Erythromycin and penicillin resistance mechanisms among viridans group streptococci isolated from blood cultures of adult patients with underlying diseases

The aim of the study was to evaluate the species distribution, antimicrobial susceptibility and erythromycin-penicillin resistance mechanisms of viridans streptococci (VGS) isolates from blood cultures of adult patients with underlying diseases. Fifty VGS blood culture isolates were screened for their antibiotic susceptibilities against penicillin G, erythromycin and tetracycline by E-test. Clindamycin, cefotaxime, chloramphenicol, levofloxacin, linezolid and vancomycin susceptibility were performed by broth microdilution method. Erythromycin and penicillin resistance genotypes, ermB and mefA/E, pbp1a, pbp2b and pbp2x are amplified using PCR method. The clinical isolates included Streptococcus mitis (n. 19), S.oralis (n. 13), S.sanguinis, S.parasanguinis (n. 6, each), S.salivarius, S.vestibularis (n. 2, each), S.constellatus, S.sobrinus (n. 1, each). The percentage resistance against erythromycin and penicillin was 36% and 30%, respectively. The genotypic carriage rate of erythromycin resistance genes were: 56% ermB, 28% mefE, 8% ermB+mefE. Penicillin-resistant isolates carried pbp2b (33.3%) and pbp2x (20%) genes. Twenty-four VGS isolates were recovered from patients with cancer. S.mitis and S.oralis predominated among patients with cancer who had erythromycin and penicillin resistance isolates. The importance of classical antimicrobial agents like penicillin and erythromycin warrants the continuous surveillance of invasive VGS isolates and can guide better treatment options especially in patients with underlying diseases.     

Adherence of group B streptococci isolated from man and cattle to human and bovine epithelial cells

Proof of adherence of group B streptococci (GBS) to human and bovine vaginal epithelial cells and to bovine cells of milk cisternae of the mammary gland was employed as a criterion determining the possibility of colonization of these organs with GBS, or as another method of testing the transfer of GBS between man and cattle GBS of both human and animal origin adhered to human epithelial cells in a similar way On the other hand, a significantly stronger adherence of bovine GBS to vaginal epithelial cells and cells of milk cisternae of cattle was found than of human GBS Thus the direction of colonization man—animal is more prob able than the opposite way Neither in animal nor in human strains a correlation between the equipment of strains with type antigens and intensity of adherence could be found     

Toxin B and A production by beta-hemolytic streptococci isolated from scarlet fever patients]

This work was aimed at the study of the frequency of isolation of beta-hemolytic streptococci from the patients suffering from scarlet fever, producing A and B toxins. Toxigenicity of the microbes was studied in the indirect agglutination test. In 68.4 per cent of cases there were isolate streptococci producing toxin A, and in 22.8 per cent--toxin B. The percentage of strongly toxigenic A-strains constituted 28.2, and of B-strains--0.6. The greatest incidence of the A and B toxigenic streptococci was observed during the autumn-winter period. Among the strains of the 4th--"leading" serological type there were the greatest number of the A-toxigenic variants, and among the streptococci belonging to the I serological type--of the B-toxigenic strains.     

Platelet aggregation by group B streptococci

Forty-six strains of group B streptococci (GBS), including various serotypes and non-serotypable strains, were tested for their ability to induce platelet aggregation in human platelet-rich plasma; four strains, all belonging to type III, showed a positive reaction. The characteristics of the reaction were investigated in these four positive strains. Aggregation was dependent on the ratio of bacteria to platelets, being maximal at a ratio of 4.3. Platelet aggregation was inhibited by EDTA (100% inhibition at 3.1 mM), indomethacin (100% inhibition at 10 mM), acetylsalicylic acid (93-100% inhibition at 5.0 mM) and quinacrine (100% inhibition at 0.25 mM). Thus the reaction was cation-dependent and required cyclooxygenase activity. Assays for cytosolic lactate dehydrogenase did not indicate platelet lysis. GBS induced the release of [3H]serotonin, which was maximal (68-78%) at 10 min after the reaction was started. Experiments with gel-filtered platelets suggested that GBS-induced platelet aggregation required both fibrinogen and heat-resistant (56 degrees C, 30 min) serum factors. Type-specific antisera prevented the platelet aggregation activity of heat-killed bacteria, but not of live bacteria. Trypsin digestion of the bacterial cells caused an almost complete loss of the platelet aggregation activity.     

Nosocomial transmission of group B streptococci.

The acquisition of group B streptococci by babies in a special-care baby unit and two postnatal wards was investigated over a six-month period using serology and phage typing. Sixty-three culture-positive babies were identified in the postnatal wards, one-third of whom had been born to mothers who were not carrying the organism in the genital tract or anorectal area during labour. A non-maternal source was identified for 14 of these 21 infants: either colonised mothers and babies in the same ward or, on one occasion, a member of the hospital staff. In the special-care baby unit, however, only one instance of nosocomial acquisition of group B streptococci was recorded despite a high prevalence of colonisation in the staff on the unit and the presence of heavily colonised babies. The results of this survey suggest that although sepsis caused by group B streptococci may be the result of nosocomial transmission, this may be prevented by careful attention to hygiene.     

Biochemical properties and whole-cell protein profiles of group G streptococci isolated from dogs

Whole-cell protein profiles obtained by SDS-PAGE were used in conjuction with physiological tests to differentiate strains of Streptococcus canis isolated from dogs. Fermentation of trehalose and lactose, aesculin hydrolysis together with production of β–D–glucuronidase and α–D–galactosidase allowed the demonstration of nine different biotypes. However, visual analysis of the protein patterns andcomparison by the coefficient of Dice showed minor differences in band patterns among strains. Only two different profiles were observed. Although a correlation between biotypingand protein profile has been found, this kind of analysis did not provide the basis for a typing method.     

Purification and partial characterization of neuraminidase from type III group B streptococci

Extracellular neuraminidase from a type III fresh clinical isolate of a group B streptococcus was purified by a combination of salt fractionation, affinity chromatography of Affi-Gel blue, ion-exchange chromatography on diethylaminoethylcellulose, and gel filtration on Sephacryl S-200. These procedures yielded enzyme which was purified approximately 1,000-fold compared with the enzyme found in the original supernatant fluid. This type III streptococcal neuraminidase had a molecular weight of approximately 125,000 as estimated by filtration on Sephacryl S-200 and approximately 106,000 when analyzed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. In contrast to the majority of other bacterial neuraminidases, the type III group B streptococcal enzyme had no effect on colominic acid or N-acetylneuramin-lactose; however, it was quite active on bovine submaxillary mucin.     

Selective broth for isolation of group B streptococci

[This corrects the article on p. 884 in vol. 26.].     

Rapid method for the detection of group B streptococci from human sources

A modification of the classical CAMP test has been devised for the rapid detection of streptococci of serological Group B from human sources. The method was compared with detection based on the development of orange pigmented colonies on a starch-based medium and with detection by conventional methods. In a survey of vaginal carriage of Group B streptococci in parturient women, the modified CAMP test detected a carriage rate of 13.09%, the starch-based, pigment enhancing medium, 5.76% and the conventional methods, 8.38%. It proved to be particularly useful for detecting the organisms in the presence of other bacteria.     

Antimicrobial susceptibility of some streptococci strains of anginosus group isolated from oral and maxillofacial infections

Streptococci strains of the anginosus group isolated from various oral and maxillofacial infections (OMF) were screened for their susceptibility to the following antimicrobial agents: benzylpenicillin, ampicillin, oxacillin, cephalothin, ceftazidime, cefotaxime, cefuroxime, erythromycin, clindamycin, tetracycline, chloramphenicol, vancomycin and trimethoprime-sulphamethoxazole. The isolates were susceptable to: clindamycin, chloramphenicol, vancomycin and all beta-lactam antibiotics, except ceftazidime to which 54.5% of the strains showed intermediate susceptibility. Intermediate susceptibility to tetracycline was found in 11.3% of the strains, whereas resistance to the same antibiotic was demonstrated in 61.4%. Resistance to erythromycin and trimethoprime-sulphamethoxazole was of 2.3% for both. In conclusion, penicillin is the drug of choice in infections caused by streptococci of the anginosus group.     

Typing of group A streptococci isolated from urban population of different social status and age

Pulse-electrophoresis, sequencing of emm genes coding protein M and PCR analysis of speA, speB, and speC genes were used for characterization of group A streptococci (GAS) isolated in different years in Moscow and Tuapse mostly from children and military staff. It has been shown that epidemic process of streptococcal infection caused by GAS in Moscow is based on circulation of many independent clones of Streptococcus pyogenes. Obtained data on complex typing of S. pyogenes would be useful for study of molecular epidemiology of diseases caused by GAS and improvement of epidemiologic surveillance.