phenylephrine-hydrochloride and Streptococcal-Infections

Topics: Acne Vulgaris; Animals; Bacteria; Celiac Disease; Cholic Acids; Colonic Neoplasms; Dental Caries; Digestive System; Endocarditis, Bacterial; Humans; Immunity; Mouth; Nose; Pharynx; Propionibacterium acnes; Skin; Staphylococcal Infections; Staphylococcus; Streptococcal Infections; Streptococcus

To describe the bactericidal and fungicidal properties of a 0.0005% chlorhexidine (CHD) solution potentiated with EDTA-Tris buffers (CHD-EDTA-Tris) and evaluate the safety of 0.0005% CHD-EDTA-Tris in the upper respiratory tract (URT) of normal horses.. Clinical, prospective study.. Eight healthy, skeletally mature horses.. In vitro-serial dilutions of CHD-EDTA-Tris and EDTA-Tris alone were evaluated for bactericidal and fungicidal activity against Aspergillus fumigatus, Escherichia coli, Staphylococcus aureus, Streptococcus equi subspecies ssp. equi, Streptococcus equi ssp. zooepidemicus, and Pseudomonas aeruginosa. In vivo-eight healthy horses were topically treated twice with 30 ml of 0.0005% CHD-EDTA-Tris. Mucosal samples from each location were evaluated for the presence of inflammation or pathologic lesions.. Solutions containing CHD were superior in fungal and bacterial killing to those without. In vitro-a 0.005% CHD-EDTA-Tris was 100% effective against all bacterial and fungal species evaluated, while a 0.0005% CHD-EDTA-Tris was less efficacious against A. fumigatus and S. equi ssp. equi. In vivo-a 0.0005% CHD-EDTA-Tris did not cause any clinical, gross, or histologic abnormalities when topically applied to the equine URT.. A 0.0005% CHD-EDTA-Tris was highly effective for killing of common bacterial and fungal isolates in the equine upper respiratory tract. Short-term topical treatment of the equine URT with dilute CHD did not cause gross or histological inflammation in the tissue.. A 0.0005% CHD solution with EDTA-Tris should be considered for treatment of clinically relevant inflammatory or infectious conditions or in the URT of the horse.

Topics: Animals; Chlorhexidine; Horse Diseases; Horses; Nose; Prospective Studies; Streptococcal Infections; Streptococcus equi

Neonatal deaths, estimated at approximately 4 million annually, now account for almost 40% of global mortality in children aged under-five. Bacterial sepsis is a leading cause of neonatal mortality. Assuming the mother is the main source for bacterial transmission to newborns, the primary objective of the trial is to determine the impact of one oral dose of azithromycin, given to women in labour, on the newborn's bacterial carriage in the nasopharynx. Secondary objectives include the impact of the intervention on bacterial colonization in the baby and the mother during the first month of life.. This is a Phase III, double -blind, placebo controlled randomized clinical trial in which 830 women in labour were randomized to either a single dose of 2 g oral azithromycin or placebo (ratio 1:1). The trial included pregnant women in labour aged 18 to 45 years attending study health centres in the Western Gambia. A post-natal check of the mother and baby was conducted at the health centre by study clinicians before discharge and 8-10 days after delivery. Home follow up visits were conducted daily during the first week and then weekly until week 8 after delivery. Vaginal swabs and breast milk samples were collected from the mothers, and the pathogens Streptococcus pneumoniae, Group B Streptococcus (GBS) and Staphylococcus aureus were isolated from the study samples. For bacterial isolates, susceptibility pattern to azithromycin was determined using disk diffusion and E-test. Eye swabs were collected from newborns with eye discharge during the follow up period, and Chlamydial infection was assessed using molecular methods.. This is a proof-of-concept study to assess the impact of antibiotic preventive treatment of women during labour on bacterial infections in the newborn. If the trial confirms this hypothesis, the next step will be to assess the impact of this intervention on neonatal sepsis. The proposed intervention should be easily implementable in developing countries.. ClinicalTrials.gov Identifier--NCT01800942--First received: February 26, 2013.

Topics: Adolescent; Adult; Anti-Bacterial Agents; Azithromycin; Delivery, Obstetric; Double-Blind Method; Female; Gambia; Humans; Infant; Infant, Newborn; Infectious Disease Transmission, Vertical; Microbial Sensitivity Tests; Middle Aged; Milk, Human; Nose; Pregnancy; Pregnancy Complications, Infectious; Staphylococcus aureus; Streptococcal Infections; Streptococcus agalactiae; Streptococcus pneumoniae; Vagina; Young Adult

Impetigo is caused by both Streptococcus pyogenes and Staphylococcus aureus; the relative contributions of each have been reported to fluctuate with time and region. While S. aureus is reportedly on the increase in most industrialised settings, S. pyogenes is still thought to drive impetigo in endemic, tropical regions. However, few studies have utilised high quality microbiological culture methods to confirm this assumption. We report the prevalence and antimicrobial resistance of impetigo pathogens recovered in a randomised, controlled trial of impetigo treatment conducted in remote Indigenous communities of northern Australia.. Each child had one or two sores, and the anterior nares, swabbed. All swabs were transported in skim milk tryptone glucose glycogen broth and frozen at -70°C, until plated on horse blood agar. S. aureus and S. pyogenes were confirmed with latex agglutination.. From 508 children, we collected 872 swabs of sores and 504 swabs from the anterior nares prior to commencement of antibiotic therapy. S. pyogenes and S. aureus were identified together in 503/872 (58%) of sores; with an additional 207/872 (24%) sores having S. pyogenes and 81/872 (9%) S. aureus, in isolation. Skin sore swabs taken during episodes with a concurrent diagnosis of scabies were more likely to culture S. pyogenes (OR 2.2, 95% CI 1.1 - 4.4, p = 0.03). Eighteen percent of children had nasal carriage of skin pathogens. There was no association between the presence of S. aureus in the nose and skin. Methicillin-resistance was detected in 15% of children who cultured S. aureus from either a sore or their nose. There was no association found between the severity of impetigo and the detection of a skin pathogen.. S. pyogenes remains the principal pathogen in tropical impetigo; the relatively high contribution of S. aureus as a co-pathogen has also been confirmed. Children with scabies were more likely to have S. pyogenes detected. While clearance of S. pyogenes is the key determinant of treatment efficacy, co-infection with S. aureus warrants consideration of treatment options that are effective against both pathogens where impetigo is severe and prevalent.. This trial is registered; ACTRN12609000858291 .

Topics: Adolescent; Australia; Carrier State; Child; Child, Preschool; Coinfection; Female; Humans; Impetigo; Infant; Male; Methicillin Resistance; Nose; Population Groups; Prevalence; Respiratory Tract Infections; Scabies; Staphylococcal Infections; Staphylococcus aureus; Streptococcal Infections; Streptococcus pyogenes; Treatment Outcome

Macrolide-resistant Streptococcus pyogenes is an emerging problem with a great public health concern throughout the world. The current study was carried out in order to investigate the possible role of pet animals in the epidemiology of such pathogen. For this purpose, nasal or oral swabs were collected from 115 pets (40 dogs and 75 cats) with respiratory illness. The collected swabs were cultured for isolation and identification of S. pyogenes. Macrolide-resistant S. pyogenes strains were initially identified after antibiotic susceptibility testing of the all obtained S. pyogenes isolates, then the phenotypic and molecular identification were done using the double-disk test and the detection of macrolide resistance genes, respectively. Of the 115 examined pet animals, S. pyogenes was recovered from 11 (9.6 %), from which, the isolation rates among dogs and cats were 15 % and 6.7 %, respectively. Macrolide-resistant S. pyogenes was isolated from dogs and cats in the following rates 10 % and 5.3 %, respectively. All macrolide-resistant S. pyogenes strains were assigned to cMLS resistance phenotype while all of them carried ermB gene only, except one strain from a cat possessed both ermB and ermTR genes. The phylogenetic analysis of 4 ermB gene sequences showed high genetic relatedness with those carried by bacteria isolated from human cases to underline the public health impact of such strains. Seriously, all macrolide-resistant S. pyogenes strains were resistant to penicillin. The emergence of penicillin-macrolide resistant S. pyogenes among pet animals underscores not only an emerging veterinary pathogen, but also an ongoing public health threat.

Topics: Animals; Anti-Bacterial Agents; Cat Diseases; Cats; Dog Diseases; Dogs; Drug Resistance, Multiple, Bacterial; Genotype; Humans; Macrolides; Microbial Sensitivity Tests; Mouth; Nose; Penicillins; Pets; Phenotype; Public Health; Streptococcal Infections; Streptococcus pyogenes

According to WHO almost half of the population undergoing infectious diseases of the upper respiratory tract one third of which is inflammatory diseases of the pharynx. This article presents the therapy issue of patients with sore throat due to acute pharyngitis and/or acute tonsillitis of non-streptococcal etiology based on our own experience and literature data. Observational study was carried out at the Otorhinolaryngology department of MSUMD n.a. A.I. Evdokimov in order to evaluate efficacy and tolerability of complex local drug Doritricin. The study involved 52 patients, objective and subjective manifestations of the disease were evaluated. Obtained data indicate the effectiveness and safety of Doritricin, as well as the possibility of reducing the number of drugs used during treatment.. По данным ВОЗ, ежегодно почти половина населения переносит инфекционные заболевания верхних дыхательных путей, треть которых составляют воспалительные заболевания глотки. В обзорной статье на основании собственного опыта и данных литературы представлена проблема лечения пациентов с болью в горле при остром фарингите и/или остром тонзиллите нестрептококковой этиологии. На кафедре оториноларингологии МГМСУ им. А.И. Евдокимова было проведено наблюдательное исследование с целью определения эффективности и переносимости комплексного препарата местного действия «Доритрицин». В ходе исследования были обследованы 30 человек, у которых оценивались субъективные и объективные симптомы. Полученные данные свидетельствуют об эффективности и безопасности «Доритрицина», а также о возможности сокращения количества применяемых препаратов.

Topics: Humans; Larynx; Nose; Peritonsillar Abscess; Pharyngitis; Pharynx; Streptococcal Infections

Many of the currently used models of bacterial meningitis have limitations due to direct inoculation of pathogens into the cerebrospinal fluid or brain and a relatively insensitive assessment of long-term sequelae. The present study evaluates the utility of a Streptococcus (S.) suis intranasal infection model for the investigation of experimental therapies in meningitis.. We examined the brains of 10 piglets with S. suis meningitis as well as 14 control piglets by histology, immunohistochemistry and in-situ tailing for morphological alterations in the hippocampal dentate gyrus and microglial activation in the neocortex.. In piglets with meningitis, the density of apoptotic neurons was significantly higher than in control piglets. Moreover, scoring of microglial morphology revealed a significant activation of these cells during meningitis. The slight increase in the density of dividing cells, young neurons and microglia observed in piglets suffering from meningitis was not statistically significant, probably because of the short time frame between onset of clinical signs and organ sampling.. The morphological changes found during S. suis meningitis are in accordance with abnormalities in other animal models and human autopsy cases. Therefore, the pig should be considered as a model for evaluating effects of experimental therapeutic approaches on neurological function in bacterial meningitis.

Topics: Animals; Brain; Dentate Gyrus; Disease Models, Animal; Inflammation; Meningitis, Bacterial; Microglia; Neurons; Nose; Streptococcal Infections; Streptococcus suis; Swine

The aim of this study was to estimate the prevalence of equine strangles and to identify associated risk factors for this disease through a cross-sectional study of nasal swabs. Nasal swabs (n=1010) from healthy equines (absence of nasal discharge, lymphadenopathy and cough) from 341 farms were plated on 5% blood agar; of these horses, 24 were identified as positive for Streptococcus equi through isolation, PCR and DNA sequencing. The estimated prevalence for individual animals was 2.3%, and for herds, it was 5.86%. Statistical analysis identified the following as associated risk factors: the number of group events that were attended by the equines (PR: 1.06); the sharing of food containers (PR: 3.74); and at least one previous positive diagnosis of strangles on the farm (PR: 3.20). These results constitute an epidemiological contribution to the horse industry and may support measures for the future control of the disease.

Topics: Animals; Brazil; Cross-Sectional Studies; Horse Diseases; Horses; Nose; Polymerase Chain Reaction; Prevalence; Risk Factors; Sequence Analysis, DNA; Streptococcal Infections; Streptococcus equi

To analyze the indications and outcomes of open neurosurgical approaches (ONA) and endoscopic transnasal approaches (ETA) in the surgical management of pediatric sinogenic subdural and epidural empyema.. Retrospective single-center study design within a tertiary care referral center setting. Children less than 18 years of age consecutively operated on between January 2012 and February 2014 for drainage of a sinogenic subdural empyema (SE) or epidural (EE) empyema were included.. success of first surgical procedure, persistent symptoms and sequelae at the end of the follow-up period.. Nine SE (53%) and 8 EE (47%) were observed. Neurological symptoms, especially seizures, were more frequent in the SE group. Perioperative pus samples were positive in 67% of the SE group and in 75% of the EE group. The most frequently isolated bacteria belonged to the Streptococcus anginosus group. CT or MR imaging showed that most empyema probably originated from the frontal sinus. However, two cases resulted from an ethmoiditis and one case from a Pott's puffy tumor, without any direct contact with the paranasal sinus. In cases of SE, the most effective surgical technique was ONA with craniotomy. Associated endoscopic sinus drainage was useful for the purpose of bacteriological diagnosis. In cases of EE, effectiveness was noted in both ONA and ETA techniques. In two cases of EE, the ETA procedure encompassed direct drainage of the empyema through the posterior wall of the frontal sinus (Draf III approach). The number of patients successfully treated after a single surgical procedure was higher in the EE group (p=0.05). Regarding outcomes, no mortalities were observed. Persistent disorders at the end of the follow-up period, especially headaches, cognitive, concentration or schooling problems, tended to be more frequent in the SE group than in the EE group (67% vs 29%), and were more commonly observed in cases requiring several surgical procedures (75% vs 12.5%) (p=0.05).. Endoscopic sinus surgery plays a critical role in the surgical management of pediatric sinogenic SE and EE. In cases of small volume EE, the endoscopic approach associated with antibiotherapy may be sufficient to treat the infectious process.

Topics: Adolescent; Child; Cognition Disorders; Craniotomy; Drainage; Empyema, Subdural; Endoscopy; Epidural Abscess; Ethmoid Sinusitis; Female; Frontal Sinusitis; Headache; Humans; Learning Disabilities; Male; Nose; Radiography; Retrospective Studies; Streptococcal Infections; Streptococcus anginosus

The BioStar STREP B Optical ImmunoAssay (STREP B OIA) (BioStar OIA Strep B Assay Kit; BioStar Incorporation, Louisville, CO, USA), commonly used for diagnosis of human maternal group B streptococcus (GBS) colonization, was evaluated for its diagnostic and analytical sensitivity and specificity to aquatic animal GBS isolates, cross-reactivity, and diagnosis and recovery of GBS directly from clinically- infected fish swabs. STREP B OIA identified 25 known fish and dolphin GBS isolates. Thirteen non-GBS negative control isolates from fish and other animals were negative, giving 100% analytical specificity and no cross-reactivity. Three groups of 6 Nile tilapia (Oreochromis niloticus) (mean weight of 40.60+/-1.70 g) each were inoculated intraperitoneally with either 10(6) colony-forming units (cfu) GBS/fish, 10(6) cfu Streptococcus iniae/fish or 100 microL of tryptic soy broth (TSB) and observed for mortality for 7 days. The nare and brain of all fish were swabbed and subjected to the STREP B OIA for detection of GBS antigen immediately after swabbing (0 h) or 24, 48 and 72 h post-swabbing and compared to conventional culture on trypticase soy agar with 5% sheep blood. The STREP B OIA method demonstrated a diagnostic sensitivity of 75.0% and a diagnostic specificity of 69.2% compared to direct TSA. The percent agreement between OIA and culture was 100%. GBS antigen could be retrieved by OIA following 72-h storage of swabs. These results demonstrate the utility of the STREP B OIA to identify GBS from culture and directly from swabs of clinically- infected fish.

Topics: Animals; Bottle-Nosed Dolphin; Brain; Cattle; Fishes; Humans; Immunoassay; Nose; Sensitivity and Specificity; Streptococcal Infections; Streptococcus agalactiae; Water Microbiology

Topics: Animals; Chronic Disease; Dog Diseases; Dogs; Endoscopy; Female; Nose; Rhinitis; Streptococcal Infections; Streptococcus equi

Streptococcus equi is the cause of strangles in horses. To improve diagnostic sensitivity, development and evaluation of DNA-based methods are necessary.. To evaluate diagnostic methods and observe the pattern of bacterial shedding during natural outbreaks.. Two herds with natural outbreaks of strangles were visited over a period of 15 weeks and 323 samples originating from 35 horses investigated. The diagnostic use of a nested PCR test was evaluated using a collection of 165 isolates of Lancefield group C streptococci (species specificity) and swabs from nasal passages or from abscesses from horses infected with S. equi (diagnostic sensitivity).. All 45 S. equi isolates tested positive in the nested PCR, whereas no amplicon was formed when testing the other 120 Lancefield group C isolates. A total of 43 samples were collected from 11 horses showing clinical signs of strangles during the study period. The diagnostic sensitivity for PCR test was 45% and 80% for samples from the nasal passages and abscesses, respectively; the corresponding diagnostic sensitivity for cultivation was 18% and 20%. The diagnostic sensitivity was significantly higher for PCR than for bacterial cultivation. Furthermore, the shedding of S. equi in 2 infected horse populations was evaluated. An intermittent shedding period of S. equi of up to 15 weeks was recorded in this part of the study. It was also shown that shedding of S. equi occurred both from horses with and without clinical signs.. The nested PCR test represents a species-specific and -sensitive method for diagnosis of S. equi from clinical samples. It may, however, be desirable in future to develop detection methods with high diagnostic sensitivity and specificity without the potential problems inherent in nested PCR.

Topics: Abscess; Animals; Denmark; Disease Outbreaks; DNA, Bacterial; Horse Diseases; Horses; Nose; Polymerase Chain Reaction; Reproducibility of Results; Sensitivity and Specificity; Species Specificity; Streptococcal Infections; Streptococcus equi

The aim of this study was to determine the serotype profile and antibiotyping of Streptococcus pneumoniae from nasal isolates in children. Nasopharyngeal swab samples obtained from 125 children were cultivated and screened for the presence of S. pneumoniae. Strains were identified according to standard microbiological methods. The isolates were serotyped by the Quellung reaction and resistance patterns were determined by the microdilution method according to NCCLS guidelines. Results indicate an overall pneumococcal carriage rate of 24% (n = 30). The most commonly isolated serotypes were 23F (20%), 6B (20%) and 14 (13%). 73% of isolates were resistant at least to one of the tested antibiotics. 47% of the strains were consistently resistant to penicillin and the serotypes 6B and 23F were frequently associated with this marker. 60% of the strains were resistant to doxycycline, 37% to trimethoprim/sulfamethoxazole and clindamycin, 30% to erythromycin, 23% to cloramphenicol, 7% to ceftriaxone and 3% to cefepime. All strains were sensible to ofloxacin, rifampin and vancomycin. The most common combined resistance patterns were PNC-ERI-TMP/SMX-DOX-CLO-CLI (16.59%) and PNC-DOX (13.27%). The results obtained in this study will allow to orient the empiric therapy for pneumococcal infections and a rational use of antibiotics in clinical practice, as well as the application of an appropriate vaccination program specially adapted to the serotypes more frequently found in children.

Topics: Carrier State; Child, Preschool; Female; Humans; Infant; Male; Nose; Serotyping; Streptococcal Infections; Streptococcus pneumoniae

Dynamics of anti-M antibody response following intranasal infection with group A Streptococcus (GAS) M-18 were investigated in a Swiss albino mouse model. Mice arranged in three groups were inoculated intranasally with 2.0x10(7) c.f.u. ml-1 of GAS M-18 on 1, 2 alternate and 3 alternate days. Plasma collected from the retro-orbital plexus was tested for antibodies by an in-house indirect ELISA. The antibody titres of the plasma samples varied from 1 : 8 to 1 : 1024 in the 1 day dose, from 1 : 4 to 1 : 256 in the 2 day dose and from 1 : 4 to 1 : 128 in the 3 day dose. Peak titres were seen on day 42 or 56 and in all cases the titres had declined by day 84. Swiss albino mouse can thus serve as a useful animal model to study different aspects of type-specific anti-M immune responses against GAS disease when designing candidate streptococcal vaccines.

Topics: Animals; Antibodies, Bacterial; Antigens, Bacterial; Disease Models, Animal; Enzyme-Linked Immunosorbent Assay; Mice; Nose; Streptococcal Infections; Streptococcus pyogenes

CD4 T cells are important for development of long-term immunity to bacterial infections. Here we describe construction of a group A streptococcus (GAS) strain that expresses the model ovalbumin epitope (OVA) on its surface, and the use of this strain in adoptive transfer experiments to study CD4 T cell response to bacterial infection in nasal-associated lymphoid tissue (NALT), which was previously shown to be a specific target for GAS colonization. The OVA(+) GAS, but not the wild-type strain was shown to activate CD4 T cells in an antigen-specific manner both in vitro and in vivo. After intranasal infection of mice with this strain, OVA-specific CD4 T cells were first activated in NALT, which is functionally equivalent to human tonsils, rather than in the cervical lymph nodes. During localized infection, OVA(+) GAS induced rapid and prolonged activation of CD4 T cells at higher magnitudes in the NALT than in draining lymph nodes and spleen, where CD4 T cells underwent little or no activation. In contrast, systemic infection induced significantly higher activation of CD4 T cells in both lymph nodes and spleens, compared to when the infection was localized in NALT. Further investigation of cellular immune responses in NALT during GAS infection using adoptive T cell transfer, combined with the model antigen on the pathogen may ultimately shed light on mechanisms for failure of children to develop protective immune responses following streptococcal tonsillitis.

Topics: Adoptive Transfer; Animals; Antigens, Bacterial; Bacterial Outer Membrane Proteins; Carrier Proteins; CD4-Positive T-Lymphocytes; Disease Models, Animal; Flow Cytometry; Lymphocyte Activation; Lymphoid Tissue; Mice; Nose; Ovalbumin; Polymerase Chain Reaction; Recombinant Fusion Proteins; Streptococcal Infections; Streptococcus pyogenes

Topics: Anal Canal; Animals; Balanitis; Child; Child, Preschool; Dermatitis; Female; Humans; Male; Nose; Streptococcal Infections; Streptococcus pyogenes; Vaginitis

EPIDEMIC: Following the notification of an unusual number of scarlet fever cases within the same primary school, the epidemiological and clinical features of the outbreak were investigated. Questionnaire information about the cases was collected from parents and general practitioners per telephone. Throat specimens were taken, before and after treatment, for culturing and specific typing of streptococci was performed to determine transmission. Within a period of one month, 21 schoolchildren in a class of 29 pupils, with a mean age of 5 years, presented with symptoms caused by streptococcal infection (attack rate: 72%). Eight had scarlet fever, 5 suffered from impetigo and 8 had pharyngitis. A further 6 children, outside of this class, had complaints of scarlet fever, impetigo or pharyngitis. For 90% (26/29) of the schoolchildren a throat culture was established. Twelve positive cultures of the same strain of beta-haemolytic group A streptococcus, T4M4 exotoxin C gene positive, were found. The advice given was to treat all positive children for 3 days with azithromycin to prevent complications and further spreading of the disease. After two weeks only one child, that had not taken the antibiotics, still had a positive throat culture. No further cases or complications were reported.. The pattern of the outbreak was typical of a person-to-person transmission. This was confirmed by typing of the isolates. The results of this study demonstrate the importance of mandatory notification of infectious clusters by institutions, such as schools, as introduced in the new Dutch Infectious Disease Act. On the one hand, the notification gives the municipal health authority the opportunity to analyse source and transmission dynamics and on the other to prevent disease and complications.

Topics: Bacterial Typing Techniques; Carrier State; Child; Child, Preschool; Disease Notification; Disease Outbreaks; Disease Transmission, Infectious; Female; Humans; Impetigo; Incidence; Male; Netherlands; Nose; Pharyngitis; Pharynx; Scarlet Fever; Schools; Streptococcal Infections; Streptococcus pyogenes

Topics: Adolescent; Cefuroxime; Cephalosporins; Facial Injuries; Female; Floxacillin; Fractures, Bone; Humans; Infusions, Intravenous; Nose; Ocular Motility Disorders; Orbit; Penicillins; Streptococcal Infections; Visual Acuity

Group A beta haemolytic Streptococcus has been one of the most serious infections in the burn patients resulting in severe cellulitis and sepsis. Penicillin has been used ever since its introduction as prophylaxis against these conditions. Penicillin prophylaxis was used in our burn unit as well without any serious evaluation until December 1992. This prospective study was therefore, undertaken to evaluate the incidence of beta haemolytic Streptococcus infection in burn patients, and its clinical outcome over a period of 5 years in the absence of prophylaxis with penicillin. 14 of the 1213 burn patients admitted to the Al-Babtain Centre for Plastic Surgery and Burns from January 1993 to December 1997 had either colonization or infection with Streptococcus spp. Their mean age was 15 years (range 1 month to 52 years) and the mean burn surface area was 20% (range 5 to 90%). Streptococci were isolated from burn wounds in 10 patients, throat in 3 and blood culture in 1. Group A Streptococcus was found in 5, group C in 3 and group D in 6 patients. In all patients except one the organisms were isolated > or =72 h post burn. The infections were successfully controlled by antibiotic and no detrimental effect was observed either on wound healing or skin graft take. There was no mortality amongst these 14 patients. The study showed that only 1.1% of the burn patients in our unit acquired Streptococcus of which only one third comprised of group A. This study thus demonstrates that the practice of penicillin prophylaxis during the first five post burn days may not be of any value and therefore, deserves discontinuation in units where the incidence of this organism is minuscule.

Topics: Adult; Age Distribution; Aged; Aged, 80 and over; Burns; Comorbidity; Data Collection; Female; Humans; Incidence; Infant; Infant, Newborn; Injury Severity Score; Kuwait; Male; Middle Aged; Nose; Pharynx; Prospective Studies; Risk Factors; Sex Distribution; Streptococcal Infections; Streptococcus pyogenes; Survival Rate

Nasal septal abscess is a rare complication of septal haematoma. Nasal obstruction and, less frequently, pain are the usual presenting features. We report a case of a nasal septal abscess in a 21-year-old female patient who developed a naso-oral fistula. To our knowledge this is the first report of such an unusual presentation of a septal abscess. The aetiology, pathogenesis and management of septal abscesses are discussed.

Topics: Abscess; Adult; Female; Fistula; Humans; Nasal Septum; Nose; Nose Diseases; Oral Fistula; Streptococcal Infections; Wounds, Nonpenetrating

Seventy-six patients with oroantral communications after tooth extraction and chronic maxillary sinusitis were treated as follows: bacterial cultures were taken in all of them and maxillary sinuses were irrigated with an antibiotic from the cephalosporin group. Then, in 36 patients, drainage using the Caldwell Luc procedure was performed, including a naso-antral window. In all patients operations were completed by closing oroantral communications with flaps of the mucosa of the alveolar process close to the fistula. Antibiotics according to antibiogram were administered to all patients at least 10 days after surgery. Retrospective comparison between the results obtained in the first group and those in the second group 1, 3 and 6 months after operation was based on objective findings (condition of the oroantral communication, maxillary sinusitis), side effects (pain, numbness of the operated area, headache) and control radiographs (clear maxillary sinus or with mucosal thickening). The study suggests that transnasal drainage is not required in maxillary sinus surgery and in the closure of oroantral communications. Equally good results are achieved by treating with antibiotics and without drainage of the maxillary sinus into the nose.

Topics: Cephalosporins; Chronic Disease; Drainage; Follow-Up Studies; Headache; Humans; Maxillary Sinus; Maxillary Sinusitis; Mouth Mucosa; Nose; Oroantral Fistula; Pain, Postoperative; Radiography; Recurrence; Retrospective Studies; Sensation Disorders; Staphylococcal Infections; Streptococcal Infections; Surgical Flaps; Therapeutic Irrigation; Tooth Extraction

The intrafamilial spread and recurrence of group A beta-haemolytic streptococci (GAS) infections was investigated. The evaluation was based on 114 patients and their families treated with penicillin for 5 days and followed for 1 month. GAS of the same T-type as that of the isolate from the index case were found in other family members in 33% of the families. Genetic finger-printing using RFLP was performed on 33 of the isolates. The mothers dominated among the index cases, 40 patients experienced recurrences, 27 of them were clinical 28 recurrences occurred within 10 days after the end of treatment. Of 20 T-typed patients with early clinical treatment failures, infected family members were detected in 16 families (p < 0.001). In 19% of the patients GAS could be isolated from the nose. These patients had more ill family members than did other patients. An extensive intrafamilial streptococcal spread was found. Most recurrences of GAS pharyngotonsillitis after penicillin treatment are probably due to "ping pong" infection from family members.

Topics: Adolescent; Adult; Bacterial Typing Techniques; Child; Child, Preschool; Disease Transmission, Infectious; Family Health; Female; Humans; Infant; Infectious Disease Transmission, Vertical; Male; Nose; Penicillins; Pharynx; Polymorphism, Restriction Fragment Length; Recurrence; Respiratory Tract Infections; Streptococcal Infections; Streptococcus pyogenes; Treatment Failure

Beta Haemolytic Streptococci(BHS) carriage rate in pregnant women during labour and its acquisition by their newborns just after birth was investigated in 60 mother baby pairs. The carriage rate of group B Streptococci (GBS) was 11.6%, acquisition rate by newborns of carrier and non-carrier mothers was 85.7% and 1.8% respectively. A total of 28.5% newborns were carrying GBS on all the skin sites and were heavily colonized and therefore, at higher risk of developing early onset of Streptococcal infections. Penicillin G and Ampicillin were most effective antibiotics against GBS.

Topics: Ampicillin; Carrier State; Female; Humans; Infant, Newborn; Nose; Penicillin G; Pharynx; Pregnancy; Skin; Streptococcal Infections; Streptococcus; Umbilicus; Vagina

The value of pernasal swabs and direct adenoid swabs in chronic adenoid and adenotonsillar disease was assessed in 175 patients. Prior to adenoidectomy (53 patients) or adenotonsillectomy (122 patients), pernasal and direct adenoid swabs were taken. Adenoid currettings and tonsil tissue were cultured. Haemophilus influenzae was the bacterium most frequently isolated from adenoid currettings and from the centre (core) of the resected tonsil. There was a close relationship between the bacteriology of the pernasal swab and the adenoid tissue and tonsil core in 72 and 71% of patients, respectively. There was an identical profile of pathogens in 52 and 49%, respectively. We suggest that in children with adenoiditis or adenotonsillitis and hypertrophy of the adenoid, a pernasal swab should be used in preference to a throat swab in selecting appropriate antimicrobial therapy. Penicillin and ampicillin are not appropriate blind therapy in chronic adenoid and adenotonsillar infections because of the prevalence of beta-lactamase-producing aerobes (40%) in adenoid and tonsil core in these conditions.

Topics: Adenoidectomy; Adenoids; Adolescent; Ampicillin; Bacteriological Techniques; beta-Lactamases; Child; Child, Preschool; Chronic Disease; Contraindications; Culture Techniques; Female; Haemophilus Infections; Haemophilus influenzae; Humans; Hypertrophy; Male; Nose; Palatine Tonsil; Penicillins; Pharynx; Pneumococcal Infections; Staphylococcal Infections; Staphylococcus aureus; Streptococcal Infections; Tonsillectomy; Tonsillitis

Topics: Adolescent; Child; Child, Preschool; Drug Resistance, Microbial; Humans; Infant; Nose; Romania; Streptococcal Infections; Streptococcus pneumoniae; United Kingdom

A total of 354 (8%) out of 4395 primary school pupils located in seven Lagos primary schools were positive for beta-haemolytic streptococci (BHS). Eighty-three (23%), 99 (28%) and 113 (32%) of the respiratory tract isolates and 25 (53%), 14 (30%) and seven (15%) of the skin-lesion isolates were identified as belonging to Lancefield groups A, C and G respectively. Prevalence rate of BHS in a rural school was different from that in urban schools.

Topics: Carrier State; Child; Humans; Nigeria; Nose; Pharynx; Prevalence; Skin Diseases, Infectious; Streptococcal Infections; Streptococcus; Urban Population

Chorioamnionitis is a frequent cause of premature labour and delivery, as well as of maternal and neonatal mortality. Group B streptococcus (GBS) has emerged over the past decade as a common pathogen in the etiology of neonatal sepsis. The case of chorioamnionitis reported here is unusual for three reasons: the premature labour was associated with intact membrane and amniotic fluid infected with GBS; all 5 infants were contaminated with GBS and all infants survived. Chorioamniotitis with intact membranes raises some questions regarding the antepartum use of steroids (potent anti-inflammatory agents), etc. The likelihood of chorioamnionitis in spite of cervical mucus, intact membranes, and the bacteriostatic activity of the amniotic fluid should alert the obstetrician to take special precautions, such as weekly vaginal cultures and appropriate vaginal antimicrobial treatment, in cases of imminent premature delivery.

Topics: Adult; Amniotic Fluid; Blood; Chorion; Conjunctiva; Delivery, Obstetric; Ear Canal; Female; Humans; Infant, Newborn; Inflammation; Male; Nose; Obstetric Labor, Premature; Pharynx; Pregnancy; Pregnancy Complications, Infectious; Quintuplets; Streptococcal Infections; Streptococcus agalactiae; Umbilical Cord

Production of hyaluronidase by 147 strains of beta hemolytic streptococci was studied employing a sensitive dye-binding assay and levels of enzyme activity were evaluated statistically. The analysis of variance showed that group A strains isolated in Rio de Janeiro produced significantly smaller amounts of enzyme than group A strains from a Minneapolis (USA) collection or than groups B and G brazilian isolates. The t test revealed that M not typable nose/throat group A strains produced more hyaluronidase than skin isolates. The analysis of variance did not show a significant difference in the enzyme production between M typable and not typable brazilian strains of group A streptococci. High enzyme--producing strains were not restricted to a few serotypes of group B streptococci.

Topics: Analysis of Variance; Humans; Hyaluronoglucosaminidase; Nose; Pharynx; Skin; Species Specificity; Spectrophotometry; Streptococcal Infections; Streptococcus; Streptococcus agalactiae; Streptococcus pyogenes

A patient is described with an orbital fistula complicating frontal sinusitis and osteomyelitis of the frontal bone. The fistula was excised, but a fortnight later an acute exacerbation occurred. From the discharging pus a Staphylococcus aureus was cultured and from mucosa obtained during surgery a microaerophilic Streptococcus. These findings led to the diagnosis: synergistic bacterial inflammation of the frontal sinus, with osteomyelitis and orbital cellulitis.

Topics: Adult; Fistula; Fractures, Bone; Frontal Sinus; Humans; Male; Nose; Orbital Diseases; Osteomyelitis; Radiography; Sinusitis; Skin Diseases; Staphylococcal Infections; Streptococcal Infections

A high incidence of group B streptococcal disease of the newborn in West Berkshire led to a prospective study of the condition. Cultures taken from 1090 babies shortly after birth showed that 65 (6%) were colonised with the streptococcus. Thirty of these babies were assigned to group 1. Bacteriological samples were taken from babies and mothers at birth and at four, eight, and 12 weeks, and also from fathers and siblings. Fifty uncolonised babies and their families were similarly studied and served as controls (group 2). In group 1,28 of the 30 mothers and 14 of the 28 fathers examined were colonised by group B streptococci. In group 2 the streptococci were isolated from three babies, 12 mothers, and 11 out of 45 fathers during follow-up. These findings suggest that group B streptococci are carried predominantly in the lower gastrointestinal and genitourinary tracts. Most families are lightly colonised, but in others maternal colonisation is stable and heavy and the incidence of paternal colonisation high. Results of serotyping suggest that sexual transmission occurs, which may explain the difficulty in eradicating the organism during pregnancy.

Topics: Adult; Anal Canal; Carrier State; Ear; Family; Female; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Male; Nose; Pharynx; Prospective Studies; Streptococcal Infections; Streptococcus agalactiae; Urethra; Vagina

Topics: Adolescent; Adult; Aged; Enterobacteriaceae Infections; Escherichia coli; Female; Humans; Male; Middle Aged; Nose; Paranasal Sinuses; Proteus; Sinusitis; Staphylococcal Infections; Staphylococcus; Streptococcal Infections; Streptococcus pyogenes

Reports of several streptococcal infections among babies after discharge from a maternity department initiated an epidemiologic study. Out of 100 infants in the 3 maternity wards 67% were colonized on the umbilicus with hemolytic streptococci group A. It was assumed that the spread had occurred from infant to infant in connection with the nursing. By means of new and strict hygienic routines, isolation and penicillin treatment of the colonized infants the spread was rapidly brought to an end. A retrospective study among the children delivered up to 6 weeks earlier showed that no less than 64% had had clinical signs of infection of possible streptococcal origin. Infections had also occurred among many family members. The observations emphasize the importance of strict hygienic routines and continuous bacteriologic surveillance in maternity departments, as well as close contact between maternity departments and health centers for children.

Topics: Adult; Bacteriological Techniques; Cross Infection; Disease Outbreaks; Disinfection; Female; Hospital Departments; Humans; Infant, Newborn; Infant, Newborn, Diseases; Nose; Nurseries, Hospital; Obstetrics and Gynecology Department, Hospital; Pharynx; Retrospective Studies; Staphylococcus aureus; Streptococcal Infections; Streptococcus pyogenes; Umbilicus

Streptococcus equisimilis (Lancefield group C), an unusual cause of nosocomial surgical infection, was isolated from two orthopedic postoperative wound infections. Both operations had been performed by the same surgeon within a three-day period. Examination of the surgeon revealed perianal dermatitis from which S. equisimilis was isolated. The organism was also recovered from the surgeon's nose and rectum. The wound infections responded to treatment with penicillin derivatives. The surgeon was successfully treated with topical bacitracin and oral penicillin and vancomycin. This report documents the pathogenicity of the C Streptococcus in postoperative infection and suggests a possible nosocomial source of the organism.

Topics: Adolescent; Anal Canal; Anti-Bacterial Agents; Carrier State; Child, Preschool; Cross Infection; Dermatitis; Female; General Surgery; Humans; Medical Staff, Hospital; Nose; Rectum; Streptococcal Infections; Streptococcus; Surgical Wound Infection

In a population of pregnant women, the prevalence of group-B streptococcal carriage was relatively low. During the 3rd trimester of pregnancy 5-6% of women haboured group-B streptococci and 8-3% were positive at the onset of labour. Some 42% of women who gave positive cultures in labour had given negative cultures during the 3rd trimester and 19% of women who were positive during late pregnancy were culture-negative in labour. The conversion of culture status observed in these women suggests that carriage may be intermittent or that new acquisition of genital-tract streptococci may occur in late pregnancy. The unpredictability of conversion diminishes the reliability of a single culture taken during the 3rd trimester of pregnancy.

Topics: Carrier State; Cervix Uteri; Ear; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Labor, Obstetric; Nose; Pregnancy; Pregnancy Complications, Infectious; Pregnancy Trimester, Third; Serotyping; Streptococcal Infections; Streptococcus agalactiae; Umbilicus; Vagina

Serial observations including cultures of the upper respiratory tract and of infected skin lesions and streptococcal antibody determinations were made over a two-year period in a semi-closed population of children between 10 months and 15 years of age. There was a high prevalence of group A streptococci in nose and throat cultures and of skin lesions containing these organisms. Almost 90% of the study population developed streptococcal impetigo during the study period. A slightly higher proportion of males than females developed skin infection but there was no relationship to age. Impetigo was observed throughout the calendar year, exceeding 12% of child-visits in one winter month, but was generally more common in the summer and fall. Conversely, group A streptococci were more often isolated from nose and throat cultures in the winter months. The increase in recovery of streptococci from nose and throat cultures lagged behind the increase in streptococcal impetigo and continued into the winter months, when the prevalence of impetigo had declined. Calculation of ratios for individual streptococcal serotypes isolated from different body sites revealed a clear cut distinction between "respiratory" and "impetigo" serotypes, with respect to both prevalence and acquisition rates. Respiratory serotypes were more commonly isolated in the winter and impetigo serotypes in the summer and fall. Significant antibody responses to extracellular antigens of the streptococcus were documented for pharyngeal acquisitions of both impetigo and respiratory serotypes and for skin lesions associated with impetigo serotypes. Group A streptococcal serotypes may be divided into three categories on the basis of their human pathogenicity for body sites: some with the potential for respiratory infection, others with the potential for skin infection and a few unusual serotypes with the potential for infecting both sites.

Topics: Age Factors; Antibodies, Bacterial; Child; Child, Preschool; Female; Humans; Impetigo; Indians, North American; Male; Minnesota; Nose; Pharynx; Respiratory Tract Infections; Seasons; Serotyping; Sex Factors; Streptococcal Infections; Streptococcus pyogenes

The mechanisms by which Streptococcus pneumoniae spreads from person to person are poorly understood. In this study, optimal methods for sampling, isolation, and identification of S. pneumoniae from healthy carriers were investigated. Factors influencing carriage rates were analyzed. Findings included the importance of pharyngeal rather than of nasal sampling in adults, the greater sensitivity of mouse inoculation compared with direct streaking of blood agar plates, and the superiority of the Quellung reaction with omniserum over the optochin disk as a means of identification of S. pneumoniae. Carriage rates were highest in children of preschool (35%) or grammar school (29%) age and in adults with preschool children in the family (18%). Rates were lowest in adults without preschool children in the family (2%-9%).

Topics: Adolescent; Adult; Age Factors; Animals; Bacteriological Techniques; Carrier State; Child; Child, Preschool; Humans; Mice; Nose; Pharynx; Population Surveillance; Streptococcal Infections; Streptococcus; Time Factors

An outbreak of streptococcal and staphylococcal skin disease was discovered in a full-term nursery after the discontinuation of bathing infants with hexachlorophene. The epidemic was only temporarily controlled by conventional means and recurred despite reinstitution of hexachlorophene bathing. Measures that decreased infants' exposure to visitors and hospital personnel and enforced aseptic techniques in the nursery were more important than use of hexachlorophene soap in achieving and maintaining control.

Topics: Anti-Bacterial Agents; Antisepsis; Cross Infection; Disease Outbreaks; Hexachlorophene; Humans; Infant, Newborn; Infant, Newborn, Diseases; North Carolina; Nose; Nurseries, Hospital; Recurrence; Skin Diseases; Staphylococcal Infections; Streptococcal Infections; Umbilical Cord

To determine the source of pyococci causing attacks of sepsis in infantile eczema 20 patients with continuing eczema were followed up for one year, regular swabs being taken from the skin, nose, throat, and family contacts. The staphylococci were phage typed and the streptococci serologically typed. Staphylococci of the same phage type in most cases remained in reservoir sites on the skin and coincidently in the nose. Staphylococci causing attacks of clinical sepsis arose from these persistently colonized sites. Staphylococci of the same phage type were also common in family contacts. Streptococci of the same group in most cases did not remain on the skin. Streptococci causing attacks of clinical sepsis arose as new infections from external sources, sometimes from throat infections in the patient or family contacts. Strains of streptococci which are known to be associated with glomerulonephritis were isolated. It has been confirmed that staphylococci resistant to neomycin and sodium fusidate quickly emerge after the topical use of these antibiotics. Streptococci are highly resistant to neomycin and gentamicin, and moderately resistant to sodium fusidate, so the use of these antibiotics in topical steroid preparations will have little effect in preventing further attacks of clinical sepsis in these patients.

Topics: Adolescent; Child; Child, Preschool; Dermatitis, Atopic; Disease Reservoirs; Drug Resistance, Microbial; Follow-Up Studies; Fusidic Acid; Gentamicins; Humans; Infant; Neomycin; Nose; Pharynx; Skin; Staphylococcal Infections; Streptococcal Infections

Fibrinous pericarditis, fibrinous pleuritis and pneumonia associated with Streptococcus zooepidemicus were observed in two lambs in a small flock of sheep. These lesions were reproduced in lambs inoculated intratracheally with Streptococcus zooepidemicus. Clinical signs included pyrexia, serous to mucopurulent nasal discharge, dyspnea and depression followed by death in six to seven days. Histologically the tissue changes were characterized by an acute inflammatory response involving bronchioles and alveoli, fibrinous pleuritis and fibrinous pericarditis.

Topics: Animals; Body Temperature; Culture Media; Female; Leukocyte Count; Lung; Lymph Nodes; Myocardium; Nose; Pharynx; Pleura; Sheep; Sheep Diseases; Streptococcal Infections; Streptococcus; Trachea

The prevalence of tetracycline-resistant beta-haemolytic streptococci in South-west Essex has been recorded over the past 10 years. It has fallen from a peak of 35% in 1965 to a level of 9.2% in 1972. Ear infections no longer provide the highest incidence of these organisms; vaginal, perineal, and skin infections now seem to be of greater relative importance but throat swabs still provide the greatest actual number of isolations. Erythromycin-resistant strains are still rare.

Topics: Drug Resistance, Microbial; Ear; Ear Diseases; England; Erythromycin; Female; Humans; Nose; Paranasal Sinuses; Perineum; Pharynx; Skin Diseases; Sputum; Streptococcal Infections; Streptococcus pyogenes; Tetracycline; Vaginal Diseases; Vulva; Wounds and Injuries

Topics: Abscess; Administration, Intranasal; Administration, Oral; Animals; Culture Media; Fluorescent Antibody Technique; Lymphadenitis; Nose; Palatine Tonsil; Streptococcal Infections; Streptococcus; Swine; Swine Diseases; Time Factors

Topics: Anesthesia, Inhalation; Bacteriological Techniques; Child; Child, Preschool; Epiglottis; Haemophilus; Haemophilus influenzae; Humans; Intubation, Intratracheal; Laryngitis; Length of Stay; Nose; Staphylococcal Infections; Streptococcal Infections; Streptococcus pyogenes; Time Factors

Topics: Abscess; Animal Feed; Animals; Carrier State; Germ-Free Life; Lymphadenitis; Nose; Palatine Tonsil; Soil Microbiology; Streptococcal Infections; Streptococcus; Swine; Swine Diseases

Coxsackievirus B(4) was isolated from the throat, nose, blood, stools and urine of a 9-year-old boy with acute glomerulonephritis and a pneumonitis. Neutralization test showed a greater than fourfold rise in the antibody titre to coxsackievirus B(4). The antistreptolysin O titre was elevated, but the complement component was within the normal range. The importance of the coxsackievirus B(4) in the pathogenesis of acute glomerulonephritis is clearly indicated; however, further investigations are needed to understand the details of the virus-kidney interaction.

Topics: Acute Disease; Antistreptolysin; Blood; Child; Complement System Proteins; Coxsackievirus Infections; Enterovirus; Feces; Glomerulonephritis; Humans; Male; Neutralization Tests; Nose; Pharynx; Pneumonia; Streptococcal Infections; Urine

Topics: Adolescent; Age Factors; Antistreptolysin; Carrier State; Child; Child, Preschool; Female; Humans; Infant; Male; Nose; Palatine Tonsil; Pharynx; Rheumatic Fever; Streptococcal Infections; Streptococcus; Tonsillectomy

Topics: Acute Disease; Antibodies; Bacteriological Techniques; Blood Sedimentation; Carrier State; Child; Female; Fluorescent Antibody Technique; Humans; Leukocyte Count; Male; Nose; Penicillin G Benzathine; Pharyngitis; Pharynx; Respiratory Tract Infections; Rheumatic Fever; Species Specificity; Streptococcal Infections; Streptococcus; Tonsillitis

Topics: Adolescent; Adult; Chronic Disease; Female; Humans; Male; Middle Aged; Nose; Palatine Tonsil; Rhinitis, Allergic, Seasonal; Staphylococcal Infections; Staphylococcus; Streptococcal Infections; Streptococcus; Tonsillectomy; Tonsillitis

Topics: Adolescent; Age Factors; Antibodies; Carrier State; Child; Child, Preschool; Diagnosis, Differential; Female; Humans; Infant; Infant, Newborn; Lymphadenitis; Male; Nose; Pharyngitis; Pharynx; Rheumatic Fever; Rhinitis; Species Specificity; Streptococcal Infections; Streptococcus

Topics: Animals; Body Temperature; Feces; Hematocrit; Leukocyte Count; Leukocytosis; Lymphadenitis; Nose; Peritonsillar Abscess; Streptococcal Infections; Streptococcus; Swine; Swine Diseases; Time Factors

Topics: Antistreptolysin; Bacteriological Techniques; Carrier State; Child; Humans; Hyaluronoglucosaminidase; Nose; Palatine Tonsil; Paranasal Sinuses; Pharynx; Respiratory System; Respiratory Tract Infections; Streptococcal Infections; Streptococcus

Topics: Air Microbiology; Carrier State; Chloramphenicol; Cross Infection; Dust; Germany, East; Hand; Humans; Nose; Penicillin Resistance; Penicillins; Pharynx; Staphylococcal Infections; Staphylococcus; Sterilization; Streptococcal Infections; Streptococcus; Streptomycin; Surgical Wound Infection; Tetracycline

The primary body site of acquisition of group A streptococci was examined prospectively in a population with endemic streptococcal pyoderma. Weekly cultures were obtained during the skin infection season from apparently normal upper respiratory and cutaneous sites (and from skin lesions when present) in 44 children and adults living on the Red Lake Indian Reservation.During the 9-week period of the study 705 of a total of 2305 cultures were positive for group A streptococci. The percentage of positive cultures from the various sites were: throat (20%); nose (24%); wrist (32%); ankle (35%); back (22%); and skin lesions (81%). Group A streptococci were also isolated from fingernail dirt, clothing and bedding as well as from a few household pets and insects.Analysis of serial cultures obtained from the same individuals at weekly intervals suggested that the strains isolated from skin lesions first appeared on normal skin in the 2 weeks preceding the lesion. Spread to the nose and throat followed skin acquisition and/or skin lesions.The high prevalence of group A streptococci on normal skin in the absence as well as the presence of pyoderma, and their appearance on normal skin before recovery from either skin lesions or the upper respiratory tract are consistent with the view that skin acquisition was a primary predisposing factor to pyoderma. Since the literature indicates that group A streptococci are rarely part of the normal skin flora, these findings raise the possibility of unique biological properties of these and perhaps other pyoderma strains, as distinct from other group A streptococci.

Topics: Adolescent; Agglutination Tests; Child; Child, Preschool; Female; Humans; Male; Nose; Pharynx; Precipitin Tests; Prospective Studies; Pyoderma; Skin; Streptococcal Infections; Streptococcus

Topics: Abscess; Animals; Bacteriophage Typing; Corynebacterium; Germ-Free Life; Lymphadenitis; Mouth; Nose; Serotyping; Streptococcal Infections; Streptococcus; Swine; Swine Diseases

Topics: Aerosols; Animals; Female; Injections; Injections, Intraperitoneal; Injections, Intravenous; Male; Mice; Nose; Pneumococcal Infections; Pseudomonas aeruginosa; Pseudomonas Infections; Spleen; Splenectomy; Staphylococcal Infections; Streptococcal Infections; Streptococcus pneumoniae

Topics: Anti-Bacterial Agents; Bacteriological Techniques; Drug Resistance, Microbial; Humans; Nose; Otitis; Pharynx; Respiratory Tract Infections; Streptococcal Infections

Topics: Asthma; Child; Humans; Infant; Nose; Staphylococcal Infections; Streptococcal Infections

Topics: Bacteriological Techniques; Carrier State; Child; Epidemiology; Family; Humans; Nose; Pharynx; Respiratory Tract Infections; Streptococcal Infections; Streptococcus

Topics: Carrier State; Corynebacterium diphtheriae; Escherichia coli; Mycobacterium tuberculosis; Neisseria meningitidis; Nose; Pharynx; Respiratory Tract Infections; Staphylococcal Infections; Streptococcal Infections

Topics: Adolescent; Carrier State; Child; Environment; Humans; Italy; Nose; Schools; Social Conditions; Streptococcal Infections; Streptococcus

Topics: Disease; Humans; Nasal Cavity; Nose; Nose Diseases; Penicillins; Pharyngeal Diseases; Pharyngitis; Pharynx; Streptococcal Infections

Topics: Humans; Nose; Pharynx; Streptococcal Infections; Streptococcus

Topics: Carrier State; Humans; Neck; Nose; Pharynx; Streptococcal Infections; Streptococcus

Topics: Bacteriology; Carrier State; Humans; Nose; Streptococcal Infections; Streptococcus

Topics: Cartilage; Humans; Nasal Septum; Nose; Sepsis; Streptococcal Infections; Streptococcus; Wounds and Injuries

Topics: Carrier State; Humans; Nose; Streptococcal Infections; Streptococcus