Group A streptococci

Antibiotic resistance plays a smaller role in pharyngitis therapy compared with other URIs. O Penicillin resistance has not yet been documented in group A streptococci, but resistance and clinical failures occur more frequently with tetracyclines, trimethoprim-sulfamethoxazole, and to a lesser degree macrolides. 

Perform laboratory testing to confirm the presence of group A streptococci. 

O Impetigo is a skin infection that most commonly afflicts young children. It is caused by group A streptococci or Staphylococcus aureus and is characterized by the development of numerous blisters that rupture and form crusts. Dicloxacillin, cephalexin, and topical mupirocin are considered the antibiotics of choice for treatment of impetigo. 

Erysipelas (Saint Anthony s fire) is an infection of the superficial layers of the skin and cutaneous lymphatics. The infection is almost always caused by /3-hemolytic streptococci, with S. pyogenes (Group A streptococci) responsible for most infections. 

M. A. Gerber, M. F. Randolph, and K. K. DeMeo, Liposome immunoassay for rapid identification of group A streptococci directly from throat swabs, J. clin, Microbiol. 28, 1463-1464 (1990). 

Group A streptococci PrtFl/Sfbl, PrtF2, LTA SOF/Sfbll, M3 protein... 

Laminin Neisseria meningitidis Staphylococcus aureus Group A streptococci NhhA... 

Natanson, S., Sela, S., Moses, A. E., Musser, J. M., Caparon, M. G., and Hanski, E. (1995). Distribution of fibronectin-binding proteins among group-A streptococci of different M-types. /. Infect. Dis. 171, 871-878. 

Bacterial endocarditis - Only in 600,000 to 1 million units/day IM extremely sensitive infections (Group A streptococci)... 

Prevention of relapses of rheumatic fever (secondary prevention) induced by throat infections caused by group A streptococci. 

Group A streptococci, which are serious human pathogens, form a-helical coiled-coil threads whose C termini are anchored in the cell membrane. They protrude through the peptidoglycan layers and provide a hairlike layer around the bacteria. A variable region... 

A careful study of various strains of Streptococcus by Wannamaker lias demonstrated that group A streptococci produce three different DNases (A, B, and C) which can be distinguished by their electrophoretic and immunological properties and by their pH optima (46)- The relative amount of each enzyme produced appears to be a function of strain variation. Streptodornase has been identified with DNase A. 

Moyle PM, Barozzi N, Wimmer N, Olive C, Good M, Toth I (2005) Development of peptide vaccines against HPV-16 associated cervical cancer and group A streptococci. Biopolymers 80(4) 556-557... 

Group A streptococci, S. aureus occasionally other gram-positive cocci, gram-negative bacilli, ancl/or anaerobes... 

Before the introduction of the H. influenzae type B vaccine in 1985, nearly aU chUdren under 6 years of age with preseptal cellulitis were foimd to have H. influenzae type B or a A pneumoniae infection. This condition was of great concern due to the mortality from secondary meningitis. Becanse H. influenza is no longer of primary concern in chUdren, the most common causative bacteria are the group A streptococci. An important component in the history of young chUdren with ceUulitis shonld be to confirm or exclude H. influenzae type B vaccination. 

Pataki J, Szabo M, Lantos E, Szekvolgyi L, Molnar M, Hegedus E, Bacso Z, Kappelmayer J, Lustyik G, Szabo G. Biological microbeads for flow-cytometric immunoassays, enzyme titrations, and quantitative PCR. Cytometry Part A 2005 68A 45-52. Martins TB, Augustine NH, Hill HR. Development of a multiplexed fluorescent immunoassay for the quantitation of antibody responses to group A streptococci. J. Immunol. Methods 2006 316 97-106. 

Rheumatic fever is caused by a large number of types of Group A streptococci and immunity is type-specific. Recurrent attacks are commonly due to infection with different strains of these, all of which are sensitive to penicillin and so chemoprophylaxis is effective. Acute glomerulonephritis is also due to group A streptococci. But only a few types cause it, so that natural immunity is more likely to protect and, in fact, second attacks are rare. Therefore, chemoprophylaxis is not used (see also p. 239). 

A 37-year-old man with diabetes had septicemia and compartment syndrome of the leg after acupuncture in the calf area (92). Decompression fasciotomy was performed and Gram-positive cocci were grown from the wound swab and group A streptococci from blood cultures. He required intensive care, including intravenous antibiotics, and eventually recovered. 

De Azavedo JC, Yeung RH, Bast DJ, Duncan CL, Borgia SB, Low DE. Prevalence and mechanisms of macrolide resistance in clinical isolates of group A streptococci from Ontario, Canada. Antimicrob Agents Chemother 1999 43(9) 2144-7. 

An area of increasing concern and clinical importance is the increasing macrohde resistance that has been reported over the last several years with some of the common pathogens, particularly Streptococcus pneumoniae, group A streptococci, and Haemophilus influenzae, and may result in failure of therapy of pneumonia, phar5mgitis, and skin infections (54). High rates of resistance of several groups of streptococci to macrohdes have been reported from all parts of the world (55-64). 

Mean antibiotic concentrations of pristinamycin in dermal interstitial fluid (from suction bullae) are low nevertheless, the concentrations achieved should theoretically inhibit the growth of group A streptococci (37). 

Maaolides are appropriate antibiotics for the management of respiratory tract infections because they are active against Streptococcus pneumoniae. Streptococcus pyogenes (group A streptococci), and atypical organisms such as Legionella pneumophila. Mycoplasma pneumoniae, and Chlamydia pneumoniae. The newer generation macrolides such as clar-... 

Hyalm onate is produced both by animals and bacteria. It was first obtained by Meyer and Palmer from the vitreous humor of cattle eyes. Since then, it has been isolated from many sources, such as Wharton s jellyconnective tissue, skin, cock s comb, synovial fluid, Rous sarcoma, myxoedemal fluids, and encapsulated strains of hemolytic streptococci. Aerobacter aerogenes may also produce hyaluronate. Group A streptococci have been principally used for the investigation of the biosynthesis of hyaluronic acid. 

L-Glutamine donates nitrogen for hexosamine synthesis in Neurospora crassa and for the n-glucosamine units of hyaluronate in streptococci. Of twenty-three amino acids (and ammonium chloride) tested with group A streptococci, L-glutamine was the only consistent nitrogen-donor for... 

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