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The epidemiological studies of Streptococcus suis infections in Japan from 1987 to 1991.

The epidemiological studies of S. suis infections in Japan were carried out between 1987 to 1991. A total of 380 S. suis strains isolated from pigs, cattle and a horse were serotyped by using antisera against S. suis types 1 to 22. A total of 318 (83.7%) of S. suis isolates were serologically typable. Serotype 2 was the most prevalent with 28.2%, followed by type 7 (10.8%), 1/2 (8.4%), 3 (7.4%) and 4 (5.5%). Of twenty S. suis strains isolated from cattle, eight were type 9, one was type 10, five were type 18, one was type 20 and five were untypable. One out of all the strains was also isolated from a racing horse with pneumonia. The majority of the isolates were originated from meningitis (38.2%), followed by from pneumonia (33.4%) and endocarditis (9.2%). Of all of the S. suis isolates, 333 isolates (87.6%) were identified correctly by API STREP 20 system.

Animals↗

Neonatal infections with Streptococcus pneumoniae.

Three cases of neonatal Streptococcus pneumoniae infections acquired during delivery are described. The cases resembled clinically group B streptococcal infections, presenting either as an early septic-pneumonic type, or as a milder disease.

Humans↗

[Streptococcus gallolyticus infections in racing pigeons, a literature review].

S. gallolyticus, formerly known as S. bovis is known since 1988 as a facultative pathogen of racing pigeons. Important clinical signs include acute mortality, inability to fly, lameness, weight loss and slimy green diarrhea. A pathognomonic sign at post mortem examination is the presence of well circumscribed areas of necrosis in the pectoral muscle. Furthermore tenosynovitis of the supracoracoid muscle and arthritis of the knee, shoulder and hock can be observed. In one study S. gallolyticus septicaemia was diagnosed in 10% of necropsied pigeons. Since S. gallolyticus was also isolated from nearly 40% of clinical healthy pigeons it is regarded as a facultative pathogen. Various biotypes, serotypes and culture supernatant phenotypes can be distinguished. Supernatant phenotypes are identified on the basis of the presence of either a T1, T2 or T3 protein triplet and the presence or absence of an extracellular A protein. S. gallolyticus strains with A protein are highly virulent, while strains with only T3 or T2 protein are of moderately or low virulence respectively. Fimbriae are only seen in highly virulent and some of the moderately virulent strains. Possible virulence factors include survival in macrophages, adhesion to cells and toxin production. Infection with serotype 1 and 2 induces some degree of protection against re-infection with serotype 1, which offers perspectives for the development of a vaccine. Experimentally ampicillin, doxycycline and erythromycin have shown therapeutic effects. For the treatment of clinical cases the use of ampicillin is advocated, together with hygienic measures, such as the use of grid floors and avoiding overcrowding.

Ampicillin↗

The effects of chlorhexidine gel on Streptococcus mutans infection in 10-month-old infants: a longitudinal, placebo-controlled, double-blind trial.

PURPOSE: This study investigated the long-term effects of 0.2% chlorhexidine gel, used as a weekly brush-on gel, on Streptoccocus mutans infection in 10-month-old infants. METHODS: The investigation followed the criteria of a placebo-controlled, double-blind, longitudinal clinical trial. Infants were recruited at birth and oral microbiological swabs were taken at 3 monthly intervals, together with medical, dental, dietary and brushing histories. Children who were found to be colonized with S. mutans were randomly assigned to either the chlorhexidine-gel group (N = 50) or placebo gel group (N = 46), and parents were instructed to brush the gel on the teeth once per week for 12 weeks. In another control group (N = 210), infants did not use either chlorhexidine or placebo gels. Saliva samples were cultured using S. mutans-selective tryptone-yeast extract-cysteine-sucrose-bacitracin (TYCSB) agar. The mean age of the children was 10.2 +/- 2.6 months at the start of the trial and subjects were followed until the ages of 18 months. RESULTS: In the children with initial low S. mutans counts of < 300 CFU/mL, there was a significant percentage reduction in S. mutans counts in the chlorhexidine-gel group compared to the placebo gel and no-gel control groups after 3 months of weekly gel brushing. However, no significant differences with the placebo group were observed after 15 months of follow-up. There were 39 children (41%) who achieved reduction of their S. mutans to 0 CFU/mL. Compared to those who remained infected with S. mutans, these children had higher toothbrushing frequencies (P < .001) and toothpaste use (P < .001), as well as lower frequencies of daily feeds (P < .01), and lesser weekly frequencies of sweet solids and liquids (P < .001). CONCLUSIONS: Children with relatively low initial S. mutans counts (< 300 CFU/mL) showed a reduction in S. mutans counts in the first 3 months when 0.2% chlorhexidine gel was brushed on the teeth weekly. No differences were observed when compared with the placebo and no-treatment groups at later follow-up periods.

Anti-Infective Agents, Local↗

Clinical features of patients suffering from Streptococcus milleri infections--a retrospective analysis.

We examined the clinical records of patients from whom S. milleri was isolated at Kyushu University Hospital from January 1987 through December 1988. Sixty-one patients were treated in 64 episodes with drainage or antibiotics. Oral and nasopharyngeal infections were observed in 27 cases, intrathoracic infections in 13, urogenital infections in 8, intraabdominal infections in 6 and skin and subcutaneous infections in 6. Except for acute bronchitis and urogenital infections, all of them were suppurative. As to underlying diseases, 21 patients had malignancies and 6 had diabetes mellitus. Leukocytopenia was not observed in any of the patients. S. milleri can be eradicated by treatment but it is sometimes replaced by other organisms. However, considering its tendency to cause suppurative infections, its pathogenic significance should be taken into account and patients should undergo surgical drainage combined with antibiotic therapy.

Humans↗

Invasive Streptococcus pyogenes infections in children.

We investigated the epidemiology and clinical features of invasive S. pyogenes infection in a pediatric population over a 7-year period (1984-90) by retrospective review. An increasing frequency in invasive infections had occurred (0-11.81/10,000 admissions). A large proportion (48%) of these were orthopedic infections. An epidemic strain was typed as M1T1. This increase appears to have occurred in the context of an overall increase in S. pyogenes infections ("scarlet fever" 1.47-11.22/10,000 outpatients; "strep throat" 4.41-46.54/10,000 outpatients).

Adolescent↗