Hemolytic Streptococcal Infections Research Articles

HEMOLYTIC STREPTOCOCCIC AND NONSTREPTOCOCCIC DISEASES OF THE RESPIRATORY TRACT

GREAT interest has been aroused in hemolytic streptococcic infection of the respiratory tract during recent years. This has been the result of the demonstration that such infection frequently initiates a complex nonsuppurative process, of which rheumatic fever is the most important and dramatic manifestation. A recent critical study1showed that this disease was invariably preceded by a hemolytic streptococcic infection. In spite of this fact, definitive clinical studies of the nature of streptococcic infection of the respiratory tract are almost nonexistent. The Dicks2and Dochez3established the fact that scarlet fever is caused by hemolytic streptococci and showed that experimental infection in human beings was not always associated with rash formation. An immunologic explanation of this phenomenon was offered. Adequate monographs describing the natural history of scarlet fever are available but deal largely with the disease as observed in children.4 The splendid work of Lancefield5

Immunologic Studies in Rheumatic Fever

Summary The antistreptolysin-patterns of 460 rheumatic children were observed during various phases of rheumatic disease. Nine distinct patterns were observed and described. These patterns seem to bear no distinct relationship to the various phases of the rheumatic process. The “classical” antistreptolysin-pattern was observed in a small group of children who suffered a rheumatic recurrence associated with a streptococcal respiratory infection. In the light of our findings, this could be interpreted only as a modified curve in a rheumatic patient suffering a hemolytic streptococcal infection.

Frequency of Hemolytic Streptococci in the Throats of Well Children in Dallas

THE general observation that hemolytic streptococcus infections become less prevalent as one approaches the tropics is supported by the available scarlet fever morbidity data for various countries as compiled by Schwentker, Janney, and Gordon.1 Even within the United States, the incidence of scarlet fever shows an association with latitude.2 The combined morbidity rate in 1944 for the states of Washington, Wisconsin; and New York was 177 per 100,000 population while that of Louisiana, Alabama, and Florida was 24. The rate for Texas was 58. On the other hand, there is evidence to show that scarlet fever3, 4 and rheumatic fever a mortality is as high in Texas as in some of the northern states. The carrier rate for group A hemolytic streptococci has been found to be related to the incidence of scarlet fever,1 68 rheumatic fever,8' 9 and certain upper respiratory infections.8' 10, 11 Although marked differences in the geographic distribution of hemolytic streptococci have been found in Army installations,8 it is not clear how closely the carrier rate is associated with latitude. In view of these facts it appears that knowledge concerning the incidence of hemolytic streptococci, particularly serological group A, in the throats of well children in the southwestern part of the United States would be a useful addition to the general picture of the distribution of these organisms and their relation to disease.

Biological Conversion of n-Butyl Penicillin into a Chemotherapeutically Active Substance

1. A subcutaneous injection of butyl penicillin conferred marked protection against hemolytic streptococcal infections in the mouse. 2. Subcutaneous injections of 200 mg exerted no appreciable effect on gonococcal infections in 2 men. 3. Following subcutaneous injections of butyl penicillin into the dog, the monkey, and man, appreciable quantities of penicillin were not recovered in the blood or urine. 4. The subcutaneous injection of from 100 to 200 mg of butyl penicillin produced no evidences of marked toxicity in the dog or the monkey. Two men reacted with evidences of moderate toxicity. 5. The tissues of the mouse can convert the chemother-apeutically inactive butyl penicillin into a chemotherapeutically active substance, presumably penicillin. The tissues of man, the monkey, and the dog cannot effect this conversion at an appreciable rate.

SULFADIAZINE AND PENICILLIN FOR HEMOLYTIC STREPTOCOCCUS INFECTIONS OF THE UPPER RESPIRATORY TRACT

ACUTE infections of the upper respiratory tract due to hemolytic streptococci, while constituting an important health problem in a civilian population, become accentuated during the time of war. This applies particularly to groups of military personnel during the early training period. Several reports have recorded attempts to control hemolytic streptococcus infections in military personnel, and the efforts have not been without some success. 1 The use of the sulfonamide compounds in the treatment of streptococcic infections of the upper respiratory tract has resulted in conflicting reports concerning the effectiveness of these drugs. 2 Until the present investigation was initiated and completed, no well controlled studies of penicillin in the therapy of infections of the upper respiratory tract, including scarlet fever, had appeared. Plummer and colleagues 3 have recorded the results of penicillin therapy in 28 cases of acute pharyngitis-tonsillitis due to group A hemolytic streptococci. No Patients with scarlet fever were treated. There

Bacteriological Investigation of Air During an Epidemic of Haemolytic Streptococcal Throat Infection

Bacteriological Investigation of Air During an Epidemic of Haemolytic Streptococcal Throat Infection

PENICILLIN TREATMENT OF SCARLET FEVER

Laboratory1and clinical2studies have shown that penicillin is highly effective against the hemolytic streptococcus. It is more active than sulfonamides in protecting mice against lethal infections with this organism.3There are also a number of reports of hemolytic streptococcic infections which resisted sulfonamide therapy but responded well to penicillin.4Such observations and the lack of toxicity of penicillin have made it the treatment of choice in severe hemolytic streptococcic infections. Direct comparisons of sulfonamide and penicillin therapy in hemolytic streptococcic infections are included in the reports already mentioned. In addition, Plummer and his co-workers5found that hemolytic streptococci could no longer be found in the majority of throat cultures taken from patients with pharyngitis or tonsillitis after forty-eight hours or more of intramuscular treatment with 15,000 units of penicillin every four hours. The organisms frequently reappeared and symptoms relapsed, if the treatment was carried

HEMOLYTIC STREPTOCOCCUS SORE THROAT

Clinicians interested in infectious disease are aware that the exposure of a group of human beings or animals to an infectious agent will be followed by the development of clinical syndromes of varying degrees of severity. It is rarely possible to describe these phenomena in detail in human beings, since artificial inoculation is infrequently performed and since natural infection is usually unsuitable because the size of the infecting dose and the strain of microorganism may be expected to vary from case to case. These difficulties are particularly evident in the study of group A hemolytic streptococcus infections, since many serologic types are known to occur among these organisms. One of us has previously described 1 certain clinical and immunologic aspects of the disease resulting from the simultaneous infection of a large group of men by a single type of hemolytic streptococcus. Clinical observations in that epidemic were incomplete. Recently another

Bacitracin: A New Antibiotic Produced by a Member of the B. subtilis Group

A new antibiotic "bacitracin" has been recovered from a strain of the B. subtilis group of organisms. It is neutral, water-soluble, non-toxic and relatively heat stable. In vitro it is active chiefly against Grampositive organisms, but the gonococcus and meningococcus are susceptible to its action. It is also active in vivo against experimentally produced hemolytic streptococcal infections in mice and gas gangrene infections in guinea pigs. Clinical use in hemolytic streptococcal and staphylococcal infections in man have given encouraging results.

ETIOLOGY AND PATHOGENESIS OF RHEUMATIC FEVER

Rheumatic fever is the cause of much disability and of many deaths resulting from the acute process and from the chronic heart disease which so frequently follows. The investigation of preventive and therapeutic measures for the control of this serious disease has been greatly hampered by the failure of many studies to establish satisfactorily its etiology and pathogenesis. During the past twenty years it has become increasingly apparent that infection by hemolytic streptococci is in some way related to the development of the rheumatic state. The evidence on which this fact has been based has been of an indirect nature and may be summarized as follows: 1. Rheumatic fever has been observed to follow known hemolytic streptococcus infections, particularly of the respiratory tract. In these circumstances it has been noted that the initial acute illness is usually followed by a latent or quiescent period, which terminates in the more or

LOCAL USE OF SULFATHIAZOLE IN MASTOIDECTOMY WOUNDS: SATISFACTORY RESULTS OBSERVED IN THIRTY PATIENTS

While chief resident physician in otolaryngology at the Graduate Hospital of the University of Pennsylvania, I became interested in the local effects of sulfathiazole on chronic mastoiditis. The effectiveness of sulfonamide drugs in the treatment of diseases which formerly had a high mortality rate challenges every physician today to discover more loci where chemotherapy may be applied. According to Kolmer, 1 ... the local or oral administration of sulfanilamide and its derivatives for the prevention of infection is worthy of serious attention and wider application. This is true not only in relation to superficial wounds and burns but with regard to the prevention of puerperal sepsis, gas gangrene, epidemics of sore throat, the extension of hemolytic streptococcic infection to the middle ear and mastoid cells, peritonitis after injury or the rupture of appendical abscesses, infection after accidental pricking of the fingers in the operating or necropsy rooms.... It is the

The Problem of the "Dangerous Carrier" of Hemolytic Streptococci: I. Number of Hemolytic Streptococci Expelled by Carriers with Positive and Negative Nose Cultures

That all carriers** of hemolytic streptococci*** are not equally capable of transmitting infection to others has become increasingly clear during recent years. Leonard Colebrook recognized, in 1933,1 that there were probably dangerous carriers, as well as relatively harmless ones among the general population. Hare,2 too, was impressed by the fact that though the average throat carrier rate for Group A streptococci in the normal population was about 7%, the number of cases of hemolytic streptococcal infection was relatively low. Coburn3'4 also stressed this problem and has suggested that biological changes take place in certain strains of streptococci which render them communicable, as contrasted with ordinary strains which are not readily communicable. During the course of studies in the transmission of hemolytic streptococcal infections over the past 2 years,5,6,7 certai facts have emerged which suggested that the most important difference between one carrier and another may reside in the actual number of hemolytic streptococci the carrier is capable of expelling, rather than in a fundamental biological change produced in the microorganisms by the carrier's tissues. These facts are:

PENICILLIN THERAPY IN HEMOLYTIC STREPTOCOCCIC PHARYNGITIS AND TONSILLITIS

Despite the advances in chemotherapy, the development of an effective treatment of such a relatively common disease as hemolytic streptococcic pharyngitistonsillitis remains an important medical problem. Although the clinical value of the sulfonamides first was demonstrated against the hemolytic streptococcus, 1 subsequent clinical observations have shown that this organism is relatively sulfonamide resistant when compared with the meningococcus, gonococcus and pneumococcus. Furthermore, some observers believe that the clinical courses of uncomplicated streptococcic pharyngitis-tonsillitis and scarlet fever are not alleviated or shortened by sulfonamide therapy, 2 although it is generally accepted that complications occur less frequently in these diseases when the sulfonamides are used 3 and the value of the sulfonamides in the treatment of hemolytic streptococcic otitis media, mastoiditis, meningitis and pneumonia is unquestioned. Since the introduction of penicillin, the superiority of this new drug over the sulfonamides in the serious hemolytic streptococcic infections has been demonstrated 4 but its

THE USE OF PENICILLIN IN RHEUMATIC FEVER

Although the etiology of rheumatic fever is not fully understood, current data indicate that attacks of this disease are generally preceded by infections with group A hemolytic streptococci. The sequence of events is so regular that one is justified in advancing the hypothesis that the streptococcic infection induces rheumatic fever. Whether group A streptococci are the only infectious agents responsible for rheumatic fever or whether they merely activate some other specific micro-organism or virus and possibly act in concert with it to produce the disease has not been determined. The temporal relationship between the hemolytic streptococcic infection and the attack of rheumatic fever is generally not immediate. In fact, the usual sequence of events is streptococcic infection, quiescent period, rheumatic fever. These phases have been designated as I, II and III respectively. It has been shown that if the initiating or inducing streptococcic infection, phase I, is prevented in susceptible

Sulfathiazole-Acetaldehyde Sodium Bisulfite in Experimental Group C Streptococcal Infections

Summary Sulfathiazole-acetaldehyde sodium bisulfite has been found to effect cures of experimental Group C hemolytic streptococcic infections in guinea-pigs, and to destroy streptococci injected into fertile eggs.

Studies on the Transmission of Hemolytic Streptococcus Infections: III. Hemolytic Streptococci in the Air, Floor Dust, and Bedclothing of Hospital Wards and their Relation to Cross Infection

Studies on the Transmission of Hemolytic Streptococcus Infections: III. Hemolytic Streptococci in the Air, Floor Dust, and Bedclothing of Hospital Wards and their Relation to Cross Infection

Studies on the Transmission of Hemolytic Streptococcus Infections: III. Hemolytic Streptococci in the Air, Floor Dust, and Bedclothing of Hospital Wards and their Relation to Cross Infection

Studies on the Transmission of Hemolytic Streptococcus Infections: III. Hemolytic Streptococci in the Air, Floor Dust, and Bedclothing of Hospital Wards and their Relation to Cross Infection

Studies on the Transmission of Hemolytic Streptococcus Infections: I. Cross Infections in Army Hospital Wards

Journal Article Studies on the Transmission of Hemolytic Streptococcus Infections: I. Cross Infections in Army Hospital Wards Get access Morton Hamburger, Jr. Morton Hamburger, Jr. From the Commission on Air-Borne Infections, Board for the Investigation and Control of Influenza and Other Epidemic Diseases in the United States Army, Preventive Medicine Service, Office of the Surgeon General, U. S. Army Search for other works by this author on: Oxford Academic PubMed Google Scholar The Journal of Infectious Diseases, Volume 75, Issue 1, July 1944, Pages 58–70, https://doi.org/10.1093/infdis/75.1.58 Published: 01 July 1944 Article history Received: 24 March 1944 Published: 01 July 1944

Some practical aspects of the rheumatic fever problem which have an important bearing in military medicine

Although the etiology of rheumatic fever is unknown, our knowledge is sufficient to warrant the development of programs of care. The close relationship between epidemic hemolytic streptococcal infections and rheumatic fever is discussed, and it is pointed out that rheumatic fever in a given population follows closely the epidemiology of hemolytic streptococcal infections. This pattern is so convincing that it forms the basis of prevention programs. Prevention programs are discussed, with especial emphasis on the careful study of respiratory infections from a bacteriologic point of view. Culturing, grouping, and typing of such infections offers a key to the streptococcus problem in a given epidemiological unit. The use of sulfonamides prophylactically is discussed. Other preventive measures than chemotherapy are mentioned. The general problem of susceptibility, as well as considerations relative to the disposition of rheumatic fever patients in the Armed Services, are evaluated. Caution against developing an unfavorable psychology in rheumatic fever patients is emphasized. Numerous gaps in·our knowledge are enumerated throughout the report. A plea is made to accept the problem as perhaps the most serious feature of the general hemolytic streptococcal problem, and some measures are discussed which may be helpful in the prevention of rheumatic fever. The authors are cognizant of the fact that, despite the close relationship with hemolytic streptococci, as indicated, there are many unsolved problems relative to the disease. These problems are by no means limited to the hemolytic streptococci association, but represent a wide variety of biologic aspects.

Transmissibility of Haemolytic Streptococcal Infection by Flies

Transmissibility of Haemolytic Streptococcal Infection by Flies