A hemolytic streptococci

Tracer species a-Hemolytic streptococci E. coli Bacteroides fragilis group... 

Continue therapy at least 24 to 48 hours after symptoms and fever subside. Treat all infections caused by group A -hemolytic streptococci for at least 10 days. 

Post-streptococcal glomerulonephritis is the result of infection with the nephritogenic strain of group A hemolytic streptococci. The streptococci are usually isolated from patients with a sore throat and, in developing countries, skin infection like impetigo or infected scabies is an important cause. There is no specific treatment except for antihypertensives, salt restriction and diuretics. Corticosteroids are of no value. The disease is self-limiting but, in some adults, it may progress to chronic renal failure. 

Neomycin is a topical aminoglycoside widely nsed for skin wounds and in otolaryngology. Its antibacterial activity resembles that of gentamicin and tobramycin, except that P aeruginosa, S. pneumoniae, and the a-hemolytic streptococci are generally resistant. Neomycin s usefnl-ness for treating acnte bacterial conjunctivitis is limited... 

With hyaluronic acid, much of the informative work on its biosynthesis has accrued from studies with bacteria. Group A hemolytic streptococci have long been known (K6) to produce hyaluronic acid identical with that present in mammalian connective tissues. The participation of uridine nucleotides in the biosynthesis of hyaluronic acid is now well... 

A 54-year-old man with rheumatoid arthritis for 12 years was given infliximab, with remission. He then developed a painful, confluent, erythematous, pustular rash over his trunk and limbs. Skin biopsy showed an acute pustular dermatitis. Five hours later he collapsed with a tachycardia (140/minute) and a blood pressure of 120/70 mmHg. He was apyrexial. His left leg was very tense, painful, and swollen, and he had a disseminated intravascular coagulopathy. There was marked necrosis of his adductor compartment and fascia of his left thigh and necrotic muscles were debrided. Blood cultures and skin swabs grew group A hemolytic streptococci. He then became unstable and died, despite efforts at resuscitation. 

Using this procedure, Consden and Stanier were able to show that a hydrolyzate of Group A hemolytic streptococci contained hexosamine, rhamnose, ribose, and glucose and, also, that a hydrolyzate of purified, human fibrin contained uronic acid, hexosamine, mannose, and galactose. A similar combination of techniques has been employed by Woodin in a study of the composition of a comeal mucopolysaccharide. It is of interest that the conditions of acidic hydrolysis necessary for releasing the n-glucos-amine moiety from heparin also result in destruction of the concomitantly released n-glucuronic acid. Traces of the intact uronic acid may be revealed by zone electrophoresis of the hydrolyzates. ... 

Nafcillin. sodium may be used in infections cau.sed solely by penicillin G-resislant staphylococci or when streptococci are present also. Although it is recommended that it be used exclu.sively for such resi.stant infections, nafcillin is also effective against pneumococci and group A hemolytic streptococci. Because, like other penicillins, it may cau.se allergic side cffcct.s. it should be administered with care. 

The cross-reactions in anti-Pn II of the C-polysaccharide of group A hemolytic streptococci - and of the derived V and D polysaccharides, together with the II-VI pneumococcal cross-reaction, - are discussed in Section 11,5. The cross-reaction of Kutira gum from Cochlo-spermum gossypium was originally attributed to the presence of multiple residues of L-rhamnose. However, subsequent chemical studies showed... 

Heymann et al. (1963) have prepared the group-specific C-polysaccharide of Group A hemolytic streptococci and found (1 —>3)-linked rhamnose units. Side groups or side chains were linked to the 2-position of rhamnose. Infrared spectra pointed to the existence of a-glycosidic linkages between the rhamnose units. 

In a study (Heymann et al, 1964) involving the structure of deacetylated C-poly-saccharide of Group A hemolytic streptococci, infrared spectroscopy has been used to observe the disappearance of amide absorption as a result of treatment at 100°C with 0.49N barium hydroxide. 

The antigenic structure of hemolytic streptococci has been extensively studied by Lancefield and her coworkers (76). It has been shown that at least two type-specific antigenic components, both probably protein in nature, are concerned with the type-specific reactions of group A hemolytic streptococci. These components have been designated M and T. In addition, the cells contain at least one species-specific protein capable of cross-reacting with pneumococci, which has been designated P (76, 144). 

Comparison of Properties of Af and T Antigens of Group A Hemolytic Streptococci... 

The production of a papainlike enzyme by certain strains of group A hemolytic streptococci and its possible relation to virulence (Elliott, 38) has already been discussed. A great many other strains of pathogenic bacteria produce proteolytic enzymes of the papain or trypsin type. 

M Protein of Hemolytic Streptococcus Group A. The experiments of Olarte referred to have now been published (154). Olarte has demonstrated that as much M protein may be recovered from the culture nitrates of certain strains of group A hemolytic streptococci as may be extracted by the Lancefield technique from the cells themselves. M protein from the culture filtrate may be fractionated by ammonium sulfate precipitation. Partially purified M protein prepared in this way did not prove to be a better antigen than material extracted from the cells at 37°C. with acid by the technique of Hirst and Lancefield loc. cit.) as had been hoped. There appears to be a correlation between mouse virulence and release of extracellular M protein. Only those strains which retain the M protein on the cell surface and do not release it into the supernatant are virulent for mice,... 

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