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PubMedDate not supplied

[Evaluation of phenotype characteristics of streptococci in the identification of the Streptococcus anginosus (Streptococcus milleri) group].

Microorganisms referred to as Streptococcus anginosus (Streptococcus milleri) group which consist of S. anginosus, S. intermedius and S. constellatus is very difficult to identify to the species level, because of their diversity of biochemical, hemolytic and serological characteristics and because of confusion surrounding their taxonomy. Identification procedures on three isolates from primary sterile sites of three different patients, using API 20A system are described. Streptococcus intermedius was established in two and Streptococcus anginosus in one case. The importance of these organisms as human pathogens should enhance efforts of clinical microbiologist towards their accurate identification.

Adolescent↗

PubMed1997

Experimental endocarditis induction and platelet aggregation by Streptococcus anginosus, Streptococcus constellatus and Streptococcus intermedius.

A total of 18 'Streptococcus milleri' strains including the ATCC type strains of Streptococcus anginosus, Streptococcus constellatus and Streptococcus intermedius were compared with Streptococcus oralis ATCC10557 for their ability to induce infective endocarditis in catheterized rats. Three days after intravenous injection of 10(8) colony-forming units all 8 S. anginosus strains tested produced infective vegetations and bacteremia in almost all rats whereas 5 S. constellatus strains and the S. oralis strain produced infective vegetations and bacteremia less frequently and 5 S. intermedius strains only occasionally. The vegetations infected with the S. anginosus strains harbored microbial cells in significantly higher numbers that those with the other strains. No strong correlation was found between the endocardial infectivity and platelet-aggregating capacity of these strains. The platelet-aggregating strains were members of the Lancefield groups F and G or ungroupable but not of group A or C.

Animals↗

PubMed1995

Streptococcus anginosus, Streptococcus constellatus and Streptococcus intermedius. Clinical relevance, hemolytic and serologic characteristics.

A collection of 518 "Streptococcus milleri" isolates recovered from clinical specimens was identified to the species level according to recently established criteria. Streptococcus anginosus was the most frequently isolated species (59.3%), followed by S constellatus (30.3%) and S intermedius (10.4%). One third (34%) of all isolates were beta-hemolytic. The majority of S anginosus isolates were nonhemolytic, carried Lancefield group F, or were nongroupable. Most of the S constellatus isolates were beta-hemolytic, as well as 16.6% of S intermedius strains. Streptococcus anginosus was recovered more often from the genital and urinary tracts and S constellatus was recovered from the thorax. Streptococcus intermedius was mostly found in the head and neck area, but was also isolated from the abdomen and the skin, bone, and soft tissue. Streptococcus intermedius and nonhemolytic isolates were recovered most often from abscess-related specimens.

Adolescent↗

PubMed1994

[Parenchymatous abscess in Streptococcus anginosus (Streptococcus milleri) septicemia. Value of their systematic search, apropos of 4 cases].

Streptococcus anginosus, the term suggested to cover a set of streptococci previously known under various names (milleri, MG, anginosus, intermedius, constellatus), is characterized by a propensity to create parenchymatous abscesses, essentially cerebral or hepatic, particularly within the terms of septicemia. These abscesses are sometimes difficult to detect due to a difficult or non-existent symptomatology. The authors report on four cases illustrating the necessity to search for them systematically by cerebral CT scan and abdominal echography or CT scan in all cases of septicemia caused by Streptococcus anginosus.

Aged↗

PubMed1988

Clinically significant Streptococcus anginosus (Streptococcus milleri) infections: a review of 186 cases.

We describe clinically significant infections due to Streptococcus anginosus in 186 patients; 114 (61.3%) males and 72 (38.7%) females, median age 42 years, range 9 months to 93 years. In 101 (54.3%) cases S anginosus alone caused infection and in 85 (45.7%) cases it was associated with other microorganisms. Abscesses accounted for 110 (59.1%) infections. Sites of infection were: miscellaneous skin and soft tissue, 64 (34.4%), intraabdominal 41 (22%), head and neck 34 (18.3%), pleuropulmonary 22 (11.8%), genitourinary 9 (4.8%), musculoskeletal 6 (3.2%), endocarditis 5 (2.7%) and primary bacteraemia 5 (2.7%). Treatment consisted of antibiotic therapy which was often prolonged, median 30 days, range 2-90 days, and surgery in 159 (85.5%). S anginosus infection was a contributory factor in two of the three deaths which occurred.

Abscess↗

PubMed1996

In-vitro antimicrobial susceptibility of the "Streptococcus milleri' group (Streptococcus anginosus, Streptococcus constellatus and Streptococcus intermedius).

A collection of 423 clinical "Streptococcus milleri' strains was speciated and tested for susceptibilities to twelve antibiotics. Only 1.4% of the strains were of intermediate susceptibility to penicillin. None of the strains exhibited high-level resistance to gentamicin. Strains resistant to erythromycin, roxithromycin and clindamycin were found with a frequency of 2.6%, 2.4% and 2.4% respectively. Doxycycline resistance was found in 5.7% of the strains and occurred most frequently in Streptococcus anginosus. All the strains were susceptible to cefotaxime, vancomycin and teicoplanin. The results of this study do not indicate changing antibiotic resistance in strains of the "S. milleri' group, but local differences in antibiotic susceptibilities may occur.

Anti-Bacterial Agents↗

PubMed2001

Streptococcus intermedius, Streptococcus constellatus, and Streptococcus anginosus ("Streptococcus milleri group") are of different clinical importance and are not equally associated with abscess.

Difficulties in distinguishing organisms of the "Streptococcus milleri group" (SMG; Streptococcus intermedius, Streptococcus constellatus, and Streptococcus anginosus), have caused ambiguity in determining their pathogenic potential. We reviewed 118 cases in which SMG isolates had been identified using 16S rDNA sequence. S. constellatus and S. anginosus were isolated far more frequently than was S. intermedius. Nearly all isolates of S. intermedius and most isolates of S. constellatus, but only 19% of those of S. anginosus, were associated with abscess. Our findings suggest that speciation of the SMG may guide diagnostic evaluation, give insight into the possible role of coinfecting organisms, and help assess the need to search for occult abscess.

Abscess↗

PubMed1988

Streptococcus anginosus ("Streptococcus milleri"): the unrecognized pathogen.

"Streptococcus milleri" is an unofficial name that has been applied to a group of streptococci which, although basically similar, show various hemolytic, serological, and physiological characteristics. The species name Streptococcus anginosus has recently been recognized as the approved name for these organisms. Streptococci known as "S. milleri" have been implicated as etiologic agents in a variety of serious purulent infections, but because of their heterogeneous characteristics, these organisms may be unrecognized or misidentified by clinical laboratorians. This review describes the bacteriological aspects of organisms known as "S. milleri," their clinical significance, and the problems encountered with their identification in the clinical laboratory.

Humans↗

PubMed1995

Hydrolytic enzymes of Streptococcus anginosus, Streptococcus constellatus and Streptococcus intermedius in relation to infection.

A collection of 518 'Streptococcus milleri' strains was tested for the presence of hydrolytic enzymes, and the results were related to the clinical significance of the strains. Ribonuclease activity was equally distributed among the three species while hyaluronidase activity was linked to Streptococcus intermedius and Streptococcus constellatus. Both enzymes were not significantly associated with infection-related strains. Deoxyribonuclease and chondroitin sulfatase activity tended to be present more frequently in Streptococcus intermedius and Streptococcus constellatus and was associated with infection-related strains (p < 0.001).

Chondroitin Sulfates↗

PubMed2025

Genomic and transcriptomic insights into the virulence and adaptation of shock syndrome-causing Streptococcus anginosus.

Streptococcus anginosus is a common isolate of the oral cavity and an opportunistic pathogen for systemic infections. Although the pyogenic infections caused by S. anginosus are similar to those caused by Streptococcus pyogenes, S. anginosus lacks most of the well-characterized virulence factors of S. pyogenes. To investigate the pathogenicity of S. anginosus, we analysed the genome of a newly identified S. anginosus strain, KH1, which was associated with toxic shock-like syndrome in an immunocompetent adolescent. The genome of KH1 contains nine genomic islands, two Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR)/CRISPR-associated systems and many phage-related proteins, indicating that the genome is influenced by prophages and horizontal gene transfer. Comparative genome analysis of 355 S. anginosus strains revealed a significant difference between the sizes of the pan genome and core genome, reflecting notable strain variations. We further analysed the transcriptomes of KH1 under conditions mimicking either the oral cavity or the bloodstream. We found that in an artificial saliva medium, the expression of a putative quorum quenching system and pyruvate oxidase for H2O2 production was upregulated, which could optimize the competitiveness of S. anginosus in the oral ecosystem. Conversely, in a modified serum medium, purine and glucan biosynthesis, competence and bacteriocin production were significantly upregulated, likely facilitating the survival of KH1 in the bloodstream. These findings indicate that S. anginosus can utilize diverse mechanisms to adapt to different environmental niches and establish infection, despite its lack of toxin production.

Streptococcus anginosus↗

PubMed2006

In vitro activity of sitafloxacin compared with several fluoroquinolones against Streptococcus anginosus and Streptococcus constellatus.

The in vitro activities of sitafloxacin and seven other fluoroquinolones a (ciprofloxacin, tosufloxacin, sparfloxacin, levofloxacin, T-3811ME, moxifloxacin and trovafloxacin) were examined by the microdilution method against 79 clinically isolated 'Streptococcus milleri' group (SMG) microorganisms. No statistically significant differences were found between the minimum inhibitory concentrations (MIC(50) and MIC(90)) against Streptococcus anginosus and Streptococcus constellatus. Sitafloxacin was the most active agent of the eight fluoroquinolones tested against SMG, with a MIC(90) of 0.06 microg/mL, which was 8 times more active than ciprofloxacin and 16 times more active than levofloxacin. Although none of the SMG strains showed high resistance to any of the fluoroquinolones tested, three agents (trovafloxacin, sitafloxacin and T-3811ME) had low MICs against 23 SMG strains against which levofloxacin had a MIC> 1 microg/mL. In conclusion, several fluoroquinolones have low MICs against SMG, but sitafloxacin has the lowest.

Anti-Bacterial Agents↗

PubMed1992

Streptococcus intermedius, Streptococcus constellatus, and Streptococcus anginosus (the Streptococcus milleri group): association with different body sites and clinical infections.

The associations of Streptococcus intermedius, S. constellatus, and S. anginosus (the three species of the S. milleri group) with clinical infections and sites of isolation were investigated by using a simple biochemical scheme to identify a collection of 153 clinical isolates. S. intermedius was associated with abscesses of the brain and liver, while both S. anginosus and S. constellatus were isolated from a wider range of sites and infections. S. anginosus strains predominated in both genitourinary and gastrointestinal sources and exhibited a wider range of phenotypes, particularly in the ability to ferment mannitol and/or raffinose.

Central Nervous System Diseases↗

PubMed2004

Molecular analysis of age-related changes of Streptococcus anginosus group and Streptococcus mitis in saliva.

The purpose of this study was to survey the prevalence of streptococcal species, especially Streptococcus anginosus (which has been reported to be associated with cancer in the upper digestive tract), Streptococcus constellatus, and Streptococcus intermedius in the saliva of different age groups. A sequence analysis of 16S rDNA was performed and DNA quantified using real-time polymerase chain reaction. The S. anginosus level increased with age, whereas the levels of S. constellatus and S. intermedius did not change. Streptococcus mitis was the predominant species in the saliva of all the age groups but, unlike the S. anginosus, the proportion of S. mitis in the salivary bacteria decreased with age. The increase in S. anginosus with age should be carefully monitored because of its association with diseases, including cancer.

Adult↗

PubMed2003

Genotyping by amplified fragment length polymorphism analysis reveals persistence and recurrence of infection with Streptococcus anginosus group organisms.

Streptococcus anginosus, Streptococcus constellatus, and Streptococcus intermedius, commonly referred to as the Streptococcus anginosus group (SAG), are commensal organisms known for their propensity to cause purulent infections which are difficult to eradicate. In this study, we determined the genetic similarities between SAG isolates consecutively recovered from single patients to assess the duration of infection or colonization. A total of 97 SAG isolates recovered from 30 patients were included; 65 (67.0%) of the isolates were abscess related. The isolates were identified by the 16S rRNA reverse line blot hybridization assay as S. anginosus (n = 34), S. constellatus (n = 55), and S. intermedius (n = 8). Amplified fragment length polymorphism (AFLP) analysis of the SAG isolates produced discriminatory and reproducible patterns. Consecutive SAG isolates with identical AFLP types were found in 27 of 30 (90.0%) patients, and consecutive isolates with only a single AFLP type were demonstrated in 21 (70.0%) patients. The median delay between the times of recovery of the first and last isolates of identical AFLP types from each patient was 36 days, and this delay extended for more than 1 year in patients with both colonizing and abscess-related SAG isolates. In six bacteremic patients, paired blood and nonblood SAG isolates showed identical AFLP types.

Adolescent↗

PubMed1990

Phenotypic differentiation of Streptococcus intermedius, Streptococcus constellatus, and Streptococcus anginosus strains within the "Streptococcus milleri group".

A biochemical scheme was developed by which strains of Streptococcus constellatus, Streptococcus intermedius, and Streptococcus anginosus can reliably be distinguished from within the "Streptococcus milleri group." Strains identified as S. intermedius were differentiated by the ability to produce detectable levels of alpha-glucosidase, beta-galactosidase, beta-D-fucosidase, beta-N-acetylgalactosaminidase, beta-N-acetylglucosaminidase, and sialidase with 4-methylumbelliferyl-linked fluorogenic substrates in microdilution trays after 3 h of incubation at 37 degrees C, together with the production of hyaluronidase. Strains of S. constellatus and S. anginosus were differentiated by the production of alpha-glucosidase and hyaluronidase by the former and the production of beta-glucosidase by the latter. The majority of strains of the S. milleri group obtained from dental plaque were identified as S. intermedius, as were most strains isolated from abscesses of the brain and liver. Strains of S. constellatus and S. anginosus were from a wider variety of infections, both oral and nonoral, than were strains of S. intermedius, with the majority of strains from urogenital infections being identified as S. anginosus.

Dental Plaque↗

PubMed1995

Fibronectin binding by Streptococcus milleri group strains and partial characterisation of the fibronectin receptor of Streptococcus anginosus F4.

The Streptococcus milleri group were shown to bind fibronectin (Fn) to their cell-surface and this binding increased the adhesion of cells to hydroxyapatite. The binding of Fn to Streptococcus anginosus F4 was studied in more detail. Fn binding to bacterial cells increased the association of the bacteria with the polymorphonuclear leukocytes obtained from the peritoneal cavity of rats but did not increase killing of the bacteria. The cell-surface receptor was a protein of M(r) 14,000 which was released from cells after mutanolysin digestion. The binding was specific, with cells having a maximum number of binding sites per cell of 770. Electron microscopy, using gold-labelled Fn, localised the receptor to areas between daughter cells.

Animals↗

PubMed1991

Emended descriptions and recognition of Streptococcus constellatus, Streptococcus intermedius, and Streptococcus anginosus as distinct species.

Strains currently classified as Streptococcus anginosus include strains previously identified as Streptococcus constellatus (Prevot 1924) Holdeman and Moore 1974, Streptococcus intermedius (Prevot 1925), and "Streptococcus milleri" (Guthof 1956) because these specific epithets were argued to be later synonyms of Streptococcus anginosus (Andrewes and Horder 1906) Smith and Sherman 1938 by Coykendall et al. (Int. J. Syst. Bacteriol. 37:222-228, 1987). However, recent data from DNA-DNA hybridization experiments, whole-cell-derived polypeptide patterns determined by sodium dodecyl sulfate-polyacrylamide gel electrophoresis, and data from phenotypic testing have demonstrated that Streptococcus anginosus strains represent three readily identifiable taxa to which the previously assigned type strains of Streptococcus constellatus (strain NCDO 2226 [= ATCC 27823], Streptococcus intermedius (strain NCDO 2227 [= ATCC 27335], and Streptococcus anginosus (strain NCTC 10713 [= ATCC 33397] have been shown to belong. Therefore, we propose recognition of Streptococcus constellatus (emend.) (type strain NCDO 2226 [= ATCC 27823]), Streptococcus intermedius (emend.) (type strain NCDO 2227 [= ATCC 27335]), and Streptococcus anginosus (emend.) (type strain NCTC 10713 [= ATCC 33397]) as distinct species and propose an emended description of each of these taxa.

Base Composition↗

PubMed2002

Isolation of a putative laminin binding protein from Streptococcus anginosus.

Viridans streptococci, including Streptococcus anginosus, are a common cause of infective endocarditis in humans. Adherence mechanisms involved in colonization of non-diseased native valves (present in 40% of native valve endocarditis) are unknown. We have previously shown that an endocarditis isolate of S. anginosus adheres to exposed basement membrane of human and porcine valve tissue in a laminin dependent manner. We now describe the partial purification of an 80 kDa putative laminin binding protein (PLBP) by biochemical methods. Amino acid sequence of PLBP peptides is similar to substrate binding proteins of ABC transporters in other Gram-positive cocci.

Amino Acid Sequence↗