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PubMed1989

Rapid identification of Streptococcus bovis by using combination constitutive enzyme substrate hydrolyses.

Several studies have documented the association of blood and rectal-culture positivity for Streptococcus bovis with gastrointestinal neoplasia, especially colonic carcinoma. Conventional methods using bile-esculin hydrolysis, salt tolerance, and sugar fermentations to differentiate S. bovis from other streptococci are laborious, slow, and relatively expensive. Commercially available systems are costly and require at least 24 to 48 h of incubation. A rapid identification procedure for S. bovis and related bacteria was developed. The method uses a reagent containing two hydrolyzable substrates, p-nitrophenyl-alpha-D-galactopyranoside and 4-methylumbilliferyl-beta-D-glucoside, in the presence of 2.5% sodium deoxycholate. This combination test, performed with a rapid assay for L-pyrrolidonyl-aminopeptidase, could distinguish S. bovis, Streptococcus equinus, Enterococcus spp., Streptococcus pneumoniae, and the viridans group streptococci in culture within 30 min. Twelve species of the genera Streptococcus and Enterococcus were tested. The rapid method correlated well with conventional techniques. The reagents are readily available, inexpensive, and easy to make and can be stored in the refrigerator for at least 6 months.

Costs and Cost Analysis↗
PubMed1995

Identification of "Streptococcus milleri" group isolates to the species level with a commercially available rapid test system.

Clinical isolates of the "Streptococcus milleri" species group were examined by conventional methods and a rapid, commercially available method for the identification of these strains to the species level. The levels of agreement between the identifications obtained with the commercially available system (Fluo-Card Milleri; KEY Scientific, Round Rock, Tex.) and conventional methods were 98% for 50 Streptococcus anginosus strains, 97% for 31 Streptococcus constellatus strains, and 88% for 17 isolates identified as Streptococcus intermedius. Patient records were also studied in order to gain information on the frequency and sites of isolation of each of the three "S. milleri" group species.

Bacterial Typing Techniques↗
PubMed2001

Identification of Enterococcus, Streptococcus, and Staphylococcus by multivariate analysis of proton magnetic resonance spectroscopic data from plate cultures.

A new fingerprinting technique with the potential for rapid identification of bacteria was developed by combining proton magnetic resonance spectroscopy ((1)H MRS) with multivariate statistical analysis. This resulted in an objective identification strategy for common clinical isolates belonging to the bacterial species Staphylococcus aureus, Staphylococcus epidermidis, Enterococcus faecalis, Streptococcus pneumoniae, Streptococcus pyogenes, Streptococcus agalactiae, and the Streptococcus milleri group. Duplicate cultures of 104 different isolates were examined one or more times using (1)H MRS. A total of 312 cultures were examined. An optimized classifier was developed using a bootstrapping process and a seven-group linear discriminant analysis to provide objective classification of the spectra. Identification of isolates was based on consistent high-probability classification of spectra from duplicate cultures and achieved 92% agreement with conventional methods of identification. Fewer than 1% of isolates were identified incorrectly. Identification of the remaining 7% of isolates was defined as indeterminate.

Culture Media↗
PubMed2003

Analysis of a viridans group strain reveals a case of bacteremia due to lancefield group G alpha-hemolytic Streptococcus dysgalactiae subsp equisimilis in a patient with pyomyositis and reactive arthritis.

Streptococcus dysgalactiae is classified by a combination of phenotypic and genotypic characteristics into Lancefield group C alpha-hemolytic Streptococcus dysgalactiae subsp. dysgalactiae and Lancefield group C, group G, and group L beta-hemolytic Streptococcus dysgalactiae subsp. equisimilis. In this study, we report the isolation of a catalase-negative, alpha-hemolytic, optochin- and bacitracin-resistant viridans group strain, which does not grow in 10 or 40% bile, on MacConkey agar or bile esculin agar, or in 6% NaCl, from the blood culture of a 73-year-old woman with pyomyositis and poststreptococcal reactive arthritis. Lancefield grouping revealed that the strain was a group G streptococcus. The Vitek system (GPI) showed that it was unidentified, and the API system (20 STREP) showed that it was 95.7% S. dysgalactiae subsp. dysgalactiae. 16S rRNA gene sequencing showed that it was a strain of S. dysgalactiae. Based on phylogenetic affiliation with 16S rRNA gene or GroEL amino acid (another bacterial gene, in addition to 16S rRNA gene, that is highly conserved) sequences, the strain is most closely related to Lancefield group C beta-hemolytic S. dysgalactiae subsp. equisimilis. PCR amplification and sequencing of the streptolysin S structural gene (sagA) and M protein gene (emm) hypervariable region showed the presence of these suspected primary virulence factors. Further studies would delineate whether the isolate is just a hemolysin-deficient variant of group G beta-hemolytic S. dysgalactiae subsp. equisimilis or a novel type of S. dysgalactiae. The present case showed that group G alpha-hemolytic S. dysgalactiae subsp. equisimilis can be associated with serious invasive infection and poststreptococcal sequelae.

Aged↗
PubMed2003

Genotyping by amplified fragment length polymorphism analysis reveals persistence and recurrence of infection with Streptococcus anginosus group organisms.

Streptococcus anginosus, Streptococcus constellatus, and Streptococcus intermedius, commonly referred to as the Streptococcus anginosus group (SAG), are commensal organisms known for their propensity to cause purulent infections which are difficult to eradicate. In this study, we determined the genetic similarities between SAG isolates consecutively recovered from single patients to assess the duration of infection or colonization. A total of 97 SAG isolates recovered from 30 patients were included; 65 (67.0%) of the isolates were abscess related. The isolates were identified by the 16S rRNA reverse line blot hybridization assay as S. anginosus (n = 34), S. constellatus (n = 55), and S. intermedius (n = 8). Amplified fragment length polymorphism (AFLP) analysis of the SAG isolates produced discriminatory and reproducible patterns. Consecutive SAG isolates with identical AFLP types were found in 27 of 30 (90.0%) patients, and consecutive isolates with only a single AFLP type were demonstrated in 21 (70.0%) patients. The median delay between the times of recovery of the first and last isolates of identical AFLP types from each patient was 36 days, and this delay extended for more than 1 year in patients with both colonizing and abscess-related SAG isolates. In six bacteremic patients, paired blood and nonblood SAG isolates showed identical AFLP types.

Adolescent↗
PubMed2006

Characteristics of Streptococcus pseudopneumoniae isolated from purulent sputum samples.

Streptococcus pseudopneumoniae is a recently described streptococcus that is phenotypically and genetically distinct from Streptococcus pneumoniae and other viridans streptococci. Key characteristics of S. pseudopneumoniae are the absence of a pneumococcal capsule, insolubility in bile, resistance or indeterminate susceptibility to optochin when incubated in 5% CO2 but susceptibility to optochin when incubated in ambient air, and a positive reaction with the AccuProbe DNA probe hybridization test. The clinical importance of this bacterium is currently unknown. We report the characteristics and associated clinical data of 35 strains of S. pseudopneumoniae isolated from sputum samples from 33 patients. All isolates produced a positive result with the NOW S. pneumoniae antigen test (Binax, Inc.). No isolate was resistant to penicillin, but 60% were resistant to erythromycin and 77% were resistant to tetracycline. All patients had lower respiratory tract symptoms, 79% had chronic obstructive pulmonary disease (COPD), and 33% had chest radiographic infiltrates. Compared with matched control patients who had Streptococcus pneumoniae isolated from sputum, patients with S. pseudopneumoniae infection were more likely to have a history of COPD (odds ratio [OR], 5.0; 95% confidence interval [CI], 1.67 to 20.11) or exacerbation of COPD (OR, 6.5; 95% CI, 2.61 to 16.20). Further research is needed to better characterize the epidemiology of S. pseudopneumoniae colonization and the role of S. pseudopneumoniae in COPD and other diseases.

Adolescent↗
PubMed1997

Lancefield grouping and smell of caramel for presumptive identification and assessment of pathogenicity in the Streptococcus milleri group.

AIM: To evaluate Lancefield grouping and caramel smell for presumptive identification of the Streptococcus milleri group, and to find whether Lancefield group, species, or protein profile correlated with virulence or infection site. METHODS: Prospective studies were made of 100 consecutive streptococcal isolates in blood cultures or pus from 100 patients in whom the severity of infection was categorised as serious, moderate, or not significant. The usefulness of Lancefield group and the caramel smell for presumptive identification was examined, and the relation of the S milleri species, Lancefield group, and SDS-PAGE protein analysis to severity of infection and infection site was investigated. Lower respiratory tract and genital tract specimens, strict anaerobes, group D streptococci, and strains identified as Streptococcus pneumoniae, Streptococcus pyogenes, or Streptococcus agalactiae were excluded. RESULTS: Most streptococci occurring in pure or significant growth density were S milleri group (87/100; 87%, 95% confidence interval 0.81-0.93). Of these, 89.7% (78/87; 0.84-0.96) were associated with infection. Lancefield group F antigen predominated (41/87; 47.1%, 0.38-0.56). Lancefield group F alone or accompanied by the caramel smell had a specificity of 100%, but a sensitivity of only 47.3% for group F alone, and 19.5% for group F accompanied by the caramel smell. There was no significant association between species, Lancefield group, and severity of infection, site of infection, or pathogenicity. SDS-PAGE analysis failed to discriminate between strains. CONCLUSIONS: Neither species nor Lancefield antigen was related to the site of infection. The presence of Lancefield group F antigen alone or accompanied by a caramel smell was a useful indicator for the S milleri group when present, but was too insensitive to use as a screening test. Most streptococci occurring in pure culture or in significant growth density were of clinical importance. Such organisms should be identified to species level to detect the S milleri group.

Bacterial Proteins↗
PubMed1992

Effects of chain length on the immunogenicity in rabbits of group B Streptococcus type III oligosaccharide-tetanus toxoid conjugates.

One method to improve the immunogenicity of polysaccharide antigens is the covalent coupling of the native polysaccharide or a derivative oligosaccharide to a carrier protein. In general, T cell-dependent properties are enhanced in conjugates of smaller saccharides, but a conformational epitope of the native polysaccharide may be better expressed in conjugates of larger saccharides. We have reported previously the synthesis and immunogenicity in animals of an oligosaccharide-tetanus toxoid conjugate vaccine against type III group B Streptococcus. In this study, we sought to determine the optimal size of group B Streptococcus type III oligosaccharide for use in a conjugate vaccine by evaluating the relative immunogenicity of conjugate vaccines containing oligosaccharides that were twofold smaller (7,000 Mr) or larger (27,000 Mr) than that reported previously (14,500 Mr). All three type III oligosaccharide conjugate vaccines were immunogenic in rabbits, in contrast to native, uncoupled group B Streptococcus type III polysaccharide. However, with respect to eliciting specific antibodies that were protective in vivo, the vaccine containing the intermediate-size oligosaccharide was superior to the smaller or larger conjugate vaccine. Analysis of opsonic activity of vaccine-induced antibodies demonstrated a predominance of IgG antibodies, thought to reflect T cell dependence, in response to shorter chain length conjugates, while the conformational epitope of the native polysaccharide was maximally expressed on longer chain length conjugates. These opposing trends may account for the optimal immunogenicity of an intermediate-size group B Streptococcus type III oligosaccharide conjugate vaccine.

Animals↗
PubMed2006

Time to positivity in blood cultures of adults with Streptococcus pneumoniae bacteremia.

BACKGROUND: previous studies have established that bacterial blood concentration is related with clinical outcome. Time to positivity of blood cultures (TTP) has relationship with bacterial blood concentration and could be related with prognosis. As there is scarce information about the usefulness of TTP, we study the relationship of TTP with clinical parameters in patients with Streptococcus pneumoniae bacteremia. METHODS: TTP of all cases of Streptococcus pneumoniae bacteremia, detected between January 1995 and December 2004 using the BacT/Alert automated blood culture system in a teaching community hospital was analyzed. When multiple cultures were positive only the shortest TTP was selected for the analysis. RESULTS: in the study period 105 patients with Streptococcus pneumoniae bacteremia were detected. Median TTP was 14.1 hours (range 1.2 h to 127 h). Immunosuppressed patients (n = 5), patients with confusion (n = 19), severe sepsis or shock at the time of blood culture extraction (n = 12), those with a diagnosis of meningitis (n = 7) and those admitted to the ICU (n = 14) had lower TTP. Patients with TTP in the first quartile were more frequently hospitalized, admitted to the ICU, had meningitis, a non-pneumonic origin of the bacteremia, and a higher number of positive blood cultures than patients with TTP in the fourth quartile. None of the patients with TTP in the 90th decile had any of these factors associated with shorter TTP, and eight out of ten patients with TTP in the 10th decile had at least one of these factors. The number of positive blood cultures had an inverse correlation with TTP, suggesting a relationship of TTP with bacterial blood concentration. CONCLUSION: Our data support the relationship of TTP with several clinical parameters in patients with Streptococcus pneumoniae bacteremia, and its potential usefulness as a surrogate marker of outcome.

Adolescent↗
PubMed1995

Rhabdomyolysis associated with bacteremia due to Streptococcus viridans.

A 25-year-old man was admitted with complaints of fever and macrohematuria. Laboratory tests showed a substantial increase in serum creatine phosphokinase and creatinine in association with myoglobinuria and proteinuria. Blood culture grew Streptococcus salivarius and Streptococcus oralis. Findings of renal biopsy were compatible with IgA nephropathy. The glomeruli had a mild mesangial proliferation without crescentic lesions. Changes of the interstitium and tubules were not evident. The clinical course and laboratory results strongly suggested a possible link between Streptococcus salivarius/oralis infection, and rhabdomyolysis. Rhabdomyolysis is rarely seen as a complication of bacterial infection, and the present case emphasizes the importance of suspecting bacteremia due to Streptococcus salivarius/oralis in the presence of rhabdomyolysis.

Acute Kidney Injury↗
PubMed2004

Clinical features of acute respiratory infections associated with the Streptococcus milleri group in the elderly.

The Streptococcus milleri group are becoming increasingly recognized as important pulmonary pathogens which may lead to the development of empyema or lung abscesses. Although several small series have been reported, the clinical and laboratory features of Streptococcus milleri infection have yet to be fully characterized in the elderly. We retrospectively examined the clinical features of 19 patients with Streptococcus milleri pulmonary disease who were admitted to our hospital between 2000 and 2002, based on their clinical records and laboratory data. The microbiological diagnosis was based on the results of quantitative sputum culture and other invasive procedures, including transthoracic needle aspiration or bronchoscopic examinations. There were thirteen cases of pneumonia, two of contaminant pneumonia and pleuritis, one of bronchitis, two of pulmonary abscess, and one of empyema. The patients ranged in age from 65 to 91. The most common symptoms at presentation were shortness of breath, coughing, sputum, and weight loss. An underlying disease existed in 14 of the 19 cases. We conclude that the Streptococcus milleri group is a more important cause of pulmonary infections than has been previously recognized.

Acute Disease↗
PubMed1983

Evaluation of nine teat dip formulations under experimental challenge to staphylococcus aureus and streptococcus agalactiae.

Nine postmilking teat dips were evaluated by an experimental challenge model against either Staphylococcus aureus, Streptococcus agalactiae, or both. Formulations containing .9 and .6% sodium hypochlorite, 1% sodium dichloro-s-triazene-trione, .55% chlorhexidine gluconate, and .35% povidone iodine reduced incidence of Staphylococcus aureus infections 56.8, 28.3, 75.9, 92.5, and 77.9%. Incidence of infections with Streptococcus agalactiae was reduced 48.1 and 63.2% by 1.7 and 1% sodium dichloro-s-triazene-trione formulations. The 1% chlorhexidine gluconate and .35% povidone iodine products reduced Streptococcus agalactiae infections 71.0 and 67.0%. Three experimental 1% iodophor formulations reduced Streptococcus agalactiae infections 28.9, 44.8, and 50.7%. The experimental challenge model was refined further and provided an efficient method to determine efficacy of postmilking teat dips.

Administration, Topical↗
PubMed1993

Use of modified Rambach agar to differentiate Streptococcus uberis from other mastitis streptococci.

The medium of Rambach was modified to permit differentiation of mastitis streptococci. A total of 377 streptococci isolated from bovine IMI was used in the study. Of the 159 strains identified as Streptococcus uberis, 151 strains (94.9%) were beta-galactosidase-positive and yielded blue colonies on modified Rambach agar. In comparison, Streptococcus agalactiae, Streptococcus dysgalactiae, Enterococcus saccharolyticus, or Enterococcus faecalis strains were negative for propylene glycol utilization (red colonies) or beta-galactosidase production; all strains yielded colorless colonies on modified Rambach agar. However, 5 of 35 (14.3%) Streptococcus equinus strains were also positive for beta-galactosidase. Results indicate that modified Rambach agar is a convenient medium for the differentiation of the Strep. uberis from the other mastitis streptococci. Furthermore, modified Rambach agar could be easily incorporated as a screening medium for Strep. uberis in mastitis bacteriology laboratories.

Agar↗
PubMed1998

[Acute mastoiditis in infants: penicillin-resistant Streptococcus pneumoniae and its therapy].

Seven patients with acute mastoiditis are reported. They were treated at Chiba Children's Hospital from 1991 to 1996. Patients included one 4-year-old child and 6 one-year-old infants. Except the 4-year-old girl whose body weight was 17 kg, all infants body weights were under 11 kgs. Chief complaints were ear discharge, retroauricular swelling and high fever (> 38 degrees C). Streptococcus pneumoniae was isolated in the 6 infants. One patient was diagnosed with penicillin-sensitive Streptococcus pneumoniae (PSSP), three patients were diagnosed with penicillin-insensitive Streptococcus pneumoniae (PISP) and the remaining patients were diagnosed with penicillin-resistant Streptococcus pneumoniae (PRSP). All 7 patients had developed otitis media subsequent to acute mastoiditis. The otitis media or earlier upper or lower respiratory infections had been treated with penicillin or cephalosporin by oral administration for more than a week. As to the therapy of acute mastoiditis, all of the patients received intravenous antibiotics. One (PSSP case) treated in 1991 received ABPC, and the others treated after 1995 received PAPM/BP for 5 to 8 days. None of the patients required mastoidectomy. In conclusion, antibiotics such as PAPM/BP with myringotomy were administered intravenously for the first treatment of acute mastoiditis in infants, as PISP and PRSP were commonly detected in the culture. We also considered that the proper administration of antibiotics could make the infants free from operation.

Acute Disease↗
PubMed2001

[Clinical significance of the Streptococcus milleri group in peritonsillar abscesses].

Few researchers have microbiologically studied peritonsillar abscesses in detail, and their results have been conflicting. Although Streptococcus pyogenes (Group A beta-streptococcus) is commonly considered an important pathogen in this infection, recent studies have demonstrated the recovery of many other streptococci mainly consisting of alpha-streptococci. Few studies have identified these streptococci at the species level, however. We studied details of bacteriology in 31 cases of peritonsillar abscess treated between 1991 and 2000. The Streptococcus milleri group was most frequently isolated (25.8%), followed by Eikenella corrodens (9.7%), Staphylococcus aureus (6.5%), and S. pyogenes (3.2%). The S. milleri group, consisting of 3 species of Streptococcus constellatus, S. intermedius, and S. anginosus, forms part of the normal flora most commonly found in the mouth, throat, gastrointestinal tract, and genital tract. These species have become known as an important pathogen in abscess disease but little attention has been paid to their role in peritonsillar abscesses. To adequately culture the S. milleri group, incubation in air containing carbon dioxide or in an anaerobic condition is required, and then the differentiation of the 3 species requires the biochemical reactivity tests. Since hemolytic patterns of the S. milleri group vary, we studied the population of alpha-, beta-, and gamma-hemolytic strains among 36 strains of this group. We found 32 (88.8%) to be alpha-hemolytic. Although not all alpha-hemolytic strains belong to the S. milleri group, a considerable number of this group could be missed among alpha-streptococci isolated from the peritonsillar abscess. As antibiotics began being used widely, normal flora such as the S. milleri group may have become an important pathogen in peritonsillar abscesses due to an imbalance between organisms and host defense.

Adolescent↗
PubMed1999

The alteration of penicillin-binding proteins (PBPs) in drug-resistant Streptococcus pneumoniae isolated from acute otitis media.

Streptococcus pneumoniae is the micro-organism most frequently isolated from acute otitis media (AOM). Recently, drug-resistant or insensitive strains have been prevalent among pneumococcal AOM cases and were reportedly associated with persistent or recurrent otitis media. The purpose of this study was to examine the alterations of penicillin-binding proteins (PBPs) in Streptococcus pneumoniae isolated from AOM. The PBP samples from 21 clinically isolated strains were examined by 14C-penicillin binding assay and also by adding CCL and CDTR as competitors of 14C-penicillin. Reduced signals in PBP1A and PBP2X/2A were typically observed with the penicillin-resistant Streptococcus pneumoniae samples, while widely different PBP profiles were obtained in each strain of penicillin-insensitive Streptococcus pneumoniae. The competitive binding assay with penicillin-insensitive strains revealed the reduced affinity of CCL to PBPs in comparison with that of CDTR. The results of the penicillin-binding assay were consistent with the results from minimal inhibitory concentration analysis, and its potential usefulness for the prediction of drug resistance was demonstrated.

Acute Disease↗
PubMed1999

The effect of nicotine on growth of Streptococcus mutans.

There is little information available concerning the effects of nicotine on oral bacteria; and in particular, Streptococcus mutans, an important microbe in the etiology of dental caries. To test the effects of nicotine, Streptococcus mutans were incubated in either 0 or 10(-1)-10(-7) M concentrations of nicotine and then plated onto mitis-salivarius-bacitracin agar. Colonies were counted and treatment groups compared. Both 10(-1) and 10(-2) M nicotine caused total inhibition of bacterial growth, while 10(-3) and 10(-4) M produced significantly more colonies than control. Also, 10(-6) and 10(-7) M nicotine produced a significant reduction in the mean number of colonies. These results suggest a biphasic, dosage-dependent effect of nicotine on the growth of Streptococcus mutans. Since 10(-3) M nicotine has been reported within the saliva of smokeless tobacco users, use of these products could stimulate growth of Streptococcus mutans and possibly place the user at increased risk for dental caries.

Dental Caries↗
PubMedDate not supplied

A first case of Streptococcus bovis bacteremia and peritonitis from endometrial cancer origin.

BACKGROUND: The most important clinical infections caused by Streptococcus Bovis are bacteremia and endocarditis. Usually, Streptococcus Bovis bacteremia has been described in association with bowel pathology. CASE REPORT: A 67-year-old woman with an history of endometrial cancer Ic was admitted with the suspicion of peritonitis at examination. At exploratory laparotomy, a total hysterectomy was performed and the abdomen was drained. Histology revealed an uterine adenocarcinoma staged IIIa with intramyometrial cocci accumulation. Streptococcus Bovis was isolated from the peritoneal fluid cultures and three haemocultures. CONCLUSION: Because we excluded bowel pathology and endocarditis, this is the first case of Streptococcus Bovis bacteremia from endometrial cancer origin.

Adenocarcinoma↗