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Streptococcus anginosus infection in oral cancer and its infection route.

OBJECTIVE: To elucidate a possible involvement of Streptococcus anginosus in oral cancer, we assessed the frequency of S. anginosus infection in oral cancer tissues, and investigated its infection route. MATERIALS AND METHOD: The tissue specimens were obtained from 46 oral cancer and three precancerous leukoplakia subjects. Frequency of S. anginosus infection was assessed by a species-specific polymerase chain reaction (PCR) assay. The genotype of the clinical isolates taken from cancer tissue and dental plaque samples was analyzed using pulsed-field gel electrophoresis (PFGE). RESULTS: S. anginosus DNA was frequently detected in squamous cell carcinoma (19/42), but not in other types of cancer (lymphoma and rhabdomyosarcoma) or leukoplakia samples. A subject-based analysis revealed that S. anginosus was solely detected in dental plaque and not in saliva from all 19 S. anginosus-positive squamous cell carcinoma cases. Further, the genotype of S. anginosus isolated from cancer tissue was identical to that from dental plaque of the same patients. CONCLUSION: Infection of S. anginosus could occur frequently in oral squamous cell carcinoma and that dental plaque could be a dominant reservoir of the S. anginosus.

Aged↗

A review of Streptococcus pneumoniae infection treatment failures associated with fluoroquinolone resistance.

We reviewed all of the published reports of cases of fluoroquinolone treatment failures for respiratory tract infection due to fluoroquinolone-resistant Streptococcus pneumoniae. There were 20 ciprofloxacin and levofloxacin treatment failures reported. Physicians should be aware, when treating pneumococcal respiratory tract infections in older patients with a fluoroquinolone, that clinical failures might occur, especially for patients with comorbid illnesses and a history of recent fluoroquinolone use.

Aged↗

An extract of the mushroom Agaricus blazei Murill administered orally protects against systemic Streptococcus pneumoniae infection in mice.

The aim was to investigate the antibacterial effect of the biologically active and edible mushroom Agaricus blazei Murill (AbM). A water extract of AbM or PBS control was administered orally before or with challenge to NIH/OlaHsd mice, experimentally infected intraperitoneally with the moderately virulent Streptococcus pneumoniae serotype 6B. End points were bacteraemia and survival rate. The AbM extract, protected against systemic S. pneumoniae 6B infection in the mice. It was most effective when given 24 h before inoculation but did also have protective effects when given together with challenge compared with control. The lack of antibiotic effect on pneumococci in vitro and increased levels of cytokines MIP-2 and TNF-alpha in the serum of mice receiving AbM extract, indicated that the protective effect of AbM was due to the involvement of the native immune system. This is the first report of anti-infection effects of AbM in vivo. Our results suggest that AbM extract may be useful as additional prophylactic and possibly therapeutic treatment against bacterial and possibly other infections in humans.

Adjuvants, Immunologic↗

Complications associated with Streptococcus equi infection on a horse farm.

Complications associated with Streptococcus equi infection developed in 15 (20.3%) of 74 horses on one farm included death, guttural pouch empyema, purpura hemorrhagica, upper respiratory tract obstruction, pneumonia, pleuropneumonia, agalactia, mesenteric lymph node abscessation, and periorbital abscessation. Death was attributed to pneumonia in 3 horses and to upper respiratory tract obstruction in 2 horses. One horse was euthanatized because of severe purpura hemorrhagica.

Animals↗

Streptococcus suis infection: a series of 41 cases from Chiang Mai University Hospital.

OBJECTIVES: The objectives of this study were (1) to assess the clinical manifestations, treatment, and outcome of Streptococcus suis infection in adult patients in northern Thailand, (2) to evaluate the anti-microbial sensitivity pattern and (3) to determine the predicting factors of high mortality rate. METHODS: A retrospective study was conducted at Chiang Mai University Hospital from May 2000 to December 2002. Anti-microbial susceptibility test was performed by agar disk diffusion and the minimal inhibitory concentration (MIC) by E-test. RESULTS: Forty-one patients (32 men and nine women, mean age 51 years) with S. suis infection were identified. Three patients had a history of exposure to pig or pork and one patient had a history of raw beef consumption. Clinical manifestations included infective endocarditis, meningitis, sepsis, spondylodiscitis, and endophthalmitis in 16, 13, 10, 1, and 1 patients, respectively. The overall mortality rate was 19.5%. On univariate analysis, low serum albumin, high serum total bilirubin, low platelet, and rapid onset of illness were significantly correlated with high mortality rate. All isolates were sensitive to penicillin (mean MIC90=0.027 microg/ml). CONCLUSIONS: S. suis infection is not uncommon in northern Thailand. High suspicion and early detection are important and could lead to the successful treatment.

Adult↗

Streptococcus suis infection in swine: a retrospective study of 256 cases. Part II. Clinical signs, gross and microscopic lesions, and coexisting microorganisms.

A retrospective study of 256 cases of naturally acquired Streptococcus suis infections in swine submitted to the Indiana Animal Disease Diagnostic Laboratory from 1985 to 1989 was undertaken to describe the clinical signs, lesions, and coexisting organisms associated with S. suis serotypes 1-8 and 1/2. Infected pigs generally had clinical signs and gross lesions referable to either the respiratory system or to the central nervous system (CNS), but not both. Neurologic signs were inversely related to gross lesions in the respiratory tract (R2 = -0.19, P = 0.003), as were respiratory signs and gross lesions in the CNS (R2 = -0.19, P = 0.003). Suppurative bronchopneumonia was the most common gross lesion observed (55.2%, overall). Fibrinous and/or suppurative pleuritis, epicarditis, pericarditis, arthritis, peritonitis, and polyserositis were also reported. In 68% of the pigs, other bacteria in addition to S. suis were isolated. Escherichia coli (35.0%) and Pasteurella multocida (30.0%) were the most commonly recovered bacterial agents. Mycoplasma and viral agents were identified less often, and their role in the development of streptococcosis was difficult to assess. In pigs infected with serotypes 2-5, 7, 8, and 1/2, suppurative meningitis with suppurative or nonsuppurative encephalitis, suppurative bronchopneumonia, fibrinopurulent epicarditis, multifocal myocarditis, and cardiac vasculitis were the most common microscopic lesions observed, whereas pigs infected with serotype 1 generally presented with suppurative meningitis and interstitial pneumonia. Microscopic lesions were morphologically similar among serotypes and were also similar to those reported with other pyogenic bacteria.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Bacteraemic Streptococcus pyogenes infection in the peri-partum period: now a rare disease and prior carriage by the patient may be important.

OBJECTIVES: To describe the features of invasive peri-partum Streptococcus pyogenes infection as it occurs in current day practice in North Yorkshire. METHODS: The case and laboratory records of all mothers and/or babies with detected S. pyogenes bacteraemia in the Harrogate and Northallerton districts of North Yorkshire (combined catchment population 260 000) were reviewed for the 20 years 1980-99. An additional bacteraemic case occurring recently in the York district was included. RESULTS: In six recorded episodes, both mother and baby were affected in three, mother only in two and baby only in one. The incidence of detected infection was one such episode per million population per year, one episode per 11 000 live births and one infected baby per 18 000 live births. Maternal features included endometritis, septicaemia, peritonitis, necrotising fasciitis and toxic shock syndrome while, in babies, infection was manifest by stillbirth or septicaemia, cyanosis, jaundice, lethargy and cellulitis. CONCLUSION: Peri-partum S. pyogenes infection is rare in North Yorkshire, with a local incidence revealed in this study of 1/million population/year, or 1:11 000 live births. Invasive neonatal infection with S. pyogenes appears to be six times less frequent in this locality than with group B streptococci. Mothers and/or their babies can be affected. Data suggests that some infection is autogenous from streptococci carried in the mother's genital tract. Although data in this setting are currently few, when a mother has suspected invasive group A streptococcal infection we recommend that the newborn child should also receive antibiotics without delay.

Adult↗

Streptococcus phocae infections associated with starvation in Cape fur seals.

Mortalities and abortions associated with starvation occurred at Cape Cross, Namibia, in Cape fur seals (Arctocephalus pusillus pusillus). Affected seals showed lethargy and emaciation, and the most common pathological signs were those of a respiratory infection, both in adults and offspring. Streptococcus phocae was isolated from adult seals, a cub and aborted foetuses.

Animals↗

[Streptococcus agalactiae infection in adults. Presentation of 3 cases].

The Streptococcus of the B group was considered during many years, as a women's prelabor pathogen and neonatus. Lastly an increase of the infections is observed, for this germ in adults, without being in connection with the pregnancy. The Streptococcus agalactiae, affect above all to patients, with any type of illness underlying. The most susceptible are the diabetics and focus of more habitual infection, the soft tissues and the bone. We described three cases of infection by Streptococcus agalactiae in adults picked up during two years, in a Service of Internal Medicine with 51 beds. We are revised Medline, from the year 1985, until 1995, confirming the drop incidence of cases.

Aged↗

Penicillin-nonsusceptible Streptococcus pneumoniae infections in children.

The emergence of penicillin-nonsusceptible Streptococcus pneumoniae (PNSSP) has brought a new clinical challenge. In Taiwan, reports of the prevalence and clinical features of PNSSP infections in children are limited. This study reviewed the resistance patterns of all clinical isolates of S. pneumoniae obtained from patients under 17 years of age from January 1993 through July 1998 in a medical center. Their clinical features and treatment responses were analyzed, with special attention paid to those patients with invasive PNSSP infections. Totally, 170 clinical isolates of S. pneumoniae were obtained from 168 patients aged under 17 years. Among those infections, there were 56 sinusitis (including 4 sinusitis with bacteremia), 44 pneumonia (including 23 pneumonia with bacteremia or empyema), 23 otitis media (including 5 otitis media with bacteremia), 9 simple bacteremia, 9 conjunctivitis, 8 meningitis, 4 peritonitis, 3 skin infections and the other 14 isolates were colonization. One hundred eleven isolates (65.3%) showed reduced penicillin susceptibility by the disk diffusion method. A trend of increasing percentiles of PRSP was noted: 27.3% (3/11) in 1993, 37.5% (9/24) in 1994, 55.5% (10/18) in 1995, 77.5% (31/40) in 1996, 66.0% (31/47) in 1997, and 87.1% (27/31) in 1998. Minimum inhibitory concentration (MIC) determinations by the E-test showed some of the isolates were intermediately resistant. Prior antibiotic usage was associated with a higher incidence of PNSSP infections. However, most children responded well to antimicrobial treatment.

Adolescent↗

Streptococcus bovis Infection in young Infants.

BACKGROUND: Sporadic cases of invasive Streptococcus bovis disease have been reported in young infants. However, little is known about the clinical manifestations or the conditions that predispose to S. bovis infection in this population. OBJECTIVE: The objective of this case series and review of the literature was to describe cases of S. bovis infection treated at 2 children's hospitals and compare patients evaluated at our institutions with those reported in the literature. RESULTS: Seven infants with S. bovis infection were treated at our institutions; 4 of the patients had S. bovis meningitis and 3 of these also had S. bovis bacteremia. Five of the patients had signs of gastrointestinal disturbance at presentation. None of the 7 patients died. Twenty-three patients with S. bovis infection reported in the literature had meningitis with concurrent bacteremia (n = 9), bacteremia alone (n = 9), meningitis alone (n = 4), and pneumonia with overwhelming sepsis (n = 1). Six (26%) of the patients reported in the literature died as a consequence of S. bovis infection. The difference in median age between our patients (14 days; range, 1-43 days) and those reported in the literature (3 days; range, 1-60 days) was not statistically significant (P = 0.49). Abdominal distention was more commonly noted among patients in our series (71%) than among patients reported in the literature (10%; odds ratio = 21.3; 95% confidence interval = 1.7-319.0). CONCLUSIONS: Bacteremia and meningitis were the most common manifestations. Gastrointestinal disturbance was common among patients in our series. The mortality rate from S. bovis infection appears to be lower than suggested by previous reports.

Bacteremia↗

Streptococcus suis infection: clinical features and diagnostic pitfalls.

Eight cases of Streptococcus suis (S. suis) infection between 1993-1999 were retrospectively studied. There were 6 cases of meningitis and 2 cases of endocarditis. Acute meningitis with early sensorineural hearing loss was the characteristic feature and the most common presentation of S. suis infection. S. suis endocarditis is a rare presentation in Thailand. This organism was often mistaken for Streptococcus pneumoniae or Streptococcus viridans. In this study, this was true in five cases in whom S. suis was identified later. However, the rapid diagnosis of S. suis meningitis may rely on Gram stain of the CSF in the setting of acute meningitis with hearing loss. These cases were treated with intravenous penicillin or ampicillin with a mean duration of 4 weeks. This treatment was very effective and there was no relapse among these patients.

Adult↗

An outbreak of Streptococcus pyogenes infection associated with calcium oxalate urolithiasis in guinea pigs (Cavia porcellus).

An outbreak of Streptococcus pyogenes infection occurred in a colony of 800 Dunkin-Hartley guinea pigs resulting in 364 (46%) deaths involving breeders, sucklings, weaners, but mainly adults used as a source of blood meals for haematophagus flies (Glossina palpalis). Clinical signs included bleeding from the nose, mouth and vagina before death. Necropsy revealed pneumonia with consolidation of one or both lungs, haemopericardium and haemothorax. There were yellowish-grey deposits in the urinary bladder of more than 50% of both affected breeders and adults used for feeding haematophagus flies. Beta-haemolytic Streptococcus pyogenes was isolated in pure culture from many tissues including the urinary bladder. The survivors were treated with oxytetracycline (Terramycin-LA; Pfizer) using the intra-muscular route and the response was good.

Animals↗

Comparison of experimental models for Streptococcus suis infection of conventional pigs.

Four different experimental models for Streptococcus suis-induced disease were compared to find a model that closely mimics naturally occurring disease in conventional pigs. Fourteen, 2-week old pigs free of S. suis type 2 were used in 2 experiments. In experiment 1, 3 pigs were inoculated intravenously (IV) and 3 pigs intranasally (IN) with S. suis. Two out of 3 of the IV-inoculated pigs exhibited signs of severe central nervous system disease (CNS) and were euthanized. Streptococcus suis type 2 was isolated from whole blood, joints, and serosal surfaces of both pigs. No clinical signs and no growth of S. suis were detected in the IN-inoculated pigs. In experiment 2, 4 pigs were inoculated IV and another 4 were inoculated IN with the same isolate as in experiment 1. One hour before inoculation the IN-inoculated pigs were given 5 mL of 1% acetic acid intranasally (IN-AA). All the IV-inoculated pigs showed CNS disease and lameness, and 2 of the pigs became severely affected and were euthanized. All the IN-AA inoculated pigs exhibited roughened hair coats and 2 pigs developed severe CNS disease and were euthanized. Streptococcus suis was isolated from the joints and blood of 3 pigs in the IV-inoculated group. Streptococcus suis was isolated from blood of 2 pigs, meninges of 3 pigs, and joints of 1 pig in the IN-AA inoculated group. Natural exposure to S. suis most likely occurs by the intranasal route. The IN-AA model should serve as a good model for S. suis-induced disease, because the natural route of exposure is intranasal and the IN-AA model was effective in inducing disease that mimics what is observed in the field.

Administration, Intranasal↗

Use of leukocytes as treatment for endometritis in mares experimentally infected with Streptococcus equi subsp. zooepidemicus.

This study compared four treatments for bacterial endometritis in mares experimentally infected with Streptococcus zooepidemicus. Twenty-five mares were used, 20 resistant and five susceptible to endometritis. Mares would be in estrus when infected. Twenty-four hours after inoculation, clinical, bacteriological and cytological examinations were performed and repeated until the first occurrence: negative cytology and no Streptococcus growth or the seventh day post-infection. All mares showed clinical signs of endometritis and were assigned to one of the following treatments: (1) intrauterine infusion of fresh leukocytes; (2) intrauterine infusion of frozen-thawed leukocytes; (3) intrauterine infusion of lysed leukocytes; (4) intrauterine infusion of recombinant human interleukin-8 (rhIL-8); (5) control. Mares were submitted to all treatments, with at least a 14-day interval between treatments in a Latin square design. Treatment did not affect (P=0.121) time needed for resistant mares to eliminate bacteria. Time needed for elimination of bacteria was similar in susceptible mares treated with fresh and frozen leukocytes (P=0.333). Susceptible mares treated with frozen leukocytes also did not differ from those treated with lysed leukocytes (P=0.227) for time to eliminate bacteria, but were significantly different (P>0.02) from those treated with rhIL-8 and control. In resistant mares, physical clearance ability was probably the responsible for bacterial elimination. Intrauterine infusions in susceptible mares with viable or lysed leukocytes associated or not to opsonizing factors, reduced the time to elimination of bacteria. Infusions with bactericidal effect (functional neutrophils and granules) was likely effective and responsible for the more rapid elimination of bacteria in susceptible mares.

Animals↗

Co-existent cross-infection with Streptococcus pneumoniae and group B streptococci on an adult oncology unit.

An outbreak of respiratory infection in an adult oncology unit is described where there was evidence of co-existent cross-infection with Streptococcus pneumoniae serotype 14 and Lancefield group B streptococcus type Ia. The presumed route of transmission was droplet spread from patient to patient. No further cases arose after the ward had been closed to new admissions and all symptomatic patients were treated with erythromycin. We suggest that patients with pneumococcal pneumonia on units housing elderly debilitated patients should be isolated. Infection control teams should be aware of the ability of Lancefield group B streptococci to spread by cross-infection among adult patients.

Adult↗