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PubMed2004

Streptococcus milleri group bacteraemia in North Yorkshire, England (1989-2000).

BACKGROUND & OBJECTIVES: Though carriage and local infection with organisms of the Streptococcus milleri group (SMG) are regular in clinical practice, bacteraemia is infrequent in man. The objective of the present study was to give an account of our experience with the SMG bacteraemia over a period of 12 yr in North Yorkshire. METHODS: The laboratory and clinical records of all clinically significant cases of SMG bacteraemia in our district general hospital catchment (combined population 260,000) were reviewed for the 12 yr period from 1989 to 2000. Viable isolates were recovered, species identified, and minimum inhibitory concentration (MIC) determined. RESULTS: Twenty nine episodes of infection gave an annual incidence of 0.93 cases per 100,000 population. Infections included abscess, pneumonia, septic arthritis, genital and urinary tract infections, endocarditis and diffuse septicaemia. Patient ages ranged from 18 to 90 yr but most patients were elderly, 82 per cent had evident predisposing conditions and mortality rate was 10 per cent. Species determination of the 22 isolates showed S. anginosus (64%), S. constellatus (27%) and S. intermedius (9%). Nearly all isolates were non-haemolytic and Lancefield grouping showed carriage of the F antigen (in 41%), C (14%) and no detected group (45%). Most of the isolates were susceptible to the antimicrobials tested. INTERPRETATION & CONCLUSION: Bacteraemia with SMG organisms was infrequent, often opportunistic and featured a low overall mortality rate. Intra-abdominal sepsis was the local feature in 16 (55%) of the patients and 9 (31%) of the total patient group showed abscess or empyema. There was a low rate of antibiotic resistance in these organisms from bloodstream infection.

Adolescent↗

PubMed1991

Conservation of the gene encoding streptococcal antigen I/II in oral streptococci.

The spaP gene of Streptococcus mutans serotype c encodes a major cell surface protein, streptococcal antigen (SA) I/II, with an Mr of 185,000, that is thought to be involved in bacterial adhesion to teeth. Proteins with significant amino acid sequence homology to SA I/II have also been found in S. sobrinus and S. sanguis. The objectives of this study were to investigate the conservation of the spaP gene in the mutans groups of streptococci and to determine whether homologous genes were present in other species of alpha-hemolytic streptococci. DNA extracted from representative strains of 19 streptococcal species was examined by Southern hybridization and partial DNA sequence analysis. A series of five overlapping DNA probes from the spaP gene were amplified by the polymerase chain reaction and used in the Southern hybridizations. The entire gene was found to be well conserved in all strains of S. mutans serotypes c, e, and f investigated. A probe from the 3' region of the gene, which encodes residues 857 to 1207 of the SA I/II protein, hybridized with DNA from a number of mutans streptococci, as well as with DNA from nonmutans alpha-hemolytic streptococci. Conservation within this region was further demonstrated by sequencing gene fragments of two strains of S. intermedius and S. oralis. The results show that some regions of the spaP gene are highly conserved not only in the mutans group of streptococci but also in other nonmutans alpha-hemolytic streptococci. This suggests that a family of cell surface proteins which, by analogy with the 185,000-Mr SA I/II of S. mutans, could be involved in bacterial adhesion might exist.

Amino Acid Sequence↗

PubMed1989

Speciation of viridans streptococci & their significance in human infections.

Sixty strains of viridans streptococci recovered, from various infections, encountered in a large referral Hospital in Tamil Nadu (south India) from December 1983 to May 1985 were characterised by conventional tests. Of these, 57 (95%) belonged to four species viz., Sanguis II, Mitis, Intermedius and Constellatus. Of the 40 strains that were assessed for their clinical significance, 23 (57.5%) were found to be either significant or of suggestive significance. The study suggested viridans streptococci are not particularly virulent pathogens. But local/systemic factors were found to predispose the subjects to this infection.

Humans↗

PubMed1997

Characterization of the Lancefield group C streptococcus 16S-23S RNA gene intergenic spacer and its potential for identification and sub-specific typing.

The 16S-23S RNA gene intergenic spacers of isolates of Streptococcus equi (n = 5), S. zooepidemicus (n = 5), S. equisimilis (n = 3) and S. dysgalactiae (n = 2) were sequenced and compared. There were distinct regions within the spacer, arranged in the order 1-9 for all S. equi and one S. zooepidemicus isolate and 1,2 and 4-9 for the remaining isolates. Region 4 was identical to the tRNA(ala) gene found in the 16S-23S intergenic spacers of other streptococci. Regions 1, 5, 6 and 7 had distinct variations, each conserved in different isolates. However, amongst the intergenic spacers there were different combinations of variant regions, suggesting a role for DNA recombination in their evolution. The intergenic spacer of all isolates of S. equi and one S. zooepidemicus isolate were almost identical. Primers derived from the variant sequences of regions 1 and 5 to 6 were used to group all S. zooepidemicus (n = 17) and S. equi (n = 5) into 1 of 8 types by polymerase chain reaction; three S. zooepidemicus isolates typed the same as S. equi. S. equi and S. zooepidemicus were clearly distinguishable from S. equisimilis and S. dysgalactiae which had shorter regions 5 and 6 and no region 7. Most homology for the group C sequences was found in previously published sequences for the 16S-23S intergenic spacers of S. anginosis, S. constellatus, S. intermedius, S. salivarius and S. agalactiae. A 75-90 nucleotide length shared with S. anginosus and S. intermedius in opposite orientations in the two main variants of region 6 supported the role for DNA recombination in the evolution of the spacer. The 16S-23S intergenic spacers indicate that S. zooepidemicus was the archetypal species for S. equi and that both are genetically more distant from S. equisimilis and S. dysgalactiae. The intergenic spacer can be used to identify specifically the group C streptococci and as an epidemiological marker for S. zooepidemicus.

Animals↗

PubMed1985

Evaluation of the API 20 STREP system for species identification of "viridans" streptococci isolated from bacteremia.

Species identifications of 71 strains of viridans streptococci isolated from blood and 4 reference strains were made by the API 20 STREP system (API system S. A., Montalieu-Vercien, France) and the conventional method. There are high levels of agreement between results obtained with the both methods for determining acidification from carbohydrate except inulin. The API 20 STREP system correctly identified 74.7% of the viridans streptococci with 9.3% low descrimination, 12% incorrect and 4% unidentified. All strains of S. mitis, S. mutans, S. salivarius and S. anginosus-constellatus were correctly identified. The correct identification rates for S. sanguis I, S. sanguis II and S. MG-intermedius were 88.9%, 68% and 61% respectively. The difference of inulin reaction and the taxonomy discrepancy may be the cause of different identification. The study indicates that the API 20 STREP system has a good potentiality for species identification of viridans streptococci at present time, however, further refinement in needed.

Bacteriological Techniques↗

PubMed2002

In vitro antimicrobial activity of a new series of 1,4-naphthoquinones.

The antibacterial activity of a series of 1,4-naphthoquinones was demonstrated. Disk diffusion tests were carried out against several Gram-positive and Gram-negative bacteria. The compound 5-amino-8-hydroxy-1,4-naphthoquinone was the most effective, presenting inhibition zones measuring 20 mm against staphylococci, streptococci and bacilli at 50 microg/ml. Methicillin-resistant Staphylococcus aureus and several clinical isolates of this bacterium were also inhibited. Naphthazarin, 5-acetamido-8-hydroxy-1,4-naphthoquinone, and 2,3-diamino-1,4-naphthoquinone were the next most active compounds. The minimal inhibitory concentration of the active compounds was determined against S. aureus, ranging from 30 to 125 microg/ml. All compounds presented a minimal bactericidal concentration higher than 500 microg/ml, indicating that their effect was bacteriostatic. The EC50, defined as the drug concentration that produces 50% of maximal effect, was 8 microg/ml for 5-amino-8-hydroxy-1,4-naphthoquinone against S. aureus, S. intermedius, and S. epidermidis. These results indicate an effective in vitro activity of 5-amino-8-hydroxy-1,4-naphthoquinone and encourage further studies for its application in antibiotic therapy.

Animals↗

PubMed1998

[Research on inhibition of sodium fluoride on five subgingival bacteria in vitro].

This in vitro study was aimed at observing inhibition action of fluoride on 5 common periodontal bacteria in subgingival microflora. The liquid media two-fold dilution method was used to determine the minimal inhibition concentration (MIC) of sodium fluoride (NaF) to 9 strains of bacteria representing the main periodontopathic species(P. gingivalis, A. actinomycetemcomitans, P. intermedius) and the periodontal beneficial species (S. sanguis) and 1 strain of S. sorbrinus. The results showed that all the bacteria were inhibited at different concentration of NaF. The MIC values ranged from 128 micrograms/ml for P. gingivalis and A. actinomycetemcomitans, 256 micrograms/ml for S. sorbrinus, 1024 micrograms/ml for P. intermedius to 2048-4096 micrograms/ml for S. sanguis. The results suggest that NaF can also be used as a periodontal anti-bacterium agent and those preparations containing about 1000 micrograms/ml fluoride can be used effectively against the periodontopathic bacteria without disturbing the local ecological balance.

Aggregatibacter actinomycetemcomitans↗

PubMed1998

[Evaluation of Fluo-Card Milleri to Identify the Isolates of Streptococcus milleri Group: Comparative Identication with Referral Fluorogenic Phenotypic Dierentiation]

Clinical isolates which belong to the "Streptococcus milleri" group were identied by the referral uorogenic phenotypic tests described by Whiley et al. [J. Clin. Microbiol., 28: 1497-1501 (1990)] and a rapid, commercially available test kits; Fluo-Card Milleri (KEY Scientific Products, Round Rock, Tex., U.S.A.) to the species level. Of 218 clinical isolates included, 196 (89.9%) were correctly identied by the Fluo-Card Milleri when compared with the reference identications. Ten isolates (4.6%) of S. constellatus resulted in the "unidentied" due to the negative interpretations for all the three enzymatic reactions. A total of twelve isolates (5.5%); five of S. anginosus, five of S. constellatus, and two of S. intermedius, were misidentied. The levels of agreement were 95.7% for S. anginosus, 91.3% for S. intermedius, and 92.6% for S. constellatus when the unidentied results were excluded.

Journal Article↗

PubMed1975

[Role of anaerobic streptococci in human pathology. Report I. Etiological significance of anaerobic streptococci in chronic tonsillitis].

The authors describe a method of isolation of anaerobic streptococci from the blood. A high seeding efficiency of anaerobic streptococci from the depth of the tonsils (75.1%) and from their surface (59.7%) and also from the blood (36%) pointed to the leading role of these microbes in the etiopathogenesis of chronic tonsillitis. In healthy individuals anaerobic streptococci are revealed (by culture method) on the surface of the tonsils but rarely (6%). Str. micros are the most incident in chronic tonsillitis (in 85.3% of cases-from the depth of the tonsils and in 77.5%-from the surface), whereas Str. anaerobius and Str. intermedius occur in individual cases only (8.4-7.5% and 6.3-15%, respectively). Pure culture of Str. micros was found in 36% of cases. Pathogenetic scheme of development of bacteriemia in chronic tonsillitis and rheumatism is presented. The isolated cultures were found to be resistant to the widely-used antibiotics.

Anti-Bacterial Agents↗

PubMed1987

Structural determinants of activity of chlorhexidine and alkyl bisbiguanides against the human oral flora.

We assayed chlorhexidine and a series of its analogues, in which the chlorophenyl terminal substituents were replaced with alkyl chains, for their in vitro antimicrobial activity against the Gram-negative and Gram-positive oral bacteria. Changes in antimicrobial activity were correlated with changes in agent structure for identification of structural criteria which may be important in the optimization of agent activity. Chlorhexidine showed substantial antimicrobial activity against the Gram-negative as well as the Gram-positive oral bacteria. The alkyl agents were comparable with chlorhexidine in their activity against Bacteroides gingivalis and Bacteroides intermedius, black-pigmented Gram-negative obligate anaerobes associated with periodontal disease in adults. Alkyl agents alexidine, heptihexidine (1,6-bis-n-heptylbiguanidohexane), hexoctidine (1,8-bis-n-hexylbiguanidoctane), and hexhexidine (1,6-bis-n-hexylbiguanidohexane), as well as chlorhexidine, were active against Actinobacillus actinomycetemcomitans, a Gram-negative organism associated with localized juvenile periodontitis. Hexidecidine (1,10-bis-n-hexylbiguanidodecane) and heptoctidine (1,8-bis-n-heptylbiguanidooctane) were more active, and hexhexidine was as active as chlorhexidine against Fusobacterium nucleatum, also associated with periodontal disease. Seven of the agents were more active than chlorhexidine against Actinomyces species. All test agents were active against Streptococcus mutans, a Gram-positive coccus associated with dental caries. Hexidecidine had activity equal to that of chlorhexidine when evaluated against the entire battery of organisms. Analysis of structure-activity relationships revealed that alkyl chains could replace chlorophenyl groups with retention or improvement of antimicrobial activity.(ABSTRACT TRUNCATED AT 250 WORDS)

Actinomyces↗

PubMed1990

The formation of hydrogen sulfide and methyl mercaptan by oral bacteria.

The capacity to form volatile sulfur compounds was tested in bacteria isolated from subgingival microbiotas and in a representative number of reference strains. A majority of the 75 tested oral bacterial species and 7 unnamed bacterial taxa formed significant amounts of hydrogen sulfide from L-cysteine. The most active bacteria were found in the genera Peptostreptococcus, Eubacterium, Selenomonas, Centipeda, Bacteroides and Fusobacterium. Methyl mercaptan from L-methionine was formed by some members of the genera Fusobacterium, Bacteroides, Porphyromonas and Eubacterium. When incubated in serum for 7 d, the most potent producers of hydrogen sulfide were Treponema denticola and the black-pigmented species, Bacteroides intermedius, Bacteroides loescheii, Porphyromonas endodontalis and Porphyromonas gingivalis. P. endodontalis and P. gingivalis also produced significant amounts of methyl mercaptan in serum. No other volatile sulfur compound was detected in serum or in the presence of L-cysteine and L-methionine. These findings significantly increase the list of oral bacteria known to produce volatile sulfur compounds.

Bacteroides↗

PubMed1981

Ultrasonic dispersion of pure cultures of plaque bacteria and plaque.

This study compared the sonic sensitivity of 12 Gram-negative and two Gram-positive bacteria commonly encountered in plaque associated with periodontal diseases. Pure bacterial cultures were grown to standard turbidity, diluted in 1/4 strength prereduced anaerobically sterilized Ringer's solution, and aliquots dispersed for 0-180 s, using an MSE sonic oscillator at 6 micron under 80% N2, 10% H2 and 10% CO2. Viable recoveries were determined on anaerobically cultured trypticase soy 5% blood agar plates. Breakage of T. denticola was assessed by electron microscopy. Gram-positive organisms tolerated sonication better than Gram-negative. A. viscous was more resistant than Strep sanguis. Gram-negative bacteria could be divided into groups according to their sensitivity. Eikenella corrodens was most resistant, followed by F. nucleatum B asaccharolyticus, Capnocytophaga gingivalis, A actinomycetemcomitans, a strain (2097) of Group IV Bacteroides, and B melaninogenicus ss intermedius resisted sonication better than "corroding' Bacteroides and oral Campylobacter. T. denticola, Selenomonas sputigena and Wolinella were most sensitive with viable counts which declined after sonication for 5-10 s. Recoveries from plaque taken from five patients with periodontal diseases increased with sonication time, reaching higher values for suprangingival than for subgingival samples.

Actinomyces↗

PubMed1988

Relationship of subgingival microbial complexes to clinical features at the sampled sites.

Subgingival plaque samples from 100 active destructive periodontal lesions and 150 inactive subgingival sites in 33 subjects were analyzed by predominant cultivable microbiota techniques. 50 isolates were characterized from each sample and where possible, the isolate was placed in 1 of 134 microbial species or groups. The sites were clustered on the basis of the proportions of all of the species detected in each sample using a minimum similarity matching coefficient and an average unweighted linkage sort. 10 clusters containing 166 sites were formed which exhibited greater than 35% minimum similarities. All clusters were made up of sites from multiple subjects and were formed on the basis of different combinations of micro-organisms. Certain complexes of micro-organisms appeared to relate to the severity of periodontal destruction and the activity of the sampled site. The combination of F. nucleatum, B. forsyth and W. recta (cluster VII) or B. gingivalis, B. intermedius and S. intermedius (cluster VIII) distinguished clusters made up of sites which on average had the most attachment loss and the deepest pockets. These clusters contained the highest proportions of active sites and sites which lost greater than 3 mm of attachment after therapy. Clusters dominated by V. parvula (cluster III), the Actinomyces sp. (cluster X) or the combination of S. sanguis II, S. mitis, V. parvula and S. intermedius (cluster II) were made up of sites which exhibited less active disease and responded more favorably to therapy. Sites in other clusters exhibited moderate levels of prior destructive disease and disease activity status closer to the mean values for all 250 sites.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed2003

Trends in fluoroquinolone resistance of bacteria isolated from canine urinary tracts.

Fluoroquinolone (FQ) antimicrobial agents are used extensively in human and veterinary medicine. Widespread use of any antimicrobial agent can apply selective pressure on populations of bacteria, which may result in an increase in the prevalence of antimicrobial-resistant isolates. Antimicrobial-susceptibility data on bacteria isolated from the canine urinary tract by the University of Missouri-Columbia Veterinary Medical Diagnostic Laboratory, Columbia, MO, were used to determine whether there has been an increase in the prevalence of FQ-resistant bacteria over time. Between January 1992 and December 2001, minimum inhibitory concentrations of either ciprofloxacin (1992-1998) or enrofloxacin (1998-2001) were determined for 1,478 bacterial isolates from the canine urinary tract. The predominant bacterial species isolated were Escherichia coli (547 isolates), Proteus mirabilis (156), and Staphylococcus intermedius (147). In all, there were 13 bacterial species with more than 25 isolates each. A significant increase in the overall proportion of resistant bacterial isolates was documented from 1992 to 2001 (Cochran-Armitage test for trend, P < 0.0001). The same increase in resistant isolates was documented when either ciprofloxacin or enrofloxacin was analyzed separately (P < 0.0001 and P < 0.0002, respectively). No difference was detected in rates of bacterial FQ resistance with regard to the sex of the dog from which the bacteria were isolated. The frequency with which some bacterial species were isolated differed with the sex of the infected dog. Proteus mirabilis was found more often in females (P < 0.0001), whereas beta hemolytic Streptococcus spp., were found more often in males (P = 0.0003). Although the overall efficacy of FQ antimicrobials remained high with greater than 80% of isolates being susceptible, the data demonstrated an increase in the proportion of resistant bacteria isolated from the urinary tract of the dog.

Animals↗

PubMed1991

Relation of baseline microbial parameters to future periodontal attachment loss.

The relationship between the level of subgingival species at baseline and subsequent attachment loss in a subject was examined. 38 subjects (14-71 years) with prior evidence of periodontal destruction were monitored 2x for pocket depth and attachment level at 6 sites per tooth at baseline and 2 months. A subject was considered to exhibit new attachment loss if 1 or more sites increased 3 mm or more in attachment level in 2 months. Subgingival plaque samples were taken at the baseline visit from the mesial aspect of each tooth (28 sites) using Gracey curettes. Samples were dispersed, diluted and plated on Trypticase soy agar supplemented with 5% sheep blood. After 7 days of anaerobic incubation, the colonies were lifted onto nylon filters, lysed and the DNA fixed to the filters. Digoxygenin-labeled DNA probes were used to enumerate 14 subgingival species. 17 of 38 subjects (44.7%) exhibited new attachment loss in 2 months. The % of the total viable count of each species was averaged for each subject. The species enumerated and the mean % of the total cultivable microbiota averaged across the active and inactive subjects were as follows; B gingivalis 2.3, 1.2; W. recta 1.3, 0.6; B. intermedius I 2.5, 2.0; B. forsythus 1.5, 1.2; A. actinomycetemcomitans serotype a 1.1, 0.8; F. nucleatum ss vincentii 1.1, 1.0; S. intermedius 2.0, 1.9; P. micros 1.5, 1.5; B. intermedius II 1.6, 1.7; A. actinomycetemcomitans serotype b 0.4, 0.6; S. sanguis I 1.8, 2.1; S. sanguis II 2.7, 3.0; V. parvula 3.9, 4.2; C. ochracea 0.9, 1.8.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed1995

[Eight cases of infection caused by the Streptococcus milleri group--significance of serum antibody titer and a comparative investigation of the backgrounds and factors of infections caused by Streptococcus milleri and Streptococcus pneumoniae].

Eight cases of infection caused by Streptococcus milleri were studied clinically, and a comparative study was made of the backgrounds and factors influencing the development of infectious diseases caused by Streptococcus milleri and Streptococcus pneumoniae. The patients (six males and two females) with infectious diseases caused by Streptococcus milleri ranged in age from 21 to 81 years old with an average age of 62.0 years. The infectious diseases encountered among the patients were pyothorax in three patients, and in one patient each pyothorax and lung abscess, pleurisy, a secondary infection of pulmonary emphysema, skin infection related to a tracheostomy, a subdural abscess and a brain abscess, respectively. Six out of the eight cases had infections which formed pus. An underlying disease existed in seven cases, and, in five of these seven cases, it influenced the general condition of these patients. Six serum antibody titers for the S. milleri groups were examined in the First Department of Internal Medicine, University of the Ryukyus. Three cases for S. anginosus, two cases for S. intermedius, and one case for S. constellatus showed high titers of X1024 or X2048. Therefore, the examination of the serum antibody titer seems useful for the diagnosis of infections caused by the S. milleri group. We also carried out a comparative investigation of the backgrounds and factors of infectious diseases caused by S. milleri and S. pneumoniae. There are more underlying diseases in infections caused by S. milleri than in those caused by S. pneumoniae. There were more smokers among the patients with infections caused by S. milleri than among those with S. pneumonia infections.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1989

Aggregation of 27 oral bacteria by human whole saliva. Influence of culture medium, calcium, and bacterial cell concentration, and interference by autoaggregation.

Twenty-seven oral strains of the genera Actinomyces (5), Bacteroides (3), and Streptococcus (19) were tested for aggregation by human whole saliva, as well as the effect of culture medium, Ca-ions, and bacteria concentration thereupon. Of the media tested, GF-broth gave rise to less interference by autoaggregation or higher aggregation titers than BHI and TSB, and was used throughout this study. In most cases, Ca-ions (1 mM) only enhanced the rate of induced aggregation, whereas raising the bacteria concentration increased the rate of both induced- and autoaggregation. The final titers, ranging from 1-64, were hardly affected by these parameters, except those of S. rattus HG 59 and S. mutans HG 199, which were respectively increased and decreased by Ca-ions. Saliva-induced aggregation was observed for 21 strains of A. viscosus, A. naeslundii, A. israelii, B. gingivalis, B. intermedius, S. cricetus, S. mutans, S. rattus, S. sanguis, and S. sobrinus, mostly within 15 min to 3 h. Seventeen of these strains also showed autoaggregation, usually well after the onset of induced aggregation. Any potential induced aggregation of B. gingivalis HG 91 was always masked by autoaggregation, as well as that of the S. mutans strains under a particular set of conditions. The aggregation rate and titer varied considerably in a mutually unrelated and strain-dependent way. These microtiterplate data were matched by the 5 spectrophotometric patterns observed for saliva-bacterial interaction, which moreover, gave the better differentiation between induced and autoaggregation. In conclusion, most strains tested can show rapid saliva-induced aggregation in a strain-dependent way, yet strongly affected by the experimental conditions and interference from autoaggregation.

Animals↗

PubMed1983

The clinical significance of streptococcal species isolated from cerebrospinal fluid.

Alpha-hemolytic (viridans) streptococci are often isolated from cerebrospinal fluid (CSF); however, the significance of such isolates is poorly understood. In order to clarify the clinical significance of isolating these organisms from CSF, we did a retrospective analysis of 43 patients, from whom eight different species of alpha-hemolytic streptococci were recovered. Eight patients (19%) had significant infections based on bacteriologic, laboratory, and clinical findings. Significant infections were associated with S. sanguis, S. salivarius, S. intermedius, S. faecalis, and S. bovis. Thirty-five patient isolates (81%) from CSF were considered as contaminants, with S. mitis being the most frequently isolated organism (49%). Direct gram stain of CSF sediment, CSF glucose concentration, and CSF cell differential were clearly abnormal in most patients with significant infections, in contrast to patients with streptococci isolated as contaminants. Cultures of the lumbar puncture skin site yielded streptococci and other bacteria, suggesting a possible reservoir for contaminants.

Cerebrospinal Fluid↗