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PubMed2005

Epidural abscess caused by Streptococcus milleri in a pregnant woman.

BACKGROUND: Bacteria in the Streptococcus milleri group (S. anginosus, S. constellatus, and S. intermedius) are associated with bacteremia and abscess formation. While most reports of Streptococcus milleri group (SMG) infection occur in patients with underlying medical conditions, SMG infections during pregnancy have been documented. However, SMG infections in pregnant women are associated with either neonatal or maternal puerperal sepsis. Albeit rare, S. milleri spinal-epidural abscess in pregnancy has been reported, always as a complication of spinal-epidural anesthesia. We report a case of spinal-epidural abscess caused by SMG in a young, pregnant woman without an antecedent history of spinal epidural anesthesia and without any underlying risk factors for invasive streptococcal disease. CASE PRESENTATION: A 25 year old pregnant woman developed neurological symptoms consistent with spinal cord compression at 20 weeks gestation. She underwent emergency laminectomy for decompression and was treated with ceftriaxone 2 gm IV daily for 28 days. She was ambulatory at the time of discharge from the inpatient rehabilitation unit with residual lower extremity weakness. CONCLUSION: To our knowledge, this is the first reported case of a Streptococcus milleri epidural abscess in a healthy, pregnant woman with no history of epidural anesthesia or invasive procedures. This report adds to the body of literature on SMG invasive infections. Treatment of SMG spinal-epidural abscess with neurologic manifestations should include prompt and aggressive surgical decompression coupled with targeted anti-infective therapy.

Adult↗

PubMed1995

Detection and incidence of the tetracycline resistance determinant tet(M) in the microflora associated with adult periodontitis.

Subgingival plaque samples were collected from 68 patients with adult periodontitis, enumerated on Trypticase-soy blood agar plates, with and without tetracycline at 4 micrograms/ml, and incubated anaerobically for 5 days. Each different colony morphotype was enumerated, and a representative colony was subcultured for identification and examined for the tetracycline resistance gene tet(M). Both PCR amplification and DNA hybridization, using a fragment of tet(M) from Tn1545, were used to detect tet(M). The PCR primers (5'-GACACGCCAGGACATATGG-3' and 5'-TGCTTTCCTCTTGTTCGAG-3') were chosen to amplify a 397 bp region of tet(M). Tetracycline-resistant bacteria represented approximately 12% of the total viable count. The percentage of tet(M)-positive bacteria in the tetracycline resistant microflora varied from < or = 0.05 to 83% (mean of 10%). tet(M) was detected in 60% of 204 tetracycline-resistant strains subcultured and identified. The tet(M) containing strains consisted of streptococci (55%, mainly S. intermedius, S. oralis, S. sanguis, and Streptococcus SM4), Actinomyces D01 (14%), Bifidobacterium D05 (11%), and Veillonella spp. (10%). Tetracycline-resistant strains in which tet(M) was not detected included the Prevotella and Bacteroides species (41%, mainly Bacteroides D28, P. intermedia, P. nigrescens, and P. oris). These results suggest that tet(M) is widely spread in the adult periodontal microflora, but it appears, with the exception of S. intermedius, to be mainly associated with microorganisms not considered to be periodontopathogens. Assessment of other tetracycline-resistant genes in oral organisms is needed to fully evaluate the nature of resistance to this antibiotic in the oral flora.

Adult↗

PubMed1996

Clinical and microbiological observations of early polytetrafluoroethylene membrane exposure in guided bone regeneration. Case reports in primates.

Premature membrane exposure at one week is described in 3 Macaca mulatta monkeys as part of a sequence of experiments on guided bone regeneration. Clinical sequelae include redness, edema, and tissue slough. Bacteroides fragilis, Streptococcus pneumoniae, Prevotella intermedia, and Staphylococcus intermedius were detected at all prematurely exposed sites. Pseudomonas maltophilia, Strept, pneumoniae, and P. intermedia were the predominant organisms detected and consisted of more than 10% of the total anaerobic count.

Alveolar Bone Loss↗

PubMed2002

Use of computerized image analysis to quantify staphylococcal adhesion to canine corneocytes: does breed and body site have any relevance to the pathogenesis of pyoderma?

An optimized system of computerized image analysis was used to investigate variations in the adherence of Staphylococcus intermedius to canine corneocytes from four different breed groups and six different anatomical sites. S. intermedius showed significantly greater adherence to the head and neck compared with the dorsum, but adherence to the limb, axilla and groin did not differ from other sites. Furthermore, there was significantly greater adherence of S. intermedius to corneocytes from the dorsum, forelimb, axilla and groin of Boxers and Bull Terriers than Spaniels and Hounds. S. intermedius, and also Pseudomonas aeruginosa, exhibited abundant adherence, which was significantly greater than Staphylococcus aureus, Streptococcus canis, Klebsiella pneumoniae and Escherichia coli. In addition, S. intermedius adherence demonstrated a sigmoid dose-response curve with increasing bacterial concentration. These results suggest that S. intermedius adheres to canine corneocytes by a specific receptor-ligand interaction and adheres to the skin of some breeds more avidly than others. However, variations in adherence between body regions would not account for the predilection sites of canine bacterial pyoderma.

Animals↗

PubMed1992

Biological characterisation of group F streptococci causing human infections.

Fifty five strains of group F streptococci (GFS) isolated from clinical samples of 53 patients with diverse diseases, were characterised by a battery of physiological tests. Among them 37 (67%) were Streptococcus anginosus F, 14 (25%) were Strep. intermedius, two of which were mannitol positive and 4 (7%) were Strep. constellatus. Determination of minimum inhibitory concentrations of penicillin, erythromycin, ampicillin, gentamicin and cefazolin showed that despite their biochemical heterogeneity, all strains were uniformly susceptible to these antibiotics. Except for bacteraemia, other diseases due to GFS responded well to surgical drainage and/or antibiotics.

Bacteremia↗

PubMed1996

Interactions between Eikenella corrodens and 'Streptococcus milleri-group' organisms: possible mechanisms of pathogenicity in mixed infections.

Interactions between the 'Streptococcus milleri-group' organisms (SMG; S. intermedius, S. constellatus and S. anginosus) and Eikenella corrodens were investigated. Coaggregation reactions occurred frequently between S. anginosus (83% of strain combinations) or S. constellatus (87%) and E. corrodens isolates, but were infrequent between S. intermedius and E. corrodens (28%). No enhancement of enzyme activities against lipid, phosphate, peptide and saccharide substrates tested were detected with combinations of species in comparison to the species alone. Exponential growth of S. constellatus and S. intermedius, in mixed culture with E. corrodens, occurred within 6h post inoculation, in comparison to 25h without E. corrodens. No growth stimulation of S. anginosus was observed. It is concluded that both coaggregation and growth stimulation occur between E. corrodens and SMG isolates, and may be important mechanisms in the establishment of mixed infections involving these bacteria.

Bacterial Adhesion↗

PubMedDate not supplied

Treatment of bacterial endocarditis with vancomycin.

Five patients with bacterial endocarditis who were allergic to penicillin were treated successfully with vancomycin. The causative microorganisms were Streptococcus bovis, S faecalis, S agalactiae, S intermedius, and Staphylococcus aureus. Except for the strain of S faecalis, vancomycin was bactericidal against these organisms at easily achievable serum concentrations. To insure a bactericidal serum titer of 1:8 or greater, streptomycin was added in the therapy of the case caused by S faecalis. There was no toxicity from vancomycin therapy in our patients except for mild phlebitis at the infusion site. Vancomycin appears to be an effective alternative to penicillin in individuals with endocarditis due to susceptible organisms. Vancomycin in combination with an aminoglycoside may be appropriate therapy for enterococcal endocarditis.

Adult↗

PubMed1984

Human neutrophil migration under agarose to bacteria associated with the development of gingivitis.

In clinically healthy gingiva and increasingly with the development of inflammation, neutrophils are found in the gingival tissues and sulcus. This study evaluated the relative ability of bacteria associated with gingival health and developing inflammation to stimulate this increase in neutrophil accumulation. Dialyzed bacterial sonic extracts (BE) in buffer and pooled human serum (PHS) from pure cultures of Streptococcus sanguis. Actinomyces viscosus, A naeslundii, Bacteroides intermedius, Fusobacterium sp and Veillonella sp were tested for stimulation of human neutrophil migration under agarose. In addition, fractions of S sanguis culture fluids (CFs) from Sephadex G-10 chromatography were evaluated. All BE solutions were incubated for 1 hour at 37 degrees C and heat-inactivated prior to testing. All BEs in buffer attracted neutrophils, with the greatest responses seen to S sanguis and B intermedius followed by A viscosus. Migration to all BEs in PHS was greater than in buffer, suggesting that all BEs are capable of generating serum chemoattractants. A viscosus BE activated serum attractants to the greatest degree. CFs of S sanguis, A viscosus, and to a lesser degree, Fusobacterium sp, also attracted neutrophils. Evidence from [3H]FMLP competitive ligand-binding assays indicated that S sanguis CFs contained low molecular weight (less than 700) chemoattractants, which were probably formylmethionyl oligopeptide-like materials. Of the bacteria associated with health, S sanguis and A viscosus appeared at least as able to generate chemoattractants during growth or with exposure to serum as bacteria associated with gingivitis. This observation suggests that these "healthy" bacteria, which are found in greater numbers with developing inflammation, may mediate increased neutrophil transmigration in early disease.

Actinomyces↗

PubMed2004

Effect of saliva on an antimicrobial tissue conditioner containing silver-zeolite.

The purpose of this study was to evaluate the influence of human saliva on the antimicrobial effect of a tissue conditioner containing an antibiotic agent, silver-zeolite. Samples of each tissue conditioner with or without silver-zeolite were prepared and a plastic disk was used as a control. Candida albicans and nosocomial respiratory infection-causing bacteria, Staphylococcus aureus, methicillin-resistant S. aureus (MRSA), Pseudomonas aeruginosa and the Streptococcus milleri group (S. constellatus and S. intermedius), were selected as test microorganisms. Antimicrobial effects of samples after water or saliva immersion for 28 days were evaluated by counting the number of viable cells [colony forming unit (CFU)] in each microbial suspension (100 microL). All data were statistically analysed by one-way anova and Bonferroni's test (P < 0.05). The antimicrobial effects of samples with silver-zeolite immersed in saliva against C. albicans, S. aureus and MRSA were observed while CFU of P. aeruginosa indicated no significant difference from that of the control. As for the S. milleri group, its CFU after saliva immersion showed the significantly smaller value than that of the control. It is concluded that the antimicrobial effects of samples containing silver-zeolite against all tested microbes except for P. aeruginosa and the S. milleri group are not influenced by saliva immersion for 28 days.

Anti-Bacterial Agents↗

PubMed1979

Description of strains of Peptostreptococcus anaerobius isolated from subcutaneous abscesses in cats.

Strains of Peptostreptococcus, Streptococcus and of a Gram-positive coccus, which was initially isolated as an anaerobe but grew subsequently as a facultative organism, were isolated from subcutaneous abscesses in cats. The cat strains of Peptostreptococcus gave metabolic fermentation products in combinations described for P. anaerobius. The Streptococcus strains conformed to the group S. intermedius. The facultative organism described had the metabolic products of P. anaerobius but the distinctly different biochemical characteristics of S. intermedius and fits neither of the genera strictly.

Abscess↗

PubMed1990

Antimicrobial effect of chlorhexidine in a controlled release delivery system.

Chlorhexidine is widely used as a mouth rinse in the prevention and treatment of periodontal diseases and dental caries. The purpose of the present study was to evaluate the in vitro antimicrobial effect of chlorhexidine in a controlled release delivery system. The controlled release dispenser comprised a polymeric inner core matrix containing the medicament with an outer vinyl membrane controlling the drug release. The effect on the following bacteria was studied: Actinobacillus actinomycetemcomitans, Actinomyces viscosus, Streptococcus mutans, Wolinella recta, Bacteroides gingivalis, Bacteroides intermedius, Eikenella corrodens, Pseudomonas aeruginosa, Enterobacter aerogenes, and Enterobacter cloacae. Chlorhexidine-containing vinyl patches with a diameter of 5.5 mm were placed on blood agar plates containing the various bacteria. The plates were incubated aerobically or anaerobically at 37 degrees C for 24 h or longer, when appropriate, and examined for inhibition of bacterial growth. Distinct zones of inhibition were seen surrounding all vinyl patches on all plates with all bacteria. Thus, the vinyl dispenser appeared to be an effective vehicle for releasing chlorhexidine to a localized area such as the surface of a tooth, a periodontal pocket, or a root canal.

Bacteria↗

PubMed2004

Identification of clinically relevant viridans group streptococci by sequence analysis of the 16S-23S ribosomal DNA spacer region.

The feasibility of sequence analysis of the 16S-23S ribosomal DNA (rDNA) intergenic spacer (ITS) for the identification of clinically relevant viridans group streptococci (VS) was evaluated. The ITS regions of 29 reference strains (11 species) of VS were amplified by PCR and sequenced. These 11 species were Streptococcus anginosus, S. constellatus, S. gordonii, S. intermedius, S. mitis, S. mutans, S. oralis, S. parasanguinis, S. salivarius, S. sanguinis, and S. uberis. The ITS lengths (246 to 391 bp) and sequences were highly conserved among strains within a species. The intraspecies similarity scores for the ITS sequences ranged from 0.98 to 1.0, except for the score for S. gordonii strains. The interspecies similarity scores for the ITS sequences varied from 0.31 to 0.93. Phylogenetic analysis of the ITS regions revealed that evolution of the regions of some species of VS is not parallel to that of the 16S rRNA genes. One hundred six clinical isolates of VS were identified by the Rapid ID 32 STREP system (bioMérieux Vitek, Marcy l'Etoile, France) and by ITS sequencing, and the level of disagreement between the two methods was 18% (19 isolates). Most isolates producing discrepant results could be unambiguously assigned to a specific species by their ITS sequences. The accuracy of using ITS sequencing for identification of VS was verified by 16S rDNA sequencing for all strains except strains of S. oralis and S. mitis, which were difficult to differentiate by their 16S rDNA sequences. In conclusion, identification of species of VS by ITS sequencing is reliable and could be used as an alternative accurate method for identification of VS.

DNA, Ribosomal Spacer↗

PubMed2005

Identification of clinically relevant viridans streptococci by an oligonucleotide array.

Viridans streptococci (VS) are common etiologic agents of subacute infective endocarditis and are capable of causing a variety of pyogenic infections. Many species of VS are difficult to differentiate by phenotypic traits. An oligonucleotide array based on 16S-23S rRNA gene intergenic spacer (ITS) sequences was developed to identify 11 clinically relevant VS. These 11 species were Streptococcus anginosus, S. constellatus, S. gordonii, S. intermedius, S. mitis, S. mutans, S. oralis, S. parasanguinis, S. salivarius, S. sanguinis, and S. uberis. The method consisted of PCR amplification of the ITS regions by using a pair of universal primers, followed by hybridization of the digoxigenin-labeled PCR products to a panel of species-specific oligonucleotides immobilized on a nylon membrane. After 120 strains of the 11 species of VG and 91 strains of other bacteria were tested, the sensitivity and specificity of the oligonucleotide array were found to be 100% (120 of 120 strains) and 95.6% (87 of 91 strains), respectively. S. pneumoniae cross-hybridized to the probes used for the identification of S. mitis, and simple biochemical tests such as optochin susceptibility or bile solubility should be used to differentiate S. pneumoniae from S. mitis. In conclusion, identification of species of VS by use of the present oligonucleotide array is accurate and could be used as an alternative reliable method for species identification of strains of VS.

DNA, Bacterial↗

PubMed1994

The bacteriology of obstructive pneumonitis. A prospective study using ultrasound-guided transthoracic needle aspiration.

Obstructive pneumonitis, the opacity that develops distal to an obstructing endobronchial lesion or external compression, is actually a combination of atelectasis, bronchiectasis with mucus plugging, and true parenchymal inflammation. In the majority of cases, it is usually not possible to determine whether infection is present or not from the radiographic findings alone. The aim of this study was to evaluate the bacteriology of obstructive pneumonitis and the influence of this result on the treatment of patients. From March 1992 to February 1993, 26 consecutive patients (20 men and six women) with obstructive pneumonitis were investigated. The obstructive pneumonitis had been caused by malignant tumors in 24 and benign lesions in two. Chest ultrasound (US) and US-guided percutaneous transthoracic aspirations were undergone to obtain specimens for microbiologic examination. Microorganisms were isolated from seven of nine febrile patients and two of 17 nonfebrile patients. A total of 16 bacterial strains are detected in obstructive pneumonitis (Pseudomonas aeruginosa, Klebsiella pneumoniae, viridant streptococci, Bacteroides fragilis, two Peptostreptococcus species, Mycobacterium tuberculosis, Pseudomonas maltophilia, Streptococcus sanguis, Staphylococcus aureus, Bacteroides thetaiotamomicrons, Bacteroides intermedius, Bacteroides species, Veillonella species, aerobic gram-positive bacilli, and Escherichia coli). In five cases the isolates were monobacteriae, and in the remaining four cases, cultures yielded more than one bacteria. The results of aspirate cultures led to changes in the initial antibiotic trial in seven of nine patients, and fever subsided thereafter. Pneumothorax occurred in one cases as the sole complication. The pathogen causing obstructive pneumonitis is very heterogeneous, and polymicrobial infection is common.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1993

Alpha-hemolytic streptococcal bacteremia: a review of 203 episodes during 1980-1991.

This is a review of 203 episodes of alpha-hemolytic streptococcal bacteremia during a 12-year period (1980-91) in a large community teaching hospital in the USA. There were 87 male and 116 female patients, with ages ranging from newborn infants to a 96-year-old; 118 patients (58.1%) were 60 years or older. 31 patients had endocarditis, 93 had bacteremia, and 79 had polymicrobial bacteremia. Streptococcus sanguis, S. mitis, S. salivarius and S. intermedius accounted for 80% of the strains. Some strains were resistant to tetracycline, nafcillin, erythromycin or clindamycin. The overall mortality was 29.6% (60 of 203 patients). There was no significant difference in the mortality among patients with endocarditis, bacteremia, and polymicrobial bacteremia. Factors that adversely influenced the mortality rate were old age (60 years and older) and rapidly fatal or ultimately fatal underlying conditions.

Adolescent↗

PubMed1990

An in vitro method to study the adherence of bacteria to saliva-treated tooth enamel sections.

An in vitro bacterial adherence assay which employed human tooth enamel sections precoated with saliva and an epifluorescent staining technique with acridine orange was developed. The assay was used to study the adherence properties of fresh and type strains of the following oral bacterial species: Bacteroides gingivalis, Bacteroides intermedius, Capnocytophaga species, Haemophilus aphrophilus, Actinobacillus actinomycetemcomitans, Peptostreptococcus species, Veillonella species, Actinomyces israelii, Streptococcus salivarius and Streptococcus sanguis. Approximately half of the bacteria tested adhered well to enamel, including the fresh isolates of B. gingivalis, B. intermedius, Veillonella species and S. sanguis. Adherence did not correlate in all cases with the known distribution of these species in vivo. Three-quarters of the fresh strains adhered better than the type strains of the same species. The assay method is an alternative to the widely used hydroxyapatite bead assay.

Bacterial Adhesion↗

PubMedDate not supplied

Hematogenous septic arthritis in the dog: results of five patients treated nonsurgically with antibiotics.

This retrospective study evaluates the effectiveness of nonsurgical treatment using antibiotics to treat hematogenous septic arthritis in five dogs. Giant-breed dogs were over-represented, with all dogs <1 year of age. Synovial fluid cultures were positive in all cases, with common bacterial species isolated that included Streptococcus B-haemolytic spp., Pasteurella multocida, and Staphylococcus intermedius. Dogs treated with appropriate duration and selection of antibiotics had clinical resolution with no residual deficits. This report and a previous clinical report demonstrate that hematogenous septic arthritis can be successfully treated nonsurgically with antibiotic therapy.

Age Factors↗

PubMed1978

Bacteria from the gut of Australian termites.

The major gut bacteria of the worker caste of nine species of Australian termites, belonging to four families, were isolated and identified to generic level. All species were either facultative anaerobes or strict aerobes. A correlation appears to exist between the major gut bacterium and the family to which the termite belongs. The major bacterium from the two lowest termites, Mastotermes darwiniensis (family Mastotermitidae) and Cryptotermes primus (family Kalotermitidae), was Streptococcus; from four species belonging to the Rhinotermitidae (Heterotermes ferox, Coptotermes acinaciformis, C. lacteus, Schedorhinotermes intermedius intermedius) it was Enterobacter; and from three species of the Termitidae (Nasutitermes exitiosus, N. graveolus, N. walkeri) it was Staphylococcus. Enterobacter was a minor symbiont of M. darwiniensis, C. primus, and N. graveolus; Streptococcus was a minor symbiont of H. ferox, C. lacteus, S. intermedius intermedius, and N. exitiosus; and Bacillus was a minor symbiont of C. acinaciformis and S. intermedius intermedius. M. darwiniensis possessed another minor symbiont tentatively identified as Flavobacterium. C. acinaciformis from three widely separated locations possessed a similar microbiota, indicating some form of control on the composition of the gut bacteria. Bacteria, capable of growth on N-free medium in the presence of nitrogen gas, were isolated from all termites, except N. exitiosus and N. walkeri, and were identified as Enterobacter. No cellulose-degrading bacteria were isolated.

Animals↗