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Enumeration of oral streptococci on media containing different concentrations of sodium and potassium ions.

Laboratory "type" strains of oral streptococci were screened for their ability to grow on mitis-salivarius agar (MSA) in the presence of increasing concentrations of either Na+ or K+ up to 500 mmol/L. Strains were generally better able to withstand increasing concentrations of Na+ than K+, although low numbers of colony-forming units (cfus) were seen with the highest concentration of either cation. Two strains of Streptococcus mutans, Ingbritt 162 and Ingbritt 175, behaved differently when the concentration of cation was increased from 50 to 200 mmol/L; the latter showed a marked increase in the number of cfus when the Na+ concentration was increased from 50 to 200 mmol/L, whereas there was a decrease with strain Ingbritt 162. Strains of oral streptococci from the saliva of adults and children were isolated on modified MSA containing known concentrations of Na+ and K+ and further examined if they showed "mutans-like" colony morphology. The number of cfus generally dropped as the concentration of Na+ or K+ was increased from 200 to 350 or 500 mmol/L. Greater numbers of streptococci were tolerant to Na+ than to K+. Half of the isolates were members of the Streptococcus sanguis group (SSG), either Streptococcus mitis or S. sanguis II, and these were more tolerant to high concentrations of Na+ or K+ than other isolates that were identified as Streptococcus morbillorum, Streptococcus acidominimus, and Streptococcus milleri.

Adult↗

Viridans streptococci in blood cultures. Can we see any patterns of species related to patient category? Review of 229 cases of positive cultures with viridans streptococci.

We present a review of 229 blood cultures with viridans streptococci collected during a period of eight and a half years from 1986 to 1994 at a teaching hospital in Sweden. The clinical significance of the growth of viridans streptococci is always uncertain, since these bacteria can be contaminants from the skin flora. Growth in more than one culture bottle strengthens the clinical value of the finding. The question was whether species identification might also help in the assessment of the clinical relevance of the finding. The results show that Streptococcus mitis occurs significantly more frequently in blood cultures from the departments dealing with cancer patients. Even with polymicrobial growth in blood cultures, S. mitis should be considered a pathogen of clinical relevance, not a contaminant.

Blood↗

Absence of glycerol teichoic acids in certain oral streptococci.

Glycerol teichoic acids were not detected immunochemically or chemically in phenol-water, hot saline (Rantz and Randall), or supernatant fluids of disrupted cells of Streptococcus mitis. Thus teichoic acids do not appear to be found in most Gram-positive bacteria, as has been suggested.

Antigens, Bacterial↗

Increased bactericidal activity of dilute preparations of povidone-iodine solutions.

Recent confirmation of intrinsic bacterial contamination of 10% povidone-iodine solution has raised questions regarding the bactericidal mechanism of iodophors and the possibility for survival of vegetative bacterial cells in iodophor solutions. In this laboratory investigation, five different species were exposed to various dilutions of three commercial preparations of 10% povidone-iodine solution; survival was assessed after exposure for time periods varying between 0 and 8 min. All brands of povidone-iodine solution tested demonstrated more rapid killing of Staphylococcus aureus and Mycobacterium chelonei at dilutions of 1:2, 1:4, 1:10, 1:50, and 1:100 than did the stock solutions, S. aureus survived a 2-min exposure to full-strength povidone-iodine solution but did not survive a 15-s exposure to a 1:100 dilution of the iodophor. Both stock and dilute preparations of 10% povidone-iodine solution demonstrated rapid bactericidal action against Klebsiella pneumoniae, Pseudomonas cepacia, and Streptococcus mitis.

Bacteria↗

Predominant microflora associated with human dental periapical abscesses.

The microflora of periapical abscesses of teeth free of periodontal disease was studied. Permucosal aspiration of abscess contents and anaerobic cultural, microscopic, and biochemical techniques indicated a mixed but somewhat specific and relatively limited facultative and obligate anaerobic flora with Fusobacterium nucleatum and Streptococcus mitis as a frequent pair.

Adult↗

In vitro activity of daptomycin against clinical isolates of Gram-positive bacteria.

We determined the activity of daptomycin, a recently FDA-approved antimicrobial agent, against clinical isolates of Gram-positive bacteria, including viridans group streptococci (16 Streptococcus mitis species group, 12 S. mutans species group, 9 S. anginosus species group, 8 S. sanguinis species group, 5 S. salivarius species group) from patients with infective endocarditis, 32 methicillin-resistant Staphylococcus aureus, 32 high-level penicillin-resistant Streptococcus pneumoniae, 38 vancomycin-resistant enterococci (including 1 linezolid-resistant isolate), and the following unusual Gram-positive bacteria: 3 Listeria monocytogenes, 4 Erysipelothrix rhusiopathiae, 9 Corynebacterium species, 10 Abiotrophia/Granulicatella species, 2 Rothia (Stomatococcus) mucilaginosus, and 4 Gemella morbillorum. Daptomycin minimum inhibitory concentration (MIC)(90) values for the viridans group streptococci, methicillin-resistant S. aureus, penicillin-resistant S. pneumoniae, and Enterococcus species were 0.5, 0.5, < or =0.125, and 4 microg/ml, respectively. The daptomycin MIC range for the unusual Gram-positive bacteria was < or =0.125-2 microg/ml. We conclude that daptomycin has in vitro activity against viridans group streptococci associated with endocarditis as well as against several types of unusual Gram-positive bacteria that can cause endocarditis.

Anti-Bacterial Agents↗

Adherence of oral streptococci: evidence for nonspecific adsorption to saliva-coated hydroxylapatite surfaces.

It is proposed that binding of oral streptococci to saliva-coated hydroxylapatite (SHA) surfaces is a multifactorial process involving both specific and nonspecific receptors. In this context, specific binding is described as a high-affinity, saturable interaction between the cell and binding surface. Conversely, nonspecific binding is considered to be a nonsaturable, generalized, low-affinity reaction. Experimental differentiation of specific binding from nonspecific binding was achieved with a competition assay which utilized a large excess of nonradiolabeled bacteria to compete with the 3H-labeled cells for attachment to receptors on 1.5 mg of SHA crystals. Competition assays of Streptococcus sanguis and Streptococcus mitis adhesion clearly demonstrated that the total binding isotherm was composed of a saturable specific binding reaction and a minor nonspecific binding component. This was further substantiated by analysis of nonlinear Scatchard plots of the total binding data. The competition data for Streptococcus mutans binding indicated that ca. 50% of the S. mutans binding appeared to be specific, although saturation of the SHA surfaces with bacterial cells could not be demonstrated. Experiments measuring desorption of radiolabeled cells from SHA crystals into buffer showed that ca. 50% of the bound S. mutans cells were removed after 4 h, whereas less than 5% of the S. sanguis cells were eluted from the SHA surfaces. The kinetics of attachment were studied by using an extract of Persea americana as a noncompetitive inhibitor of adherence. The total cell binding data for these experiments suggested a very rapid binding reaction followed by a slower rate of attachment. It was concluded from these three different experimental approaches that adherence of selected oral streptococci to SHA surfaces involves specific, high-affinity and nonspecific, low-affinity binding reactions. The concept is developed that in vitro streptococcal attachment to SHA can be described as a two-reaction process in which the low-affinity interaction of the cell with the SHA surface precedes the establishment of the stronger, specific bonds needed for the maintenance of streptococci in the oral cavity.

Adsorption↗

Cohesion between oral streptococci and Neisseria pharyngis on saliva-coated glass, in the presence and absence of sucrose.

Ten strains of oral streptococci, comprising nine species, were screened for their in vitro cohesive interactions with a freshly isolated strain of Neisseria pharyngis. Strains of mutans streptococci, Streptococcus salivarius, Streptococcus sanguis I, Streptococcus milleri and Streptococcus mitis were able to cohere with N. pharyngis cells attached to a salivary pellicle adsorbed to glass. The cohesion was either due to coaggregation between the different genera or modification of the salivary pellicle by N. pharyngis MW2. S. sanguis II and Streptococcus oralis strains could not cohere with the N. pharyngis strain. Extracellular polysaccharide formed from sucrose was found to mediate cohesion between certain strains of mutans streptococci or S. oralis and N. pharyngis MW2.

Bacterial Adhesion↗

Experimental transient bacteraemias in human subjects with clinically healthy gingivae.

Thirty-six subjects with no evidence of clinical gingival inflammation underwent a standardized toothbrushing procedure. Blood specimens, obtained from a vein in the antecubital fossa during the last 30 seconds of brushing, were cultured under aerobic and stringent anaerobic conditions. Three subjects exhibited detectable bacteraemias, Propionibacterium sp. being isolated from two of the subjects, while Actinomyces sp., Streptococcus sanguis and Streptococcus mitis were isolated from the third. The implications of these results are discussed.

Actinomyces↗

Characterization of the adherence of Porphyromonas gingivalis to oral streptococci.

Adherence of Porphyromonas gingivalis to strains of Streptococcus sanguis and Streptococcus mitis deposited on nitrocellulose paper was investigated. A variety of laboratory strains and clinical isolates of P. gingivalis bound to both S. sanguis and S. mitis. Binding of P. gingivalis to all but one of the streptococci was not inhibited by salivary molecules. Pretreatment of P. gingivalis with periodate and pretreatment of S. sanguis and S. mitis with pronase decreased binding, suggesting that adherence may be mediated by a protein on the streptococci interacting with a carbohydrate on P. gingivalis. Binding was not inhibited by a selection of simple sugars. The ability to adhere to early plaque bacteria such as S. sanguis and S. mitis may be important in the colonization of the mouth by P. gingivalis.

Bacterial Adhesion↗

Streptococcal meningitis in adult patients: current epidemiology and clinical spectrum.

Streptococci other than Streptococcus pneumoniae are a rare cause of bacterial meningitis in adults. We report 29 cases of streptococcal meningitis (1977-1997). The patients comprised 19 men and 10 women, with a mean age +/- standard deviation of 47 +/- 18 years. Nine cases were secondary to neurosurgical procedures, seven to brain abscess, five to cerebrospinal fluid pericranial fistula, and three to endocarditis. Causative microorganisms included the following: viridans group streptococci, 20 cases; anaerobic streptococci, 3; Streptococcus agalactiae, 3; Streptococcus bovis, 2; and Streptococcus pyogenes, 1. Four Streptococcus mitis strains showed decreased susceptibility to penicillin (MIC, 0.5-2 microg/mL). Five patients (17%) died. The infection is increasing in the hospital setting. Streptococci resistant to penicillin should be considered in the empirical treatment of nosocomial meningitis. In cases of community-acquired infection, anaerobic streptococci or streptococci of the Streptococcus milleri group should alert the clinician to the presence of an undiagnosed brain abscess, whereas oral streptococci of the viridans group suggest the diagnosis of bacterial endocarditis.

Adolescent↗

Characterisation of viridans group streptococci with different levels of Tet(M)-mediated tetracycline resistance.

Streptococcus oralis 264-3, Streptococcus mitis 254-1 and S. mitis 264-1, isolated from the oral cavities of two children were each found to carry the tet(M) gene but exhibited different degrees of reduced susceptibility to tetracycline (tetracycline MICs of 2, 8 and 64 mg/L, respectively). The aim of this study was to determine the molecular basis for the different levels of tetracycline resistance (Tc(R)) observed. Escherichia coli HB101 carrying the cloned tet(M) genes exhibited similar levels of tetracycline susceptibility to those observed in the parental streptococcal strains (MICs of 1, 16, and 64 mg/L for tet(M) genes from S. oralis 264-3, S. mitis 254-1 and S. mitis 264-1, respectively). DNA sequencing revealed that S. oralis 264-3 had a tet(M) gene highly homologous to tet(M) carried by Tn916 from Enterococcus faecalis (99.6% identity), while the intermediate- and high-level Tc(R) strains had tet(M) sequences that resembled the tet(M) gene of Tn5251 from Streptococcus pneumoniae (99.3% and 99.4% identity, respectively). No differences were observed in the upstream attenuator structure for each of the strains and differences in reduced tetracycline susceptibilities could be attributed to changes in the deduced amino acid sequences of the Tet(M) proteins.

Adolescent↗

Secretory IgA adsorption and oral streptococcal adhesion to human enamel and artificial solid substrata with various surface free energies.

In this paper, secretory IgA adsorption from a single component sIgA solution and from human whole saliva onto human enamel and artificial solid substrata with various surface free energies was studied as a function of time. ELISA indicated that screening or displacement of adsorbed sIgA by other salivary proteins occurred only on low surface free energy substrata, not on high surface free energy substrata such as enamel. In addition, the adhesion of three oral streptococcal strains (Streptococcus mitis BMS, S. sanguis 12, and S. mutans NS), also having widely different surface free energies, to sIgA-coated surfaces was studied. The adhesion of all three streptococcal strains was significantly reduced in the presence of a sIgA coating. However, ranking the adhesion data with respect to the various substrata revealed a similar order to that in the case of uncoated substrata, indicating that substratum properties were at least partly transferred by the adsorbed protein film to the interface with adhering micro-organisms. For S. sanguis 12 and S. mitis BMS, adhesion decreased proportionally with the amounts of sIgA detected by ELISA, but for S. mutans NS such relations with the amounts of sIgA detected on the protein-coated substrata were not found. Thus, for S. mutans NS a specific antibody effect seems to exist in addition to a non-specific protein effect like that observed for S. sanguis 12 and S. mitis BMS.

Adsorption↗

Molecular basis of resistance to macrolides and other antibiotics in commensal viridans group streptococci and Gemella spp. and transfer of resistance genes to Streptococcus pneumoniae.

We assessed the mechanisms of resistance to macrolide-lincosamide-streptogramin B (MLS(B)) antibiotics and related antibiotics in erythromycin-resistant viridans group streptococci (n = 164) and Gemella spp. (n = 28). The macrolide resistance phenotype was predominant (59.38%); all isolates with this phenotype carried the mef(A) or mef(E) gene, with mef(E) being predominant (95.36%). The erm(B) gene was always detected in strains with constitutive and inducible MLS(B) resistance and was combined with the mef(A/E) gene in 47.44% of isolates. None of the isolates carried the erm(A) subclass erm(TR), erm(A), or erm(C) genes. The mel gene was detected in all but four strains carrying the mef(A/E) gene. The tet(M) gene was found in 86.90% of tetracycline-resistant isolates and was strongly associated with the presence of the erm(B) gene. The cat(pC194) gene was detected in seven chloramphenicol-resistant Streptococcus mitis isolates, and the aph(3')-III gene was detected in four viridans group streptococcal isolates with high-level kanamycin resistance. The intTn gene was found in all isolates with the erm(B), tet(M), aph(3')-III, and cat(pC194) gene. The mef(E) and mel genes were successfully transferred from both groups of bacteria to Streptococcus pneumoniae R6 by transformation. Viridans group streptococci and Gemella spp. seem to be important reservoirs of resistance genes.

Anti-Bacterial Agents↗

Evaluation of a rapid system for species identification of alpha-hemolytic streptococci.

A new 4-h commercial system (API 20S; Analytab Products, Plainview, N.Y.) for the identification of streptococci was compared with the conventional biochemical profile method in the species identification of alpha-hemolytic streptococci. A total of 194 clinical isolates (including 74 isolated from blood cultures, 64 isolated from wound cultures, and 56 isolated from respiratory cultures) and 20 reference strains were tested. Only 4 of the 20 reference strains were correctly identified to species level by the API 20S system. Six were identified to group level (viridans), four were incorrectly identified, and six did not conform to the identification key. Of the 194 clinical isolates tested, 79 (39%) were correctly identified to species level, 34 (17.5%) were identified to group level, 34 (17.5%) were incorrectly identified, and 50 (25.8%) did not conform to the identification key. Of the 12 different species of alpha-hemolytic streptococci isolated from clinical specimens, the API 20S system consistently identified Streptococcus faecalis and Streptococcus faecium, but consistently misidentified the other 10 species, especially Streptococcus mitis. Our results indicate that for identification to species level, the API 20S system is of little value for alpha-hemolytic streptococci other than enterococci.

Bacteriological Techniques↗

Characterization of tufted streptococci isolated from the "corn cob" configuration of human dental plaque.

Streptococci isolated from "corn cob" configurations of human dental plaque possess a polar fibrillar tuft extending 100 to 150 nm from one pole of the cell. The two strains studied were physiologically related to the Streptococcus sanguis-Streptococcus mitior group and were most similar to Streptococcus mitis ATCC 903. The corn cob streptococci were serologically related to S. sanguis serotype 1. The polar tuft contained at least two antigenically distinct components, one serologically related to the glycerol phosphate backbone of teichoic acid. The other was an electrophoretically slow-moving antigen similar to a component of S. mitis ATCC 903. It is suggested that the corn cob streptococci in vivo adhere to Bacterionema matruchotii by means of the polar tuft.

Animals↗

Inhibition of adhesion of viridans streptococci to fibronectin-coated hydroxyapatite beads by lipoteichoic acid.

Fibronectin-coated hydroxyapatite (FnHA) beads were used in a model adhesion assay to isolate the lipoteichoic acid (LTA) mediated adhesion of oral streptococci. Representative strains of the commonly isolated viridans streptococci were incubated with FnHA beads in the presence and absence of exogenous LTA. The LTA inhibited the adhesion of all strains to a greater or lesser extent, but only a very few strains were inhibited by more than 90%. Strains of Streptococcus sanguis Type II and Streptococcus mitis which synthesize an amphiphile other than LTA were also inhibited. The findings provided circumstantial evidence for the involvement of LTA in the adhesion of this group of oral bacteria.

Bacterial Adhesion↗

Restriction endonuclease-fragment polymorphisms of oral viridans streptococci, compared by conventional and field-inversion gel electrophoresis.

Oral streptococci formerly classified as Streptococcus sanguis or Streptococcus mitis have recently been divided into four species. Two additional species have also been proposed for this group. Each species is genetically distinct, but they have many traits in common, which makes it difficult for clinical isolates to be identified by phenotypic tests. Genotypic comparison may provide an alternative approach. This study used DNA fingerprint analysis for comparison of genotypes of 21 reference strains--classified as Streptococcus gordonii, Streptococcus sanguis, Streptococcus oralis, "Streptococcus parasanguis", or "Streptococcus crista" in previous DNA hybridization studies--and 17 clinical and laboratory strains placed in those groups on the basis of phenotypic tests. HinDIII and PvuII digests were run in conventional horizontal agarose gels. SfiI digests of reference strains and two laboratory strains were run in field-inversion gels. Fingerprint patterns were compared by visual examination, cluster analysis of densitometric traces, and lane-matching software. Only two "S. crista" strains and two parent mutant lineages showed fingerprint patterns that were identical by visual examination. Fingerprint patterns of all other strains were unique. Cluster analysis results could not be considered valid, since replicate lanes in different gels were not grouped together. HinDIII and PvuII digests contained too many bands for correct matching by lane-matching software. SfiI digests were correctly matched by computer, with the same results as visual examination. Results indicate that the diversity of strains within these streptococcal species was too great to permit species identification by DNA fingerprint patterns. This genotypic diversity suggests that isolates from unrelated hosts may have been separate for long periods of time.(ABSTRACT TRUNCATED AT 250 WORDS)

Bacterial Proteins↗