Occurrence of Streptococcus milleri among beta-hemolytic streptococci isolated from clinical specimens

Ruoff, Kathryn L.; Kunz, Lawrence J.; Ferraro, Mary Jane

doi:10.1128/jcm.22.2.149-151.1985

Cited by 38 publications

(18 citation statements)

References 11 publications

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“…Streptococci were included in the study if they were identified as "S. milleri" by the API 20 Strep system supplied with database 4.0 (Biomerieux, Marcy l'Etoile, France). Hemolysis was assessed by observation of the subsurface growth in stabbed sheep blood agar plates (13). Lancefield grouping was performed on all isolates (Streptex; Murex Diagnostics, Dartford, United Kingdom).…”

Section: Methodsmentioning

confidence: 99%

Rapid species identification of "Streptococcus milleri" strains by line blot hybridization: identification of a distinct 16S rRNA population closely related to Streptococcus constellatus

et al. 1996

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A collection of 399 "Streptococcus milleri" strains were identified to the species level by the use of a line blot assay. Their PCR-amplified partial 16S rRNA gene sequences were hybridized with species-specific 5-biotinylated oligonucleotide probes homologous to the bp 213 to 231 regions of the 16S rRNA gene sequences of the type strains Streptococcus anginosus ATCC 33397, Streptococcus constellatus ATCC 27823, and Streptococcus intermedius ATCC 27335. The hybridization results were compared with the reference phenotypic identification method data (R. A. Whiley, H. Fraser, J. M. Hardie, and D. Beighton, J. Clin. Microbiol. 28:1497-1501, 1990). Most strains (357 of 399 [89.5%]) reacted unambiguously with only one probe. However, 42 of the 399 strains (10.5%) reacted with both the S. constellatus-and S. intermedius-specific probes; 41 of them were phenotypically identified as S. constellatus. These dually reactive strains hybridized with a 5-biotinylated probe based on the bp 213 to 231 region of the 16S rRNA gene sequence of one of two species. Analysis of the 5 ends of the 16S rRNA gene sequences (487 bp) demonstrated that the dually reactive strains represent a distinct rRNA population sharing 98.1% sequence similarity with S. constellatus. Phenotypic consistency between the dually reactive strains and the S. constellatus strains was not demonstrated. Line blot hybridization proved to be a simple and inexpensive method to screen large numbers of strains for genetic relatedness, and it allowed the detection of a distinct 16S rRNA type within the "S. milleri" group.

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Section: Methodsmentioning

confidence: 99%

Rapid species identification of "Streptococcus milleri" strains by line blot hybridization: identification of a distinct 16S rRNA population closely related to Streptococcus constellatus

et al. 1996

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“…In a study examining beta-hemolytic streptococci from routine clinical specimens, 75% of the isolates identified as GCBHS were actually S. milleri (21). The clinical isolates of beta-hemolytic S. milleri had the common feature of smallcolony formation and a positive Voges Proskauer reaction (production of acetoin).…”

Section: Discussionmentioning

confidence: 99%

“…None was isolated from blood or other sterile body fluids. No attempt was made to establish the clinical correlation for those bacteriological findings (21).…”

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Report of cases of and taxonomic considerations for large-colony-forming Lancefield group C streptococcal bacteremia

Carmeli

Ruoff

1995

J Clin Microbiol

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Traditionally, group C streptococci include four species: Streptococcus equisimilis, S. zooepidemicus, S. equi, and S. dysgalactiae, the first three of which are group C beta-hemolytic streptococci (GCBHS). However, many of the beta-hemolytic streptococci carrying Lancefield group C antigen isolated from clinical specimens are S. milleri. These organisms can be differentiated by colony size. We retrospectively collected data concerning large-colony-forming GCBHS bacteremia that occurred during a period of 8 years at the Massachusetts General Hospital. A total of 222 cases of beta-hemolytic streptococcal bacteremia were identified; data on the Lancefield grouping were available in 192 cases: 45 cases (23.6%) were group A, 96 cases (50%) were group B, 7 cases (3.6%) were group C (large colony forming), and 44 cases (22.9%) were group G. The medical records for cases of large-colony-forming GCBHS bacteremia were reviewed. In one case, the isolate was thought to be a contaminant; the other six cases are reported (five males and one female; mean age, 55 years). All patients had severe underlying conditions, and none had a history of exposure to animals. The clinical syndromes included two cases of cellulitis and one case each of endocarditis, myocardial infarction complicated by infection, pneumonia, and myofasciitis. The diagnoses for two patients with endovascular infections were delayed. Three of the six patients had fatal outcomes, and other two, after prolonged hospitalization, were transferred to a long-term rehabilitation center. We concluded that the severe outcomes reflect delay in diagnosis and treatment as well as the severity of the underlying diseases. The taxonomy of GCBHS is discussed. More reports differentiating large-and small-colony-forming GCBHS are needed.

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“…These have been the large-colony Lancefield group C Streptococcus dysgalactiae subsp. equisimilis (heretofore referred to as Streptococcus equisimilis) and the small-colony Lancefield group C streptococcus Streptococcus anginosus (6,21,25,33).…”

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Epidemiologic evidence for Lancefield group C beta-hemolytic streptococci as a cause of exudative pharyngitis in college students

et al. 1997

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The isolation rates of strains of group C beta-hemolytic streptococci from throat swab cultures of patients with exudative pharyngitis, the common cold, and healthy controls were compared. By using a cohort study design in a college health service, patients with exudative pharyngitis were retrospectively identified by description of tonsillar exudate on chart review. Patients with rhinoviral infection were prospectively identified during a common cold study. Healthy controls were prospectively recruited from patients presenting with noninfectious conditions. Isolation of Lancefield group A and C beta-hemolytic streptococci from throat cultures was used as an outcome measurement. A total of 265 students (62% female; average age, 20.2 years) with exudative pharyngitis were identified. A total of 75 students (60% female; average age, 21.7 years) from a common cold study with rhinoviral infection were identified. A total of 162 students (53% female; average age, 22.6 years) were recruited as healthy controls. Group A beta-hemolytic streptococci were isolated from 5% of patients with pharyngitis but none of those with rhinovirus (P ‫؍‬ 0.045) and none of the controls (P ‫؍‬ 0.007). Group C Streptococcus dysglactiae subsp. equisimilis was isolated from 11% of patients with pharyngitis but none of those with rhinovirus (P ‫؍‬ 0.006) and 2% of controls (P ‫؍‬ 0.001). Lancefield group C Streptococcus anginosus was isolated from 8% of patients with pharyngitis but 3% of those with rhinovirus (P ‫؍‬ 0.18) and 1% of controls (P ‫؍‬ 0.006). Heavier growth of colonies on the primary culture plate was observed for patients from whom S. equisimilis and group A beta-hemolytic streptococci were isolated. Lancefield group C beta-hemolytic streptococci appear to be associated with exudative pharyngitis in college students.

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Occurrence of Streptococcus milleri among beta-hemolytic streptococci isolated from clinical specimens

Cited by 38 publications

References 11 publications

Rapid species identification of "Streptococcus milleri" strains by line blot hybridization: identification of a distinct 16S rRNA population closely related to Streptococcus constellatus

Rapid species identification of "Streptococcus milleri" strains by line blot hybridization: identification of a distinct 16S rRNA population closely related to Streptococcus constellatus

Report of cases of and taxonomic considerations for large-colony-forming Lancefield group C streptococcal bacteremia

Epidemiologic evidence for Lancefield group C beta-hemolytic streptococci as a cause of exudative pharyngitis in college students

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