SummaryTo initiate an investigation into the biochemistry and mechanism of group B b-hemolytic Streptococcus virulence, bacterial cultures grown in suspension were centrifuged, and the bacteria and media were subjected to extensive fractionation. Each fraction was assayed for physiologic activity by repeated intravenous infusion into adult unanesthetized sheep. Pulmonary artery pressure, arterial P*, and rectal temperature were monitored. The media fraction, but not the bacteria, contained a component (molecular weight, 2 x lo6) composed of 84% carbohydrate and 16% protein with physiblogic~ activity. Two mg quantities, when infused, caused the ~ulmonarv artery pressure to increase 100%. Po2 to decrease by iO% and -chills -i d fever. The active component could be degraded by hot phenol-water extraction into a pure polysaccharide (molecular weight, 200,000). This lower molecular weight polysaccharide retained the identical physiologic properties when infused in the sheep. The degraded component precipitated with group B-specific antiserum.This study demonstrates that, in the sheep, a pure polysaccharide is the physiologically active part of a high-molecular-weight toxin synthesized by group B b-hemolytic Streptococcus type 111 and that this component has a different carbohydrate composition from the group ~-c a~s u l a r antigen.
SpeculationThe clinical syndrome associated with group B /3-hemolytic Streptococci in early onset disease is caused by the interactions of an extracellular bacterial component and a specific target tissue in the infected infant.Group B P-hemolytic Streptococcus has become a major pathogen in newborn nurseries in the United States (19). Two distinct clinical syndromes have been described (1) depending on the age of presentation. The early onset disease, characterized by a shortlived picture and with a mortality rate in some series of over 50% (18,34), has been compared clinically by many investigators (13,20,25) to gram-negative endotoxin shock. Although the clinical and laboratory picture suggests the presence of bacterial products with endotoxin-like properties, such products have so far not been identified.The presence of extracellular toxins has been described for a number of strains of group A hemolytic Streptococci. They have been associated with the erythema of scarlet fever, a pyrogenic response in rabbits, and the enhancement of gram-negative endotoxin shock in mice, monkeys, and rabbits (10,21,38). Several workers have attempted to characterize potentially pathogenic extracellular products produced by group B P-hemolytic Streptococci. Todd, in 1934 (33), described the production of an oxygen stable, non-immunogenic hemolysin; McClean, in 1941 (26), demonstrated that these organisms elaborated a hyaluronidase; Brown et al., in 1974 (6), reported the isolation of the protein's cyclic adenosine 3'5'-monophosphate factor; and Milligan et al. in 1977 (27), described the presence of neuroaminidase (sialidase) in concentrated culture filtrates. The role of these products in the pathoph...