jul, 68(7), 1155 - 61 An investigation into the use of restriction endonuclease analysis for the study of transmission of mutans streptococci; Kulkarni GV et al.; Restriction endonuclease analysis (REA) was performed on the total cellular DNA from each of 396 strains of mutans streptococci (1) to determine its potential usefulness for the study of transmission of the organism and (2) to document the proportions and variety of strains harbored by members of a small group of families . The DNA was digested with restriction enzyme EcoRI and/or HindIII, electrophoresed on agarose gels, and the resulting patterns compared . The strains examined included fresh isolates from 58 subjects, including 19 strains from each member of five families . The sensitivity and reproducibility of REA patterns from the mutans streptococci seemed ideal for studies of their epidemiology and transmission . The pattern of each isolate from humans was unique, except for isolates from the same individual or from the same family . REA types from subjects from different families were always heterogeneous . A high frequency of multiple REA types (up to 5) was observed in many subjects . While evidence for intra-familial transmission was obtained, including transmission between spouses, there was also strong evidence of frequent sources of infection outside of the family . Mutations of strains to streptomycin resistance or to lactate dehydrogenase deficiency caused no detectable change in the REA patterns . The lack of plasmids in any of the 57 fresh isolates that were examined for them suggested that they may have contributed little to the heterogeneity of the patterns seen. Proc Natl Acad Sci U S A, 1989 Jul, 86(14), 5340 - 4 Characterization of the termini and transposition products of Tn4399, a conjugal mobilizing transposon of Bacteroides fragilis; Hecht DW et al.; We have isolated a 9.6-kilobase conjugal transposon, Tn4399 from Bacteroides fragilis, that is capable of mobilizing nonconjugal plasmids in cis . Here we characterize the ends of the transposon, its target-site requirements, and the products of transposition into the B . fragilis chromosome and two sets of B . fragilis-Escherichia coli shuttle vectors . With the exception of an additional cytosine residue in the left end, there are perfect 13-base-pair (bp) inverted repeats at the ends of Tn4399 . Insertion of Tn4399 resulted in a 3-bp target-site repeat in 8 out of 12 independent transpositions and showed a high insertion-site specificity . A remarkable feature of Tn4399 insertions is the presence of an additional 5 bp located between the right inverted repeat and the target-site repeat . Four sequence variations of the 5 bp were found, with absolute conservation at positions 1, 2, and 5 . Only two of the variations were present in junction fragments of all three copies of Tn4399 contained in the chromosome of the original donor strain, B . fragilis TM4.2321 . Tn4399 appears to represent a new type of conjugal transposon . In contrast to Tn916 and Tn1545, described in streptococci, Tn4399 creates a target-site repeat and contains an additional 5 bp at the right end only, between the transposon and the target sequence . In addition, Tn4399 can mobilize plasmids in cis. J Bacteriol, 1989 Jul, 171(7), 3603 - 8 Tn4399, a conjugal mobilizing transposon of Bacteroides fragilis; Hecht DW et al.; Conjugal transposons play an important role in the dissemination of antibiotic resistance determinants in the streptococci and have been postulated to exist in Bacteroides fragilis . To investigate the presence of conjugal transposons in B . fragilis, we employed a Tra- derivative of the transfer factor pBFTM10 contained in the chimeric plasmid pGAT400 delta BglII . We attempted to restore transferability to this plasmid from a series of transconjugants generated by crossing B . fragilis TMP230 containing the TET transfer factor with B . fragilis TM4000, a standard recipient . Transconjugant TM4.2321 transferred pGAT400 delta BglII to Escherichia coli HB101 at almost the same frequency as did the Tra+ parental plasmid, pGAT400 . Analysis of the transferred plasmids revealed the presence of 9.6 kilobases of additional DNA in every case but at different positions in independent isolates . The presence of this DNA, designated Tn4399, allowed the pGAT400 delta BglII derivatives to retransfer from the TM4000 background to B . fragilis or E . coli recipients . DNA hybridization studies demonstrated the presence of one copy of Tn4399 in TMP230 and three copies at new sites in TM4.2321 . Tn4399 is a new B . fragilis transposon with unique transfer properties that may play a role in the dissemination of drug resistance genes . It differs from previously described conjugal transposons by its ability to mobilize nonconjugal plasmids in cis. Infect Immun, 1989 Jul, 57(7), 1906 - 15 Molecular and immunochemical characterization of recombinant Escherichia coli containing the spaA gene region of Streptococcus sobrinus; Ogundipe JO et al.; We identified and characterized a recombinant Escherichia coli containing the entire gene for surface protein antigen A (spaA) of Streptococcus sobrinus 6715 . The recombinant E . coli was isolated from a cosmid gene bank of size-fractionated S . sobrinus DNA fragments, and recombinants expressing the SpaA protein were detected immunologically . Subcloning experiments showed that the DNA sequences encoding the SpaA protein could be isolated on two contiguous EcoRI fragments, 3.7 and 3.3 kilobases (kb) in size, both contained on a 16.2-kb BglII fragment . Southern blot hybridization experiments using the EcoRI fragments to probe genomic DNAs from various serotypes of the mutans group of streptococci revealed DNA sequence homology not only to S . sobrinus 6715 (serotype g) chromosomal DNA but also to S . sobrinus serotype d DNA . Weak hybridization signals to Streptococcus mutans serotypes c, e, and f and to Streptococcus cricetus serotype a were observed with the 3.3-kb EcoRI fragment . These results suggest that the coding sequence for the spaA gene is probably conserved in S . sobrinus strains . Plasmid-encoded polypeptides made in E . coli minicells revealed that transcription of the spaA gene was initiated on the 3.7-kb EcoRI fragment and that its product size was about 210 kilodaltons . The cloned SpaA protein was purified from the periplasmic protein of E . coli, and monospecific antiserum against the cloned product was prepared in rabbits . The data obtained from various physiochemical and immunological procedures allowed us to conclude that the coding sequence for the entire spaA gene of S . sobrinus 6715 had been successfully cloned in E . coli and that faithful expression of the cloned product could be obtained. Arch Inst Pasteur Tunis, 1989 Jul-Oct, 66(3-4), 243 - 50 {Fast identification of Streptococcus pyogenes serotype M.12 in throat swabs by an improvised coagglutination technique}; Boujaafar N et al.; A rapid procedure for identification of Streptococcus pyogenes serotype M . 12 directly in throat swabs, is reported and compared with standard culture method on blood agar plates and typing of group A Streptococci isolated, with double gel immuno-diffusion . This procedure consist of chlorhydric acid extraction of swabs and testing of the extract towards specific M . 12 protein serum using extemporaneous coagglutination technique . We have tested 1100 throat swabs, with this procedure and with standard culture procedure . Identification of group A Streptococci serotype M . 12 with reported method is obtainable within 30 to 45 minutes of receipt of the clinical specimen . This method is easy to perform, with a sensitivity and a specificity respectively: 89.7% and 98.8%. Eur J Clin Microbiol Infect Dis, 1989 Jul, 8(7), 629 - 31 Association of penicillin-tolerant streptococci with epidemics of streptococcal pharyngitis in closed communities; Dagan R et al.; The association of penicillin-tolerant streptococci with reported epidemics of streptococcal pharyngitis in Israel was studied . The streptococcal strains had been isolated during 11 epidemics of community-acquired pharyngitis and 6 food-borne epidemics of pharyngitis occurring in the last 15 years . Strains were stocked lyophilized . Isolates were defined as tolerant if the MBC/MIC ratio for penicillin was greater than or equal to 32 . All 122 group A streptococcal strains isolated during the epidemics of community-acquired infection showed tolerance to penicillin . In contrast, none of the 52 strains from food-borne epidemics (24 group A, 18 group C and 8 group G) was tolerant. Arch Otolaryngol Head Neck Surg, 1989 Jul, 115(7), 856 - 9 Penicillin and clindamycin therapy in recurrent tonsillitis . Effect of microbial flora; Foote PA Jr et al.; Fifty patients, scheduled for an elective tonsillectomy because of recurrent group A beta-hemolytic streptococcal tonsillitis, participated in a prospective randomized study that compared the efficacy of presurgical treatment with either phenoxymethyl penicillin or clindamycin hydrochloride in eradicating group A beta-hemolytic streptococci and beta-lactamase-producing bacteria (BLPB) from the tonsillar core . They were randomized into three groups as follows: 11 received penicillin, 22 received clindamycin, and 17 received no therapy . Group A beta-hemolytic streptococci were isolated from 8 (40%) of 17 untreated patients, 4 (36%) of 11 patients treated with penicillin, and none of 22 patients treated with clindamycin . Twenty-one BLPB were isolated from 16 (94%) of 17 untreated patients, 11 BLPB from 9 (82%) of 11 patients treated with penicillin, and 7 BLPB from 7 (32%) of 22 patients treated with clindamycin compared with penicillin or no therapy . Of the 22 patients treated with clindamycin, 10 were younger than 12 years of age . The BLPB were eradicated in nine patients (90%) . However, BLPB were eradicated only in 6 (50%) of the 12 patients who were aged 13 years and older . These data illustrate the efficacy of clindamycin therapy in eradicating group A beta-hemolytic streptococci, as well as BLPB, in recurrent inflamed tonsils, especially in persons aged 12 years old and younger. Biochim Biophys Acta, 1989 Jun 27, 991(3), 395 - 8 Molecular surface characterization of oral streptococci by Fourier transform infrared spectroscopy; van der Mei HC et al.; In order to characterize the molecular composition of oral streptococci, infrared transmission spectroscopy on freeze-dried cells dissolved in KBr was used . All infrared spectra show similar absorption bands for the strains studied with the most important absorption bands located at 2930 cm-1 (CH), 1653 cm-1 (AmI), 1541 cm-1 (AmII) and two bands at 1236 cm-1 and 1082 cm-1, which were assigned to phosphate and sugar groups . However, calculation of absorption band ratios normalized with respect to the integrated intensity of the CH stretching region around 2930 cm-1, show significant differences between the strains . Both Streptococcus mitis strains possess high AmI/CH and AmII/CH absorption band ratios compared to the other strains . Streptococcus salivarius HBC12, a mutant strain devoid of all proteinaceous surface appendages, shows significantly lower AmI/CH and AmII/CH band ratios with respect to its parent strain S . salivarius HB . Two positive relationships could be established both between the AmII/CH absorption band ratio and the N/C elemental surface concentration ratio of the strains previously, determined from X-ray photoelectron spectroscopy (XPS) and also between AmI/CH and the fraction of carbon atoms at the surface involved in amide bonds, determined by XPS as well . From this comparison, it is concluded that transmission infrared spectroscopy can be employed as a technique to study the molecular surface composition of freeze-dried microorganisms. Science, 1989 Jun 23, 244(4911), 1487 - 90 Protection against streptococcal pharyngeal colonization with a vaccinia: M protein recombinant; Fischetti VA et al.; Phagocytosis of group A streptococci requires type-specific antibodies directed against the variable determinants of the bacterial surface M protein molecule . As a step toward developing a broadly protective anti-streptococcal vaccine, a vaccinia virus (VV) recombinant was constructed that expresses the conserved region of the structural gene encoding the M6 molecule (VV:M6') . Mice immunized intranasally with the VV:M6' virus showed markedly reduced pharyngeal colonization by streptococci after intranasal and oral challenge with these bacteria . M protein-specific serum immunoglobulin G was significantly elevated in vaccinated animals and absent in controls . A similar approach may prove useful for the identification of protective determinants present on other bacterial and viral pathogens. Tidsskr Nor Laegeforen, 1989 Jun 10, 109(16), 1773 - 4 {Toxic shock syndrome without any relation to the use of tampons or staphylococcal infection}; Jacobsen MB et al.; Toxic shock syndrome is a generalized disease traditionally thought to be caused by toxinproducing strains of Staphylococcus aurus . The syndrome is characterized by fever, hypotension, erythema of the skin, erythematous desquamation and multiple organ involvement . We present a case where the causative agent was most probably streptococci, thus demonstrating that the syndrome probably has a heterogeneous, toxin-related etiology. Eur J Epidemiol, 1989 Jun, 5(2), 189 - 92 Prevalence of Streptococcus mutans and dental decay in school children from Siena (Italy); Gasparini R et al.; Epidemiological indexes of dental decay and prevalence of Streptococcus mutans in dental plaque were studied in a group of 255 schoolchildren aged 6-11 from a suburban area near Siena (Italy) . Mutans streptococci were isolated from 17.4% of subjects: a significant correlation with dental decay indexes and with the presence of active caries was observed. Antimicrob Agents Chemother, 1989 Jun, 33(6), 970 - 2 Comparison of the in vitro activities of fenticonazole, other imidazoles, metronidazole, and tetracycline against organisms associated with bacterial vaginosis and skin infections; Jones BM et al.; The in vitro antibacterial activity of the antifungal compound fenticonazole was compared with those of clotrimazole, miconazole, tetracycline, and metronidazole against 177 strains of bacterial species associated with either bacterial vaginosis (BV) or skin infections by agar dilution MIC determinations . BV-associated Bacteroides isolates of the Bacteroides melaninogenicus-B . oralis group, Gardnerella vaginalis, Mobiluncus spp., and anaerobic, gram-positive cocci were highly susceptible to fenticonazole, clotrimazole, and miconazole; but Bacteroides spp . not associated with BV, Bacteroides ureolyticus and the Bacteroides fragilis group, were resistant . All Bacteroides strains were susceptible to metronidazole, but the susceptibility of G . vaginalis and Mobiluncus spp . varied . Among the skin bacteria, Staphylococcus aureus, coryneforms, and streptococci were highly susceptible to the imidazoles; but Staphylococcus epidermidis strains were generally resistant . This antibacterial activity may give fenticonazole a useful role in the topical treatment of vaginal discharge and in mycotic skin infections that are superinfected with bacteria. Oral Microbiol Immunol, 1989 Jun, 4(2), 77 - 81 Possible effect of medically administered antibiotics on the mutans streptococci: implications for reduction in decay; Loesche WJ et al.; The decline in dental caries in children in North America, Scandinavia, Britain, Ireland and many Commonwealth nations is well documented . The multiple uses of fluoride can account for most, but not all, of this reduction . In this investigation, data are provided which suggest a relationship between antibiotic usage for medical purposes and a decline in both mutans streptococci (MS) and caries . Children attending Grades 1 and 2 in the Coldwater, Michigan school system and who reportedly never received antibiotics had significantly higher proportions of MS in the fissure plaques of first molars than subjects who received antibiotics . The level of decay in the primary dentition was inversely related to the reported usage of antibiotics . The frequent usage of antibiotics could reduce the incidence of dental caries by delaying the colonization of the teeth by the MS . This was evaluated by a prospective study in infants to determine what effect reported antibiotic usage would have on the colonization of newly erupting primary teeth . Only 2 of 10 infants cultured at 2 to 3 week intervals for periods up to 1 year after tooth eruption became colonized by the MS . One had never received antibiotics and the second had been on antibiotics for a single 5-day period . Seven of the 8 non-colonized infants had received antibiotic therapy for periods ranging from 10 to 181 days . Both the Coldwater study and the prospective study of infants suggested a relation between frequency of antibiotic usage for medical purposes and the MS levels on the teeth. Oral Microbiol Immunol, 1989 Jun, 4(2), 71 - 6 Relationship between mutans streptococci in saliva and their colonization of the tooth surfaces; Lindquist B et al.; The relationship between the salivary concentration of mutans streptococci and their prevalence on different tooth surfaces was studied in 114 subjects . Plaque samples were obtained from all tooth surfaces in the dentition and the infection magnitude of mutans streptococci was determined . The salivary concentrations of mutans streptococci correlated significantly with the number of colonized tooth surfaces and with the infection level of mutans streptococci for individual teeth or groups of tooth surfaces . The highest correlation values were found for buccal and approximal surfaces and for molars followed by premolars and anterior teeth . The 10 tooth surfaces best reflecting the salivary levels of mutans streptococci were 5 buccal and 5 approximal sites, 6 of them localized on maxillary posterior teeth . A significant positive relationship was noted between the prevalence of mutans streptococci in saliva and on the dorsum of the tongue. J Dairy Sci, 1989 Jun, 72(6), 1547 - 56 Field survey of clinical mastitis in low somatic cell count herds; Hogan JS et al.; Nine commercial dairy herds, each with low herd milk somatic cell counts, were monitored for 1 yr to determine prevalence of intramammary infections and rates of clinical mastitis . Staphylococcus species was the bacterial group most frequently isolated from quarters at calving and at drying off . Environmental streptococci and coliform intramammary infections totaled less than 6% of quarters at both calving and at drying off . Staphylococcus aureus were isolated from less than 1% of quarters and Streptococcus agalactiae from 0% of quarters at both calving and drying off . A total of 646 clinical cases of mastitis were diagnosed in 548 quarters of 406 cows . Mean rate of clinical mastitis among herds was .457 clinical cases/305 cow-days . Rates of clinical mastitis ranged among herds from .273 to .748 clinical cases/305 cow-days . Coliforms and bacteriologically negative and environmental streptococci accounted for 82.3% of clinical cases . Rates of clinical mastitis and severity of clinical signs differed among herds, seasons of the year, parity groups, and stages of lactation . Rates of clinical mastitis were highest during summer, in first lactation cows, and during the first 7 d of lactation. Zentralbl Hyg Umweltmed, 1989 Jun, 188(3-4), 343 - 64 {Medical waste . 1 . Microbiologic studies of wastes of various specialties at a large and small hospital in comparison to housekeeping waste}; Jager E et al.; Hospital wastes, similar to household refuse, from normal and high risk areas of a big and a smaller hospital were tested quantitatively and qualitatively for nosocomial infective agents . The results were compared with those of household refuse . 20-25 samples from care and operating wards were examined each for 3 months . The whole content of a waste bag was suspended without a preceding sorting . After this treatment the eluat was microbiologically examined . The results of the test proved that the germ concentration of the hospital waste was less or similar than that of household refuse . The median for gram negative rods in household refuse was e.g . 4 log10-steps higher than in wastes from operating wards . The statistical analysis confirmed these highly significant differences between the wastes from the high risk operating areas of the big and smaller hospital and the household refuse for all investigated bacteria groups . There are nearly no differences between the wastes from normal wards and from household refuse regarding germ concentration for different groups, e.g . gram negative rods or D-streptococci, and no higher germ concentration in any case . In conclusion hospital wastes must be disposed with special hygienic measures inside the hospital, outside the hospital they can be disposed together with household refuse. J Perinatol, 1989 Jun, 9(2), 131 - 6 Polymicrobial sepsis among intensive care nursery infants; Faix RG et al.; To determine the incidence, characteristics, and course of polymicrobial sepsis among infants in intensive care nurseries, we reviewed all such episodes in our neonatal unit from September 1971 through June 1986 . We identified 15 episodes (3.9% of all cases of culture-proven sepsis during the survey period) in which blood or cerebrospinal fluid (CSF) culture yielded multiple organisms felt to represent true pathogens . Mortality associated with late-onset polymicrobial sepsis (7 of 10; 70%) was significantly higher (P less than .001) than in late-onset monomicrobial sepsis (86 of 370; 23%) . Six patients were 37 weeks' gestation or greater at birth, and five were younger than 4 days of age when the polymicrobial culture was obtained . Group D streptococci were recovered in eight cases (53%) . Gastrointestinal foci appeared to be common among infants with late-onset polymicrobial infection (5 of 10), while prolonged rupture of membranes was frequently associated with early-onset infection (4 of 5) . Though recovery of multiple organisms from blood or CSF may not always be significant, one should not immediately assume contamination . A report of more than one organism growing from a normally sterile body fluid in an intensive care nursery infant should be considered significant, and therapy should be adjusted to provide appropriate antimicrobial agents for all reported organisms if the infant has not substantially improved in the interval since the culture was actually obtained. Epidemiol Infect, 1989 Jun, 102(3), 379 - 90 Group C streptococci in human infection: a study of 308 isolates with clinical correlations; Barnham M et al.; A collection of 308 clinical isolates of beta-haemolytic Lancefield group C streptococci was assembled from laboratories in England, Nigeria and New Zealand . Of these, 276 isolates were Streptococcus equisimilis, 23 S . milleri and nine S . zooepidemicus . Isolates of S . equisimilis in the African collection, though few, gave higher rates of lactose and raffinose fermentation, aesculin hydrolysis and positive alpha-galactosidase reactions than those from elsewhere . Erythromycin resistance was found in 1.9% of the English isolates of S . equisimilis . Strains from superficial infections accounted for 88% of the collection and were most commonly isolated from the upper respiratory tract, skin or wounds . Amongst the 36 patients yielding isolates from deep sites S . equisimilis was found in septicaemia, cellulitis, abscess, peritonitis, septic arthritis, pneumonia, mycotic aneurysm and acute epiglottitis, S . milleri was found in abdominal abscesses, peritonitis, pleural empyema and osteomyelitis and S . zooepidemicus was found in septicaemia, pneumonia, meningitis and septic arthritis . Within the collection an unselected general catchment of 214 isolates of group C streptococci from the laboratories in Yorkshire showed the following species: from 199 superficial infections 94% S . equisimilis, 5% S . milleri and 1% S . zooepidemicus and 15 patients with deeper, more aggressive infections 67, 27 and 6.7% of these species respectively. J Bacteriol, 1989 Jun, 171(6), 2981 - 5 Transport of glutamine by Streptococcus bovis and conversion of glutamine to pyroglutamic acid and ammonia; Chen GJ et al.; Streptococcus bovis JB1 cells energized with glucose transported glutamine at a rate of 7 nmol/mg of protein per min at a pH of 5.0 to 7.5; sodium had little effect on the transport rate . Because valinomycin-treated cells loaded with K and diluted into Na (pH 6.5) to create an artificial delta psi took up little glutamine, it appeared that transport was driven by phosphate-bond energy rather than proton motive force . The kinetics of glutamine transport by glucose-energized cells were biphasic, and it appeared that facilitated diffusion was also involved, particularly at high glutamine concentrations . Glucose-depleted cultures took up glutamine and produced ammonia, but the rate of transport per unit of glutamine (V/S) by nonenergized cells was at least 1,000-fold less than the V/S by glucose-energized cells . Glutamine was converted to pyroglutamate and ammonia by a pathway that did not involve a glutaminase reaction or glutamate production . No ammonia production from pyroglutamate was detected . S . bovis was unable to take up glutamate, but intracellular glutamate concentrations were as high as 7 mM . Glutamate was produced from ammonia via a glutamate dehydrogenase reaction . Cells contained high concentrations of 2-oxoglutarate and NADPH that inhibited glutamate deamination and favored glutamate formation . Since the carbon skeleton of glutamine was lost as pyroglutamate, glutamate formation occurred at the expense of glucose . Arginine deamination is often used as a taxonomic tool in classifying streptococci, and it had generally been assumed that other amino acids could not be fermented . To our knowledge, this is the first report of glutamine conversion to pyroglutamate and ammonia in streptococci. Zh Mikrobiol Epidemiol Immunobiol, 1989 Jun, (6), 34 - 8 {Phase changes in the population of group A streptococci and their influence on the course of the epidemic process of tonsillitis}; Khodyrev AP et al.; This work presents the data on the complex evaluation of the population of group A streptococci, studied at each of four phases (reservation, epidemic transformation, epidemic spread, reservational transformation) of the course of the epidemic process of streptococcal infection of the respiratory tracts (tonsillitis) in an organized group of adults . The characterization of the phases of the infective agent in accordance with the level of the carrier state, the size of streptococcal foci and the virulence of streptococci is given . Thus, the study shows that the heterogeneity of group A streptococci with respect to their virulence reaches its maximum level at the phases of reservation and epidemic spread and its minimum level at the phases of epidemic and reservational transformation . The size of streptococcal foci in carriers and the virulence of streptococci isolated from them are the inter-related unidirectional signs of the population of the infective agent and, at the same time, the main factors responsible for the phase character of the epidemic process and the morbidity level in tonsillitis. Vaccine, 1989 Jun, 7(3), 217 - 24 Structural similarity of the type-specific group B streptococcal polysaccharides and the carbohydrate units of tissue glycoproteins: evaluation of possible cross-reactivity; Hayrinen J et al.; Type-specific capsular polysaccharides of group B streptococci show striking structural similarity with the terminal sugar sequences of tissue glycoconjugates . The polysaccharides have been put forward as vaccines against neonatal meningitis . A potential source of hazard in immunization of pregnant mothers may be the presence of the cross-reactive components in adult or fetal tissues . A radioactive ligand binding assay was used to test human immune sera to type Ia, II and III group B streptococcal polysaccharides for binding to tissue-derived glycopeptides showing structural similarities with the streptococcal polysaccharides . Of the 13 glycopeptides of human and rat tissues studied, representing a wide selection of structures known to occur in glycoproteins, only two showed some reactivity with the antisera . The reactivity with human small intestinal glycopeptides could be explained by the presence of natural blood group A antibodies, and was not related to the streptococcal group B antibodies . The basis of the reactivity of a high-molecular-weight glycopeptide from rat kidney with some of the sera was unknown, but was unrelated to the vaccination and clearly could not be inhibited with the streptococcal polysaccharides . Thus, no immunological cross-reactions of the tissue glycopeptides studied could be demonstrated with the group B streptococcal antisera. J Clin Microbiol, 1989 Jun, 27(6), 1352 - 6 Restriction endonuclease analysis of human and bovine group B streptococci for epidemiologic study; Denning DW et al.; Group B streptococci, a frequent cause of neonatal sepsis and meningitis, postpartum endometritis, and bovine mastitis, may be acquired by several modes of transmission . Detailed epidemiologic study is hampered by the lack of a sufficiently discriminatory typing system, especially for type III and nontypable strains . We examined 54 epidemiologically well-characterized strains by restriction endonuclease analysis (REA) and compared the results with those obtained by serotyping . REA patterns were inspected without knowledge of the epidemiological or serotyping data . Among 21 type Ia, Ia/c, and Ib/c isolates, we found 10 REA patterns; among 5 type II and IIc isolates, we found 5 REA patterns; among 13 type III isolates, we found 6 REA patterns; and among 15 nontypable human and animal isolates, we found 7 different REA patterns . Double digestion of type III isolates with EcoRI and BglII helped us to distinguish the isolates . In total, 28 REA patterns were found in six serotype groups and one nontypable group . Some geographically and epidemiologically separate isolates had identical REA patterns, suggesting dissemination of a limited number of clones . We conclude that REA is a promising tool for detailed epidemiological study of group B streptococci. Eur J Obstet Gynecol Reprod Biol, 1989 Jun, 31(3), 221 - 6 Chlorhexidine for prevention of neonatal colonization with group B streptococci . V . Chlorhexidine concentrations in blood following vaginal washing during delivery; Nilsson G et al.; Chlorhexidine 2 g/l was applied to the vagina of 96 women during delivery, whereas 28 served as controls . Both groups were given a shower using a chlorhexidine soap, and outer washing of the outer anogenital tract was also performed in all patients using chlorhexidine 2 g/l . Using a gas chromatographic method with a detection limit of 10 ng chlorhexidine per ml blood, 10-83 ng/ml was demonstrated in 34 (35%) of the study group patients, whereas the remaining study group patients and controls showed no detectable chlorhexidine . Performing the washing a second time after 6 hours in 14 patients and a third time in 3 patients after a further 6 hours did not result in increased serum levels . It was concluded that small amounts of chlorhexidine are absorbed through the vaginal mucosa and that chlorhexidine is not accumulated in the blood on repeated usage with 6 hour intervals during delivery. Infect Dis Clin North Am, 1989 Jun, 3(2), 221 - 45 Infections of prosthetic heart valves and cardiac pacemakers; Heimberger TS et al.; Prosthetic valve endocarditis may be considered present when two fo the following criteria are met: (1) two or more blood cultures are positive with the same organism in the absence of extracardiac infections, (2) evidence of bacterial endocarditis by histology or cultures is obtained from surgical or autopsy specimens, and/or (3) a clinical picture compatible with endocarditis (fever, new or changing regurgitant murmur, splenomegaly, hematuria, or evidence of peripheral emboli) is present . The overall incidence of PVE ranges from 0.98 to 4.4 per cent . Early and late PVE (that is endocarditis developing less than 60 and 60 or more days following valve implantation, respectively) accounts for 18 to 36 per cent and 64 to 82 per cent of infections, respectively . The overall mortality is 53 per cent and is higher in patients with early versus late PVE . Coagulase-negative staphylococci are responsible for a higher percentage of early (43 per cent) than late (28 per cent) infections . Streptococci are more common in late (27 per cent) than in early (3 per cent) PVE, while diphtheroids are most common in early PVE . The diagnosis of PVE may be difficult to establish, especially in patients with postoperative bacteremias who have other potential sources of extracardiac infections . Antimicrobial therapy is generally based on the susceptibility of the offending pathogen . With respect to the use of synergistic combinations, results are controversial, and most available data are derived from patients with native-valve endocarditis . Surgery remains an important aspect of treatment, and the mortality among patients who undergo early surgical intervention, particularly if their illness is complicated, is less than in those who are treated only with antibiotics . Indications for surgery include: (1) moderate-severe refractory congestive heart failure, (2) persistent bacteremia or fungemia, (3) multiple emboli, (4) myocardial abscesses, (5) relapsing PVE, and possibly (6) patients with clinical evidence of PVE and negative blood cultures and persistent fever despite 1 week or more of appropriate antibiotics . Pacemaker infections occur in less than 6 per cent of patients who undergo pacemaker insertion . These infections generally result from wound contamination at the time of surgery, and 75 per cent of infections are due to staphylococci . Staphylococcus aureus causes most infections occurring within 2 weeks after surgery, while S . epidermidis causes most later infections . The need to remove infected pacemakers is controversial. Eur J Pediatr, 1989 Jun, 148(7), 679 - 81 Concentrations of ceftazidime, tobramycin and ampicillin in the cerebrospinal fluid of newborn infants; Tessin I et al.; Thirty-five neonates with suspected septicaemia were randomized to treatment with tobramycin or ceftazidime, both in combination with ampicillin . Concentrations of antibiotics in the CSF were measured 1 h after the third, fourth or fifth injection . In 13 of 17 neonates tobramycin CSF concentrations were below 0.5 mg/l . Ceftazidime CSF concentrations ranged from 2.5 to 17 mg/l, which should be sufficient for treatment of infections with group B streptococci and most aerobic gram-negative bacilli but not all strains of Staphylococcus aureus . Ampicillin CSF concentrations ranged from 1 to 80 mg/l, which should be sufficient for treatment of meningitis caused by enterococci and Listeria monocytogenes, the most important neonatal pathogens not covered by ceftazidime. Epidemiol Infect, 1989 Jun, 102(3), 391 - 400 Beta-haemolytic streptococci from the female genital tract: clinical correlates and outcome of treatment; Lewis RF; Clinical features, treatment and outcome were assessed retrospectively by means of a questionnaire in 174 patients in general practice whose vaginal swabs yielded beta-haemolytic streptococci . These were compared with 96 patients whose swabs yielded no recognized microbial pathogens . Patients with group B streptococci did not differ in any of these parameters from the control group, but those with group A streptococci were more likely to have vaginal soreness, a purulent discharge, and to respond to anti-streptococcal antibiotics . Implications for laboratory reporting are discussed. Proc Natl Acad Sci U S A, 1989 Jun, 86(12), 4741 - 5 Fc-receptor and M-protein genes of group A streptococci are products of gene duplication; Heath DG et al.; The partial nucleotide sequence for an Fc-receptor gene from an M-type 76 group A streptococcus was determined . DNA sequence analysis revealed considerable sequence similarity between the Fc-receptor and M-protein genes in their proposed promoter regions, signal sequences, and 3' termini . Additional analysis indicated that the deduced Fc-receptor protein contains a proline-rich region and membrane anchor region highly similar to that of M protein . In view of these results, we postulated that Fc-receptor and M-protein genes of group A streptococci are the products of gene duplication from a common ancestral gene . It is proposed that DNA sequence similarity between these two genes may allow for extragenic homologous recombination as a means of generating antigenic diversity in these two surface proteins. Arch Dermatol, 1989 Jun, 125(6), 779 - 82 Streptococcal cause of erysipelas and cellulitis in adults . A microbiologic study using a direct immunofluorescence technique; Bernard P et al.; We prospectively studied 42 adult patients with acute dermis and soft-tissue infections (27 with erysipelas and 15 with acute cellulitis) involving the lower limb in all except one case . Streptococcus organisms (groups A, C, D, and G) were researched in skin biopsy specimens by a direct immunofluorescent (DIF) technique using commercially available antibodies . Our results showed that DIF gives a sensitivity of 0.70 for the in situ detection of streptococci in cases of erysipelas and cellulitis . With the obvious contribution of this DIF technique, streptococcal pathogens could be detected in situ and grouped in 19 of 27 cases of erysipelas (group A, 13; group B, 1; group C, 1; and group G, 4) and in ten of 15 cases of cellulitis (group A, 9; group B, 1) . Combined data, including conventional cultures, DIF studies, and serologic findings, established that Streptococcus organisms, especially Streptococcus pyogenes (A), were, in nearly all cases, responsible for both erysipelas (26/27 cases) and acute cellulitis (11/15 cases) involving the lower limb in adults. Gifu Shika Gakkai Zasshi, 1989 Jun, 16(1), 16 - 39 {Characterization of fatty acid composition in the cytoplasmic membrane of Streptococcus mutans}; Kato M; The present study was performed to investigate the role of the fatty acid composition of cytoplasmic membranes in bacterial differentiation and the appearance of cariogenic properties of Streptococcus mutans . Bacterial fatty acid composition was effective for differentiation of Streptococcus mutans from the other oral streptococci . The composition obtained from the reference strains and the clinical isolates involved five groups and was useful as a rapid screening index for Streptococcus mutans . Compositional changes in membrane lipids played important roles in synthesis and secretion of extracellular glucosyltransferase for Streptococcus mutans . A characteristic property of Streptococcus mutans, resistance to 40% sucrose in the medium, is ascribable to compositional changes in membrane lipids, especially the glycolipids, of Streptococcus mutans. G Ital Dermatol Venereol, 1989 Jun, 124(6), 303 - 5 {Persistent lymphedema of the penis and scrotum after recurrent episodes of cellulitis and urethritis caused by Chlamydia trachomatis}; Carlino A et al.; A 20 year old man affected by a persistent peno-scrotal lymphedema is reported . This condition followed recurrent attacks of cellulitis and a chronic urethritis . From the urethral discharge we isolated Chlamydia trachomatis and, only during the attacks of cellulitis, Group G Streptococcus . This pathogen cannot be isolated from microflora of the normal urethra and rarely cause cellulitis . In our opinion Chlamydial infection favoured the urethral colonization of Group G Streptococci and their passage in the loose connective tissue of the penis and scrotum . Lymphedema, clinically inapparent before the first attack, become progressively more severe and recurrent attacks took place at intervals without obvious re-exposure to an exogenous source of streptococci . The operative treatment of persistent lymphedema is lymphangiectomy and lymphangioplasty. Tokushima J Exp Med, 1989 Jun, 36(1-2), 11 - 6 Biliary stones and bacteriae in bile study in 211 consecutive cases; Matin MA et al.; A retrospective study have been performed to investigate the correlation between stone formation and bacteriae in the bile of 211 consecutive biliary stone patients (133 females and 78 males, age ranged 1.3 to 87.0 years old, 196 cholecystolithiasis, 54 choledocholithiasis and 9 hepatolithiasis) . They had undergone surgery since January 1980 to December 1987 . Bile was collected to perform bacterial culture from the gallbladder and common bile duct during operation and all stones had been classified according to morphology after surgery and confirmed with component analysis if necessary . Totally 5115 stones had been collected and 20.4% had been classified as pure cholesterol stone, 16.8% as combination stone, 17.2% as mixed stone, 23.6% as calcium bilirubinate stone, 17.6% as black stone, 0.8% as calcium fatty acid stone and 3.6% as unknown . In bile culture, 84 from the gallbladder and 31 from the common bile duct were positive . Streptococci were the most frequent and followed by Klebsiella, Escherichia coli and so on . A higher incidence of positive culture was shown in calcium bilirubinate and lower incidence was shown in cholesterol stones . These results suggest that bacteriae in the bile may play a role in the formation of pigment biliary stones. Nippon Sanka Fujinka Gakkai Zasshi, 1989 Jun, 41(6), 676 - 82 {Antibodies to group B streptococci in maternal and cord sera}; Kubota T et al.; Group B Streptococcus (GBS) antibody concentrations were studied in 214 pregnant women, of which 91 were carriers and 123 were noncarriers . The method using EIA was designed to measure antibodies to Type Ia, Ib, Ic, II, III and Group B . By means of AGG (Agglutination), antibodies to Type Ib, II, and Group B could also be measured . 1) The Group B antibody concentration in pregnant carriers of GBS (mean: 13.9 microliters with EIA, 4.77 microliters with AGG) was significantly greater than that in noncarriers (mean: 10.6 microliters with EIA, 3.64 microliters with AGG) . 2) In most of the cases studied, the cord serum concentration was similar to the maternal concentration when EIA was used . On the other hand the antibody concentrations in cord serum were lower than those in the maternal serum when AGG was used . 3) In a premature baby (1,768g) and in a baby with Downs' syndrome the cord serum concentration was lower than the maternal concentration, while in a large baby (4,074g) the cord serum concentration was higher than the maternal concentration . 4) Using EIA, the type-specific antibody which coincided with the type of strain isolated from each vaginal carrier showed a higher concentration than any other type-specific antibody. Zh Mikrobiol Epidemiol Immunobiol, 1989 Jun, (6), 86 - 90 {Autoantibodies to different layers of epidermis during immunization of BALB/c mice with a culture of Group A Streptococcus treated with pepsin}; Bazanova EA et al.; As revealed in the indirect immunofluorescence test, antibodies to the cross-reacting group A streptococcal polysaccharide determinant (A-PS), common to the antigen of the basal cell layer of the epidermis, regularly occur at the end of the first cycle and disappear after further immunization of BALB/c mice with the pepsin-treated culture of group A streptococci . This model may be used for the study of antibodies to A-PS, cross-reacting with the cells of the basal layer of the epidermis, in the development of the autoimmune process linked++ with group A streptococcal infection. Pathol Biol (Paris), 1989 Jun, 37(5 Pt 2), 568 - 72 {Selection of constitutive mutants of gram-positive cocci inducible resistant to macrolides, lincosamides and streptogramins (MLS): comparison of the selective effects of the MLS}; Leclercq R et al.; Mutation frequencies to constitutive resistance were determined for 7 strains inducible resistant to the MLS antibiotics (5 Staphylococcus aureus, 1 group G Streptococcus and 1 Streptococcus sanguis) . In the 5 staphylococcal strains, mutants were generally selected at a frequency of 10(-9) to 10(-10) (ranging from 4.10(-8) to 9.10(-11) on plates containing 50 mg/l of the following non-inducer MLS: spiramycin, josamycin, midecamycin, miocamycin, lincomycin, clindamycin, and pristinamycin factor I (PI) . No mutant was selected by 50 mg/l of pristinamycin factor II (PII) or by pristinamycin complex (P) . Absence of selection of constitutive mutant by P was due to the low MICs of the antibiotic against the constitutively resistant strains and to the effect of PII: the emergence of the mutants constitutively resistant to PI was prevented by a 6-hour contact of the culture with PII (50 mg/l) . MICs and MBCs of the pristinamycin against 9 constitutive mutants were respectively 2 to 4-fold and 2 to 8-fold greater than that against the wild-strains . In the streptococci, no constituvely resistant mutant was selected . Therefore, the risk of selection of resistant mutants by a non inducer MLS in the course of the treatment of infections due to inducible resistant staphylococcus appeared to be low, especially in the case of pristinamycin. Pediatr Dermatol, 1989 Jun, 6(2), 134 - 8 Impetigo contagiosa III . Comparative efficacy of oral erythromycin and topical mupirocin; Barton LL et al.; Ninety-seven patients with impetigo were prospectively enrolled in a study to determine the comparative efficacy of systemic and topical antibiotic therapy . After obtaining a bacterial culture from a representative lesion, the children were randomized to receive seven days of either oral erythromycin or topical mupirocin administered three times daily . Staphylococcus aureus alone was isolated from 51% and in association with group A beta-hemolytic streptococci (GABS) from 29%; GABS alone was isolated from 4% of patients . Of 48 children who received erythromycin, 43 (90%) were clinically improved or cured, and 11 of 17 were bacteriologically cured . Of 49 children who received mupirocin, 47 (96%) were clinically improved or cured, and 10 of 14 were bacteriologically cured . At three-week follow-up, clinical cure rates and number of secondary household cases of impetigo were equivalent in both treatment groups . Mupirocin appears to be a well-tolerated, albeit expensive, alternative to erythromycin for the treatment of impetigo. Epidemiol Infect, 1989 Jun, 102(3), 401 - 12 Inhibitory substances produced by Streptococcus salivarius and colonization of the upper respiratory tract with group A streptococci; Huskins WC et al.; It has been proposed that inhibitory substances produced by viridans streptococci colonizing the upper respiratory tract aid in eradication of established group A streptococcal colonization of that site . We studied the prevalence of inhibitory-substance producing strains of Streptococcus salivarius in throat cultures from three groups of children: 16 children with persistently positive throat cultures for group A streptococci despite receiving recommended therapeutic courses of antibiotics (group I), 26 children from whom group A streptococci were eradicated from the upper respiratory tract by antibiotic therapy (group II), and 18 children who never harboured group A streptococci in their upper respiratory tract during the study period (group III) . An in vitro deferred antagonism method was employed to detect inhibitory substances; 5233 strains of S . salivarius were examined . Strains of S . salivarius producing inhibitory substances were isolated from 76-88% of the children in each group on at least one occasion . However, only a small percentage of subjects in each group harboured strains producing these substances in every throat culture . The mean total percentage of S . salivarius strains producing inhibitory substances was 21.8% in children in group I, 22.4% in children in group II, and 16.4% in children in group III; these percentages were not statistically different (P greater than 0.1) . In this study, we could not confirm a significant role for inhibitory substances produced by S . salivarius in the eradication of group A streptococci from the upper respiratory tract of colonized individuals. Pathol Biol (Paris), 1989 May, 37(5), 459 - 64 {Frequency and severity of systemic infections caused by Streptococcus mitis and sanguis II in neutropenic children}; Leblanc T et al.; We have retrospectively evaluated 24 sepsis episodes caused by viridans streptococci in 23 neutropenic children during a 21 months period at the Pediatric Hematology Unit of St . Louis Hospital . The underlying malignancies included acute lymphoblastic leukemia, acute non lymphoblastic leukemia, aplastic anemia and solid tumor . In 17 children neutropenia, defined as a neutrophil count of less than 500 per cubic millimeter, was caused by cytotoxic chemotherapy . For 6 other children neutropenia was consequential to pretransplant treatment regimen for autologous bone marrow transplantation including cytotoxic chemotherapy and total body irradiation . All patients had a silicone rubber atrial catheter . In 9 patients sepsis was associated only with fever for less than 48 hours . In 5 other children fever was prolonged more than 72 hours in spite of specific antimicrobial therapy . No other organism was isolated . In 10 patients, however, the infectious syndrome was severe and the features included cardiac failure (7 patients), pneumonia (7 patients) resembling adult respiratory distress syndrome, encephalopathy (3 patients) without meningitis and proteinuria, 7 of these patients needed a management in a pediatric intensive care unit and 2 died in spite of adapted antibiotics . Streptococci were isolated in blood cultures in 23 children. Gaoxiong Yi Xue Ke Xue Za Zhi, 1989 May, 5(5), 249 - 63 {Bacteriological study of chronic paranasal sinusitis}; Juan KH; Analysis was done on the bacteria flora and the antibiotic sensitivity of 533 maxillary sinuses in 430 patients with chronic sinusitis treated at the Kaohsiung Medical College Hospital during the past 10 years . Among antral flora, Streptococcus sp . were the most common (212 strains, 38.4%), followed by Staphylococcus epidermidis (140 strains, 25.4%) and Staphylococcus aureus (33 strains, 5.9%) . These three G(+) bacteria made up 70% (69.87%) of the total . The percentage of gram-negative and anaerobic bacteria was 20.8% and 8.7%, respectively . Of the total bacteria cultures, 17.8% showed no-growth . These results were similar to those reported in a similar study 10 years before . For the Streptococci and Staphylococci (70% of the total number), the most susceptible antibiotics in vitro were cephalosporin, followed in order by clindamycin, erythromycin, chloramphenicol, and cotrimoxazole . The effectiveness of ampicillin, gentamicin, minocycline appears to have been decreasing in the past 10 years . Tetracycline and penicillin effectiveness was worse . The susceptibility spectrum of the G(-) bacteria did not appear greatly changed from 10 years ago, for example, colistin and newly-synthesized aminoglycoside were rather sensitive . In addition a review was conducted of related papers of the past 70 years with a discussion of some controversial problems. Stomatologiia (Mosk), 1989 May-Jun, 68(3), 23 - 5 {Indices of microorganism sensitivity to antiseptics in apical periodontitis}; Budevskaia TV et al.; High incidence of detection of staphylococci aur . and epiderm.; streptococci hemolyt . and virid., and gram-negative microorganisms in dental root channels in periodontic patients was established . Among antiseptic drugs, most toward major periodontal++ initiators were pervomur, iodopyrone, chlorhexidine, ethonium. Zentralbl Bakteriol, 1989 May, 271(1), 54 - 60 Streptolytic activities of a lytic enzyme from Staphylococcus hyicus; Frede C et al.; The LE IIIb fraction of the bacteriolytic enzyme from Staphylococcus hyicus could be isolated by ionic exchange chromatography and subsequent gel filtration . Isoelectric focusing of the highly purified enzyme preparation revealed an isoelectric point at pH 10.3 . The lytic activity of LE IIIb on streptococci of various serogroups could be effectively analyzed with the help of an aggregometer and expressed as increase of transmittance at 546 nm . The streptococci differed in their LE IIIb lysis pattern, which was more pronounced with those of serological groups C and D and Streptococcus uberis . The lytic effect of the LE IIIb fraction was optimal at low molarity (0.01 mol/l) of the lysis buffer and reduced in the presence of HgCl2 and EDTA. Vet Med (Praha), 1989 May, 34(5), 257 - 66 {Isolation and characteristics of nutritional variants of streptococci of animal origin}; Skardova O; Four strains of nutritionally variant streptococci (NVS) were isolated from the milk of mastitic cows and one strain from the lungs of a laboratory Norway rat which died from suppurative pneumonia . In primary cultivation NVS grew aerobically and anaerobically within 48-hour incubation at a temperature of 37 degrees C as minute nonhemolytic satellite colonies around a previously overlaid S . aureus strain or around other gram-positive and gram-negative bacteria . In the first subcultures NVS were growing in nutrient media enriched with 10% bovine serum and 5% staphylococcal filtrate, or 0.02% to 0.002% pyridoxal hydrochloride . All isolates did not grow in presence of 10%, 40% bile, and 6.5% of sodium chloride, neither did they grow at a temperature of 45 degrees C, they did not hydrolyze sodium hippurate, esculin, arginine, they did not produce levane and dextran from saccharose, they produced acid from mannitol, sorbitol, inulin, lactose, raffinose, trehalose, glucose, saccharose and maltose . Two strains produced acid from xylose and four strains from salicin . The strains isolated from mastitis did not have different biochemical properties from those isolated from a laboratory Norway rat with pneumonia . All strains of NVS were sensitive to chloramphenicol, ampicillin, gentamycin, lincomycin and cephalothin, four strains were sensitive to erythromycin and tyrosine, two to penicillin and one to streptomycin, oxytetracycline, chlortetracycline and novobiocin . All strains were resistant to neomycin, tetracycline, oxacillin and sulphonamides . The antigen prepared from the isolated strains by the method of Fuller did not react with any streptococcal group serum A-Z. Ann Pediatr (Paris), 1989 May, 36(5), 303 - 7 {Materno-fetal infections caused by unusual germs . Apropos of 9 cases}; Rapin F et al.; A retrospective study carried out from January 1981 through August 1988 identified nine cases of materno-fetal infections (Staphylococcus aureus, 1 case; Klebsiella pneumoniae, 3 cases; enterococcus, 3 cases; Hemophilus influenzae, 1 case; and Pneumococcus, 1 case) in six girls and three boys; four premature infants developed respiratory distress requiring mechanical ventilation . In four cases, maternal history found risk factors for infection . All patients developed circulatory failure and one had purulent meningitis . Diagnosis was confirmed upon recovery of the microorganism from a central sample in six cases; in three cases, only the peripheral cultures were positive but diagnosis was supported by the positive maternal history and by clinical findings . Bacterial species were not associated with specific clinical or biological features, but infections due to Hemophilus influenzae, Klebsiella pneumoniae and pneumococcus were particularly severe (two deaths and two infants with neurologic sequelae) . In some studies, unusual microorganisms account for 46% of septicemias and 36% of purulent meningitis . Group D streptococci are the most common bacteria in this category and may account for 10% to 15% of early neonatal septicemias . Organism-specific features are analyzed on the basis of data from the literature . Concerning therapy, this epidemiologic aspect of materno-fetal infections complicates the choice of the initial antimicrobial agents; because third-generation cephalosporins are not effective on listeria and group D streptococci, we advocate more widespread use of the ureidopenicillins instead of ampicillin. Br Vet J, 1989 May-Jun, 145(3), 263 - 75 Pathology and bacteriology of adult male Antarctic fur seals, Arctocephalus gazella, dying at Bird Island, South Georgia; Baker JR et al.; A high mortality rate occurs in Antarctic fur seal males on the breeding breaches of Bird Island, South Georgia . The main causes of death were infections of fighting wounds and pneumonias . The bacteria involved appear to be opportunistic pathogens, predominantly various strains of streptococci. J Med Microbiol, 1989 May, 29(1), 19 - 27 Identification of viridans streptococci by pyrolysis-gas chromatography; French GL et al.; An isothermal method of pyrolysis-gas chromatography (Py-GC) was used for the identification of viridans streptococci . Pyrograms from 104 reference strains were subjected to a discriminant analysis to produce classification coefficients for the identification of 74 test organisms . Five groups representing recognised species were discriminated but Streptococcus milleri strains could not be distinguished from S . sanguis . If S . milleri and S . sanguis are regarded as a single pyrogroup, only three strains out of 74 were incorrectly identified by Py-GC . A multidimensional scaling analysis of the Py-GC data produced a similar species grouping, but this statistical method was less satisfactory for pyrogram data than discriminant analysis . While Py-GC was moderately successful for the identification of viridans streptococci, this study indicated that the technique has limited use in diagnostic medical microbiology because it is time-consuming and lacks flexibility. Am J Clin Pathol, 1989 May, 91(5), 620 - 4 Molecular analysis of viridans and nutritionally deficient (variant) streptococci causing sequential episodes of endocarditis in a patient; Stein DS et al.; Clinical blood isolates from sequential episodes of endocarditis occurring over a six-month period of time in an addict were investigated . The pathogens were Streptococcus sanguis II, Streptococcus mitis, and a nutritionally deficient (variant) streptococcus . The authors determined the DNA relatedness of these isolates by antibiograms, plasmid profiles, chromosomal endonuclease restriction digestions, and dot blot DNA-DNA hybridization analyses . The S . sanguis II and nutritionally deficient streptococcal strain had similar antibiograms being resistant to penicillin; neither produced beta-lactamase . No plasmids were found . The restriction endonuclease chromosomal digestion patterns of these isolates were unique and epidemiologically unrelated to each other . Dot blot DNA-DNA hybridizations, using the nutritionally deficient streptococcal DNA as the probe, showed homology to the preceding clinical isolates, S . sanguis II and S . mitis, at 15.4% and 45.1% hybridization levels, respectively . The nutritionally deficient streptococcus was only 4.2% homologous to a S . mitis ATCC strain and another nutritionally deficient streptococci isolate . Therefore, this patient had endocarditis with three distinct streptococcal strains. Obstet Gynecol, 1989 May, 73(5 Pt 1), 721 - 6 Use of ampicillin and corticosteroids in premature rupture of membranes: a randomized study; Morales WJ et al.; A randomized study was conducted to investigate the effects of antenatal corticosteroids and ampicillin in the management of preterm pregnancies under 34 weeks complicated by premature rupture of membranes . Patients with documented lecithin/sphingomyelin (L/S) ratios of less than 2.0 and a singleton gestation were eligible to participate in the study . One hundred sixty-five patients qualified and were randomized, using sealed envelopes, to four study groups . All patients were followed expectantly . Group I (41 patients) received neither ampicillin nor corticosteroids . Group II (43 patients) received 24 mg of antenatal betamethasone . Group III (37 patients) received 2 g of intravenous ampicillin every 6 hours, with discontinuation of antibiotic therapy if cultures were negative for pathogenic bacteria . Group IV (44 patients) received both corticosteroids and ampicillin as described for groups II and III, respectively . Compared with patients not receiving corticosteroids, those administered antenatal corticosteroids experienced a reduction in the incidences of respiratory distress syndrome (53 versus 26%), bronchopulmonary dysplasia (23 versus 9%), severe grades of intracranial hemorrhage (15 versus 3%), and patent ductus arteriosus (18 versus 6%), with no difference in the incidence of maternal or neonatal infection . Compared with patients not receiving antenatal antibiotics, the group of patients treated with ampicillin on admission had a lower incidence of clinical chorioamnionitis (4 versus 26%) and neonatal sepsis (5 versus 10%) . This reduction in infectious morbidity by antenatal ampicillin was restricted to those patients (28.4% of the study population) colonized with group B streptococci.(ABSTRACT TRUNCATED AT 250 WORDS) J Infect, 1989 May, 18(3), 231 - 48 Invasive streptococcal infections in the era before the acquired immune deficiency syndrome: a 10 years' compilation of patients with streptococcal bacteraemia in North Yorkshire; Barnham M; Significant streptococcal (non-pneumococcal, non-enterococcal) bacteraemia was detected in 100 patients in two Health Districts of North Yorkshire in the decade 1978-1988 . Patients with these infections accounted for 11% of the total 902 patients in the districts in whom bacteraemia was diagnosed during the period . Infection was most often seen with beta-haemolytic streptococci (52 patients) comprising Lancefield group A (Streptococcus pyogenes) (20 patients), group B (13), group C (5), group G (9), haemolytic Streptococcus milleri and non-groupable streptococci (5) . The wide variety of serious infections included cellulitis, abscess, septicaemia, pneumonia, septic arthritis, necrotising fasciitis, acute endocarditis and mycotic aneurysm . Of these 52 patients, 21 (40%) died . alpha-Haemolytic streptococcal bacteraemia was diagnosed in 38 patients of whom 24 (63%) suffered from endocarditis and three (8%) died . Three of ten patients with non-haemolytic or anaerobic streptococcal bacteraemia died also . Six of the 100 patients with streptococcal bacteraemia had concomitant acute virus infections . Of the total 56 patients with infective endocarditis diagnosed in the districts during the period, streptococci were responsible in 30 (54%) of them . The predisposing factors, clinical features and outcome of the infections are described and discussed. J Clin Microbiol, 1989 May, 27(5), 1008 - 10 Evaluation of the Minitek Gram-Positive Set for identification of streptococci isolated from bovine mammary glands; Watts JL; A total of 127 isolates were used to evaluate the Minitek Gram-Positive Set for identification of streptococci cultured from bovine mammary glands . The overall accuracy of the Minitek Gram-Positive Set was 34.6% . Of 12 Streptococcus agalactiae strains, 4 (33.3%) were correctly identified . Of 43 Streptococcus dysgalactiae strains, 32 (74.4%) were identified correctly . Of 44 Streptococcus uberis strains, 42 (95.5%) were identified as Enterococcus spp . Poor performance was attributed to the limited number of veterinary strains in the data base . Incorporation of large numbers of veterinary isolates into the data base is needed for further development of this system. Am J Clin Pathol, 1989 May, 91(5), 589 - 93 A double-blinded comparative evaluation of three media for chromophore testing with viridans and nutritionally variant (deficient) streptococci; Stein DS et al.; A double-blinded prospective comparison of chromophore testing among 109 clinical isolates of alpha-hemolytic gram-positive cocci and 48 strains of nutritionally variant (deficient) streptococci (NVS) for its sensitivity, specificity, and predictive value under stimulated clinical laboratory conditions was performed after growth in three different media--Todd-Hewitt broth supplemented with 10 micrograms/mL of pyridoxal (THBP), THBP with 0.8% (w/v) yeast-extract (THBP + YE), and a semisynthetic chemically defined medium with Todd-Hewitt dialyzate (CDMT) . The chromophore detection rates of Streptococcus mitis were 60.7, 67.9, and 78.6% after growth in THBP, THBP + YE, and CDMT, respectively . After growth in THBP there was significantly lower chromophore detection than either THBP + YE or CDMT for NVS (P less than 0.001), with a trend toward significantly less detection for S . mitis (0.15 greater than P) . For Streptococcus sanguis II the detection rates were 45.7, 57.1, and 54.3%, respectively, for each medium . There was no significant difference between the detection rates after growth in THBP + YE or CDMT . One NVS was persistently chromophore negative, the first so described . There was a similar number of presumably false positive chromophore S . sanguis I strains (3 of 12) detected after growth in THBP + YE or CDMT . The sensitivity of chromophore detection for NVS (pooling results in THBP + YE and CDMT) was 95.8% and specificity was 59.6% . For a nonvariant streptococcus, the sensitivity was 61.9% and specificity was 93.5% for an isolate to be either S . mitis or S . sanguis II. J Dent Res, 1989 May, 68(5), 750 - 60 Bacterial adhesion to oral tissues: a model for infectious diseases; Gibbons RJ; The majority of bacteria which colonize humans display sharp host and tissue tropisms; consequently, relatively little is known about how they initiate colonization on mucosal surfaces . The mouth has a variety of features which have enabled it to serve as a useful model for the discovery of basic principles of host-parasite interactions occurring in mucosal environments . Early studies demonstrated that indigenous bacteria attach to surfaces of the mouth in a highly selective manner; attachment was often observed to correlate with colonization . These studies led to the recognition that bacterial attachment is an essential step for colonization in environments which contain surfaces exposed to a fluid flow . Bacterial adhesion has subsequently grown into a major area of infectious disease research . Many bacteria have been found to possess proteinaceous components, called "adhesins", on their surfaces which bind in a stereochemically specific manner to complementary molecules, or "receptors", on the tissue surface . Adhesins are often lectins which bind to saccharide receptors, but some adhesins are thought to bind to proteinaceous receptors . Studies of components of human saliva, which adsorb to hydroxyapatite (HA) surfaces similar to those of teeth, and promote the attachment of prominent plaque bacteria, have revealed that the acidic proline-rich proteins (PRPs) promote the attachment of several important bacteria . These include strains of Actinomyces viscosus, Bacteroides gingivalis, some strains of Streptococcus mutans, and others . The salivary PRP's are a unique family of molecules . However, segments of PRPs are structurally related to collagen . This may be significant, since B . gingivalis and certain cariogenic streptococci bind to collagenous substrata, and such interactions may facilitate their invasion into gingival tissues, or into dentin or cementum, respectively . Another unexpected observation was that although A . viscosus and other bacteria bind avidly to PRPs adsorbed onto apatitic surfaces, they do not interact with PRPs in solution . PRP molecules evidently undergo a conformational change when they adsorb to HA, and adhesins of A . viscosus recognize cryptic segments which are only exposed in adsorbed molecules . This provides the bacteria with a mechanism for efficiently attaching to teeth while suspended in saliva . It also offers a molecular explanation for their sharp tropisms for human teeth . It has proven convenient to refer to such hidden receptors for bacterial adhesins as "cryptitopes" (from cryptic, meaning hidden, and topo, meaning place).(ABSTRACT TRUNCATED AT 400 WORDS) Infect Immun, 1989 May, 57(5), 1573 - 81 Identification of non-immunoglobulin A-Fc-binding forms and low-molecular-weight secreted forms of the group B streptococcal beta antigen; Brady LJ et al.; The beta antigen expressed on the surfaces of certain strains of group B streptococci has been reported to bind to the Fc region of human immunoglobulin A (IgA) . In this study, we screened 100 isolates of group B streptococci for expression of both beta antigen and IgA-Fc-binding activity . We identified two isolates which expressed the beta antigen but could not bind human IgA Fc fragments and also observed variability in IgA-Fc-binding activity among other beta-antigen-expressing strains . Novel low-molecular-weight forms of beta antigen were secreted by four beta-antigen surface-negative isolates and included IgA-Fc-binding (Mrs, 55,000 and 53,000) and non-IgA-Fc-binding (Mr, 38,000) molecules . These results suggest that the IgA-Fc-binding site represents a unique domain of the beta antigen . The 55,000- and 53,000-Mr forms of secreted beta antigen were functionally and antigenically representative of the size-heterogeneous (Mr, up to 145,000) beta-antigen molecules expressed by surface-positive strains . The cell surface-localized IgA-Fc-binding molecules could bind only human serum IgA efficiently; however, once solubilized, these molecules could bind both human serum and secretory IgAs. Nippon Jibiinkoka Gakkai Kaiho, 1989 May, 92(5), 703 - 8 {Bacteriological investigation of the pre- and postoperative transition of the pharyngeal flora in the patients received tonsillectomy}; Fujimori I et al.; Several investigations have been reported on the interactive relation between the normal flora and the pathogenic micro-organisms in the human upper respiratory tracts (Thompson, Sanders, etc) . It has also been known that some alpha-streptococci have inhibitory effect on the growth of group A beta-hemolytic streptococci . A study upon the role of alpha-streptococci in the throat (tonsil and pharynx) was performed using 73 culture specimens (throat swabs) obtained from 42 patients . Forty-four specimens were taken from the patients who received tonsillectomy, pre- and postoperatively, and 29 were from the patients who did not receive the operation . In the group of patients who received tonsillectomy, alpha-streptococci with inhibitory effect on the growth of group A beta-streptococci were detected less frequently preoperatively, when compared with the patients without tonsillectomy . On the other hand, postoperatively, marked increase of alpha-streptococci of these types was found in the normal flora of the throat . However, further detailed study on this subject is necessary because of the exceptional results in our observations. Indian Pediatr, 1989 May, 26(5), 460 - 5 Analysis of blood-culture isolates from neonates of a rural hospital; Chaturvedi P et al.; All blood culture reports obtained from newborns admitted in a neonatal care unit during 1983-87 were reviewed to determine the current bacteriological profile of neonatal septicemia . A total of 1160 neonates of high risk category or having clinical features suggestive of septicemia were subjected to blood culture study during this period . The culture positivity rate was 73% . Of these, 24.9% cultures were polymicrobial . Among the 1059, growths obtained, 60.1% were Gram negative, with Klebsiella, E . coli and Pseudomonas as the commonest pathogens . In Gram positive group, coagulase negative Staphylococci were most frequent, constituting 24% of the total isolates . An increasing incidence of coagulase positive Staphylococci and Pseudomonas infections was observed in recent years . Another significant finding was a comparatively high prevalence of Group D beta hemolytic isolates among streptococcal growths, with S . fecalis as the single commonest streptococci isolate. J Hosp Infect, 1989 May, 13(4), 337 - 47 An outbreak of puerperal fever caused by group C streptococci; Teare EL et al.; Between 19 February and 18 April 1987, 33 confirmed cases of puerperal fever caused by Streptococcus equisimilis serotype T204 occurred at three hospitals in and around Chelmsford . Most of the cases (70%) occurred on one ward, in which toilet seats and a shower are believed to have aided transmission, although insufficient data were obtained to exclude a role for person-to-person spread . Possession of M-protein antigen was demonstrated in the outbreak strain. J Infect, 1989 May, 18(3), 221 - 9 Topical antibiotics in the treatment of superficial skin infections in general practice--a comparison of mupirocin with sodium fusidate; White DG et al.; A total of 413 eligible patients took part in an observer-blind randomised multicentre clinical trial in order to compare the clinical and bacteriological efficacy of mupirocin (Bactroban) ointment with sodium fusidate (Fucidin) ointment for treating superficial skin infections seen in general practice . Mupirocin was applied twice daily and sodium fusidate thrice daily for a period of 7 days . Both treatments were similarly effective with 97% patients treated with mupirocin and 93% patients treated with sodium fusidate responding . Mupirocin was significantly more effective in the treatment of acute primary skin infections and in the treatment of a subgroup of patients with impetigo (P less than 0.01) . Of the organisms detected before treatment began, 93% were not found after treatment with mupirocin compared with 89% after treatment with sodium fusidate . Staphylococcus aureus and/or beta-haemolytic streptococci appeared to be eliminated in significantly more patients treated with mupirocin (96%) compared with those treated with sodium fusidate (88%), (P = 0.03) . Both treatments were well tolerated. J Clin Microbiol, 1989 May, 27(5), 1050 - 4 Molecular species of R-protein antigens produced by clinical isolates of group B streptococci; Flores AE et al.; Clinical isolates of group B streptococci from body fluids and mucosal surfaces were examined for production of a trypsin-resistant antigen known as R protein . R protein was extracted with 1% trypsin from cells grown in a semidefined medium . The extracts were tested by immunodiffusion in agarose with a panel of antisera for detection and precise identification of the four species of R protein described by Wilkinson . R antigen was present in 49 of 131 (37%) of the strains tested . Analysis by serotype revealed that 0 of 2 type Ia, 0 of 11 Ib, 1 of 16 (6%) Ia/c, 12 of 15 (80%) II, 0 of 20 II/c, 35 of 49 (71%) III, 0 of 6 IV, and 1 of 12 (8%) nontypeable strains produced R antigen . Production of the R protein and the trypsin-resistant or alpha component of the c protein appeared to be mutually exclusive . R antigen was more prevalent in isolates from blood (50%) than in those from mucosal sites (27%) for type II strains; no difference was seen for type III strains from these sites . Concordant results were obtained with five paired body fluid-mucosal surface isolates from individual patients and with isolates from 17 mother-baby pairs . The most frequent species of R antigen was R4 (45 of 49), followed by R1 (4 of 49) . These two species of R protein were biochemically (trypsin resistant and pepsin sensitive) and immunologically identical to the R-protein antigens produced by prototype strains of groups A, B, and C streptococci. J Periodontol, 1989 May, 60(5), 255 - 8 Oral hygiene and the prevalence of oral group D streptococci in medically-physically compromised and periodontal disease patients; McCrary BR et al.; The relationship between oral hygiene and oral Group D streptococcal carrier status was examined in two groups of dental clinic patients . Eighteen medically-physically compromised and 20 periodontitis patients were selected for study . Oral hygiene status was assessed and the prevalence of oral Group D streptococci was determined by sampling the oral cavity with a vigorous 15 second rinse with 5 ml peptone-saline solution . Three ml of each sample was cultured at 40 degrees C in 30 ml of SF broth for 72 hours . Esculin fermenting colonies isolated from the SF broth were characterized biochemically according to standardized procedures and patients were classified as either carriers or non-carriers . Group D streptococci were detected in 27.8% of the medically-physically compromised group and 4.5% of the periodontal disease patients . The mean DI-S score of the medically-physically compromised group was significantly lower than in the periodontal group . Within the medically-physically compromised group, the DI-S means of carriers and non-carriers were not significantly different . The data indicated no important relationship between oral hygiene and the prevalence of oral Group D streptococci in the groups studied. Arch Mal Coeur Vaiss, 1989 May, 82(5), 779 - 84 {54 cases of infectious endocarditis seen in 32 years in a population of 2038 congenital heart diseases}; Corone P et al.; A longitudinal study of a 32-year period (1954-1987) involving 2038 patients with congenital heart defects followed by the same physician yielded 54 cases of infective endocarditis (IE) . Complex cyanogenic cardiopathies were particularly exposed to the risk of infection (8.2 IE for 1000 patient-years), then came ventricular septal defects (2.4), tetralogy of Fallot (2.3), aortic stenosis (2.0) and atrioventricular canal (1.7) . The risk was smaller in patients with Eisenmerger complex (1.2), persistent arterial canal (1.4) and coarctation (0.7) . Patients under 10 years of age (16.7%) were less affected than young adults in the 20-29 years age-group (33.4%) . The organisms most frequently isolated were streptococci (42%); staphylococci ranked second (23%) . Less common organisms were found in 14% of the cases, and blood cultures were negative in 21% . Systemic prophylaxis with penicillin V, introduced 16 years ago, seems to have almost halved the incidence of infective endocarditis due to penicillin-sensitive organisms. Ann Intern Med, 1989 Apr 15, 110(8), 612 - 6 Pharyngitis in adults: the presence and coexistence of viruses and bacterial organisms; Huovinen P et al.; STUDY OBJECTIVE: To determine the presence and coexistence of viruses and bacterial organisms causing pharyngitis in adults . DESIGN: Open study using diagnostic methods, including rapid antigen-detection techniques, to test for the presence of viruses of the respiratory tract, as well as Mycoplasma pneumoniae . Chlamydia trachomatis, the Chlamydia species strain TWAR, and beta-hemolytic streptococci . SETTING: Open health care . PATIENTS: One hundred six consecutive adult patients, 15 to 65 years old, whose chief complaint was sore throat . MAIN RESULTS: Of the 106 patients, beta-hemolytic streptococci were found in only 24 patients (5 patients with group A streptococci, 13 with group C, 5 with group G, and 1 with group F); M . pneumoniae was found in 10 patients, the Chlamydia species strain TWAR in 9 patients, and viruses in 27 patients . Two microbes were simultaneously isolated in 3 patients, and no microbial findings were detected in 33 patients . CONCLUSION: Because 19 patients were infected with the Chlamydia species strain TWAR and M . pneumoniae, and 24 patients were infected with beta-hemolytic streptococci, the diagnostic procedures and therapies for adult patients with pharyngitis need to be reconsidered . The results of our study also confirm earlier suggestions that the Chlamydia species strain TWAR alone is a causative agent for pharyngitis in adults. Infect Immun, 1989 Apr, 57(4), 1177 - 85 Protracted anemia associated with chronic, relapsing systemic inflammation induced by arthropathic peptidoglycan-polysaccharide polymers in rats; Sartor RB et al.; Mild hypoproliferative anemia with abnormal iron metabolism frequently accompanies chronic inflammation and infection in humans . To determine whether anemia is associated with chronic relapsing arthritis induced by bacterial cell wall polymers, serial determinations of the hematocrit were measured in rats injected intraperitoneally with sonicated peptidoglycan-polysaccharide fragments from group A streptococci . Acute anemia peaked 5 to 10 days after injection, and chronic, spontaneously relapsing anemia persisted for 309 days . 51Cr labeling demonstrated decreased erythrocyte survival, i.e., a half-life of 8.4 days in cell wall-injected rats versus 11.8 days in controls . Erythrocytes were mildly microcytic, and leukocyte counts were elevated during early spontaneous reactivation of arthritis, 15 days after injection of peptidoglycan-polysaccharide . Bone marrow myeloid/erythroid precursor ratios were elevated in arthritic rats (P less than 0.0001) . Purified peptidoglycan produced an acute anemia lasting 10 days, while injection of group A streptococcal polysaccharide and mutanolysin-digested cell wall did not affect the hematocrit . The minimal effective dose of peptidoglycan-polysaccharide was 5 micrograms of rhamnose per g (body weight) . Serum iron and transferrin levels were decreased in cell wall-injected rats (P less than 0.005) and were closely correlated with hematocrit values and joint inflammatory scores . Stainable iron was increased in the liver, spleen, and mesenteric lymph nodes and unchanged in the bone marrow of cell wall-injected rats . Anemia accompanying chronic, relapsing systemic inflammation induced by peptidoglycan-polysaccharide polymers appears to be an excellent animal model of the anemia of chronic disease. FEMS Microbiol Lett, 1989 Apr, 49(2-3), 239 - 42 Determination of viridans streptococci surface lipoteichoic acid by enzyme linked immune sorbent assay; Hogg SD et al.; An enzyme linked immune sorbent assay (ELISA) was developed to measure bacterial surface lipoteichoic acid (LTA) . Numerous strains of oral streptococci belonging to the 'viridans' group were examined on three separate occasions . The results show that, under these cultural conditions, oral streptococci do not normally express LTA on the cell surface . Occasionally strains produced amounts of LTA detectable using the ELISA but this was not a reproducible phenomenon. Can J Microbiol, 1989 Apr, 35(4), 515 - 7 Invasion of HeLa cells by beta-hemolytic group G streptococci; Nath SK; The invasion of HeLa cells by beta-hemolytic Lancefield group G streptococci was studied by measuring the number of bacterial cells that survive exposure to gentamicin . Approximately 50% of bacteria introduced to the HeLa cell monolayer survived gentamicin treatment, suggesting that they were intracellular . Electron microscopy of these preparations showed intracellular bacteria in the cytoplasm, not surrounded by host cell membranes . Trypsinized bacteria incubated with HeLa cells were all killed by gentamicin . It appears that the beta-hemolytic group G streptococci have mechanisms for entry into human epithelial cells which may have importance in the virulence of the organisms. Antimicrob Agents Chemother, 1989 Apr, 33(4), 580 - 2 Antimicrobial susceptibilities of Streptococcus species that cause septicemia in neutropenic patients; Venditti M et al.; Sixty-three consecutive streptococcal blood isolates from neutropenic patients, represented mainly by viridans group streptococci, were evaluated in vitro for antibiotic susceptibility . Of these isolates, 79.3% were highly susceptible to penicillin (MIC, less than or equal to 0.12 microgram/ml) . Overall, imipenem was the most active agent, followed by teicoplanin and vancomycin . All other agents showed decreased activity against streptococcal isolates that were not highly susceptible to penicillin. J Antimicrob Chemother, 1989 Apr, 23 Suppl D, 55 - 60 Treatment of skin and soft tissue infections: a comparative study of cefmetazole and cefoxitin; Frank E et al.; In this comparative study, both cefmetazole and cefoxitin were found to be safe and effective in the treatment of skin and soft tissue infections . Greater activity of cefmetazole against some strains of Staphylococcus aureus, Streptococcus pneumoniae, beta-haemolytic streptococci and aerobic Gram-negative bacilli was confirmed . A 90% or better cure rate was achieved with both drugs . At late follow up, three patients treated initially with cefmetazole had recurrent signs and symptoms . However, these three patients had vascular insufficiency which predisposed them to infection . Since cefmetazole has a longer half-life than cefoxitin, it may prove to be more convenient, or more cost effective, or both, in these and other infections. Mol Gen Genet, 1989 Apr, 216(2-3), 372 - 9 Cell surface proteins of a group A streptococcus type M4: the IgA receptor and a receptor related to M proteins are coded for by closely linked genes; Lindahl G; Two genes coding for cell surface proteins were cloned from a group A streptococcus type M4: the gene for an IgA binding protein and the gene for a fibrinogen binding protein . Both proteins were purified and partially characterized after expression in Escherichia coli . There was no immunological cross-reaction between the two proteins . The IgA binding protein, called protein Arp4, is similar to an IgA receptor previously purified from another strain of group A streptococci, but the proteins are not identical . Characterization of many independent clones showed that the two proteins described here are coded for by closely linked genes . Bacterial mutants have been found which have simultaneously lost the ability to express both genes, and a simple method to isolate such mutants is described . The existence of these variant