No abstract

There has been a dramatic increase in the number of detected cases of streptococcal TSS over the 14 years since the first case was recognized here. There was a wide range of invasive forms of infection, a high fatality rate even in fit young adults, and a rapid course from onset to death. There was a high association of TSS with aggressive streptococcal infection producing local tissue necrosis.

Streptococcus pyogenes is an uncommon cause of community-acquired pneumonia and there have been few recent specific accounts of the condition. To describe the current nature of this disease in the UK, data was gathered on patients with clinical pneumonia from whom Streptococcus pyogenes was cultured principally from blood or other relevant normally sterile sites. In the Harrogate and Northallerton districts of North Yorkshire, pneumonia accounted for nine (20%) cases and a quarter of all deaths in a complete sequence of 45 patients with Streptococcus pyogenes bacteraemia detected during the 16-year-period 1981-1996. An analysis is presented of those cases together with eight recent cases from counties York, Durham and Isle of Wight during 1995-1997. Of the total 17 cases, nine occurred in women and eight in men; the age range was 30-92 years. The organism was isolated from blood culture in 15 (88%) patients. Eight (47%) patients died, five within 1 day of hospitalisation. Fourteen (82%) cases occurred in the winter months October to March, including all the fatal cases and all eight in which a clinical 'viral' prodrome was observed. Predisposing medical or surgical conditions were present in 65% of the patients. Major complications included septicaemia, pleural reaction, shock, pulmonary cavitation, osteomyelitis and metastatic abscesses. Seven serotypes of Streptococcus pyogenes were encountered, with M-type 1 predominating (the cause in 60% of cases). All infections were community acquired; two small clusters of fatal pneumonia were seen.

No abstract

The nutrition and metabolism of a recently isolated Micrococcus species resistant to closes of gamma radiation as high as 6 × 106 r.e.p. were studied by manometric and radioactive tracer techniques. Methionine, the only amino acid shown to be essential in a chemically defined medium, appears to be rapidly incorporated into the cells. DL-Glutamic acid is readily metabolized, the D isomer apparently after an initial lag. Among the simple carbohydrates, fructose, glucose, and glycerol are readily utilized. The operation of the tricarboxylic acid cycle is suggested by the oxidation of certain TCA intermediates. The prompt conversion of C-1 of gluconate to CO2, in the presence of glucose, may indicate that a C1–C5 cleavage pathway is operative for catabolism of glucose in this organism.