Infections due to Gram-Positive Cocci

2009 ◽  
Author(s):  
Dennis L. Stevens
Keyword(s):  
Rheumatic Fever ◽  
Antibiotic Treatment ◽  
Acute Rheumatic Fever ◽  
Clinical Manifestations ◽  
Underlying Disease ◽  
Adverse Outcomes ◽  
Group A Streptococci ◽  
Gram Positive ◽  
Group A ◽  
Gram Positive Cocci

The gram-positive cocci that produce infection include pneumococci, group A streptococci, non?group A streptococci (including groups B, C, D, G, and nongroupable streptococci), anaerobic streptococci, enterococci, and staphylococci. This chapter discusses the pathogenesis, diagnosis, and treatment of infections associated with each of these gram-positive cocci, including methicillin-resistant Staphylococcus aureus (MRSA). The clinical infections caused by each of these organisms are reviewed. Tables describe the incidence of pneumococcal disease according to age and underlying disease, factors associated with adverse outcomes in pneumococcal pneumonia; medically important streptococci and enterococci; antibiotic treatment for penicillin-resistant Streptococcus pneumoniae, enterococcal infections, and staphylococcal infections; laboratory tests for streptococcal pharyngitis; clinical manifestations and antibiotic treatment for staphylococcal toxic-shock syndrome (TSS); revised Jones criteria for the diagnosis of acute rheumatic fever, and drug treatment of acute rheumatic fever. This review contains 105 references.

Clinical features and diagnosis of acute rheumatic fever

ESC CardioMed ◽  
2018 ◽  
pp. 1138-1140
Author(s):  
Antoinette Cilliers
Keyword(s):  
High Risk ◽  
Rheumatic Fever ◽  
Acute Rheumatic Fever ◽  
Clinical Signs ◽  
Clinical Manifestations ◽  
Heart Association ◽  
Risk Groups ◽  
Group A ◽  
High Risk Populations ◽  
Minor Criteria

The diagnosis of acute rheumatic fever cannot be made using a single test. The diagnosis requires the recognition of a complex of clinical signs divided into major and minor manifestations as well as laboratory investigations aided by application of the Jones criteria, originally devised in 1944. The clinical manifestations are secondary to the effects of antibodies produced against the group A Streptococcus organism which cross-react against cardiac, skin, synovial, and neurological tissue associated with signs of inflammation. Several adjustments to the Jones criteria have been published over the last 70 years. The latest 2015 American Heart Association modification includes echocardiography/Doppler studies to diagnose subclinical carditis and also incorporates risk stratification whereby at-risk populations are divided into low- and moderate-to-high-risk groups. The presence of a single episode of a fever of at least 38°C and a slight elevation of the erythrocyte sedimentation rate to at least 30 mm/hour are classified as minor criteria in moderate- and high-risk populations. A monoarthritis or polyarthralgia are included as major criteria in the same risk group.

scholarly journals PRODUCTION OF BACTERIOCINES BY GROUP A STREPTOCOCCI WITH SPECIAL REFERENCE TO THE NEPHRITOGENIC TYPES

1966 ◽  
Vol 124 (3) ◽  
pp. 279-291 ◽  
Author(s):  
Ann G. Kuttner
Keyword(s):  
Rheumatic Fever ◽  
Inhibitory Action ◽  
Acute Rheumatic Fever ◽  
Characteristic Property ◽  
Streptococcal Pharyngitis ◽  
Group A Streptococci ◽  
Zones Of Inhibition ◽  
Group A ◽  
The Many ◽  
Living Bacteria

Colicinelike substances, bacteriocines, are produced by many strains of Group A and non-Group A streptococci. Bacteriocines were detected by their inhibitory action on the growth of 2 Group A strains which served as indicators. Streptococcal bacteriocines were demonstrable on agar plates only if the bacteriocine-producing strain and the indicator lawn were alive and actively growing. The inhibitory substances diffused slowly into the agar during the course of growth. Bacteriocines were not replicated in the zones of inhibition in which the microorganisms of the indicator strains were killed. Attempts by various methods to separate bacteriocines from living bacteria were unsuccessful. In contrast to the many strains which produced bacteriocines, only a few strains of Group A streptococci were suitable to serve as indicators for bacteriocine production. Strains of Group A streptococci of the nephritogenic types 12, 4, and 49 produced bacteriocines most consistently. Strains of other types, isolated from patients with acute rheumatic fever or from children with uncomplicated streptococcal pharyngitis, produced bacteriocines infrequently. Among non-Group A streptococci bacteriocine-positive and bacteriocine-negative strains occurred in approximately equal numbers. It was shown by Wilson and by Bernheimer that the majority of the strains of the nephritogenic types were leukotoxic and produced DPNase. Bacteriocine production is another common characteristic property of these special types.

scholarly journals Reactivity of Rheumatic Fever and Scarlet Fever Patients' Sera with Group A Streptococcal M Protein, Cardiac Myosin, and Cardiac Tropomyosin: a Retrospective Study

2000 ◽  
Vol 68 (12) ◽  
pp. 7132-7136 ◽  
Author(s):  
Kevin F. Jones ◽  
Stephen S. Whitehead ◽  
Madeleine W. Cunningham ◽  
Vincent A. Fischetti
Keyword(s):  
Retrospective Study ◽  
Rheumatic Fever ◽  
Scarlet Fever ◽  
Acute Rheumatic Fever ◽  
M Protein ◽  
Group A Streptococci ◽  
Cardiac Myosin ◽  
Streptococcal M Protein ◽  
Group A ◽  
Low Levels

ABSTRACT Archived sera (collected in 1946) from acute rheumatic fever (ARF) and untreated scarlet fever and/or pharyngitis patients were reacted with streptococcal M protein, cardiac myosin, and cardiac tropomyosin. Except for very low levels to tropomyosin, antibodies to other antigens were not elevated in the sera of ARF patients relative to those of non-ARF patients, even though there was roughly equivalent exposure to group A streptococci. This suggests that antibodies to these molecules may not play a central role in the induction of ARF.

scholarly journals The association of starch-accumulating strains of Group A streptococci with acute nephritis and acute rheumatic fever

1959 ◽  
Vol 57 (2) ◽  
pp. 235-247 ◽  
Author(s):  
Nuala Crowley
Keyword(s):  
Rheumatic Fever ◽  
Acute Rheumatic Fever ◽  
Technical Assistance ◽  
Starch Synthesis ◽  
Group A Streptococci ◽  
Cultural Conditions ◽  
Board Of Governors ◽  
Group A ◽  
Common Serotypes ◽  
Synthesis And Degradation

On the basis of starch synthesis and degradation by the strains three subdivisions of Group A streptococci were made. In defined cultural conditions about a third of the strains accumulated starch, the majority belonging to one subgroup. Of patients from whom starch-accumulating strains were isolated at the onset of infection, the observed numbers who developed either acute nephritis or acute rheumatic fever were more than three times the expected numbers. Of eighty-six strains, including forty-six members ofType 12, and forty belonging to several other serotypes, which were associated with either nephritis or rheumatic fever, more than 90% were starch-accumulating strains. Though 47% of allType 12strains accumulated starch, there was a primary association of starch-accumulating strains and the sequelae, irrespective of serotype. On the basis of type-frequency, and the starch synthesizing and degrading activities of the three most common serotypes,Types 1, 4and 12, together with the host factor (for only 25% of patients infected with starch-accumulating strains developed the sequelae) the chances ofType 12incidents are four to one againstTypes 1and 4. The probability of the findings occurring by chance was considerably less than 0·001.Technical assistance was paid for by grants from the Royal Free Hospital Endowment Fund, and I thank the Board of Governors of the Hospital. The drawings were made by Mrs Audrey Besterman, medical artist. For all their help and patience I wish to thank Dr R. E. O. Williams, Dr M. Patricia Jevons, Mr W. R. Maxted, Dr P. J. L. Sequeira, Dr W. J. Whelan and Dr Rebecca Lancefield.

scholarly journals Serological Evidence of Immune Priming by Group A Streptococci in Patients with Acute Rheumatic Fever

2016 ◽  
Vol 7 ◽  
Author(s):  
Jeremy M. Raynes ◽  
Hannah R. C. Frost ◽  
Deborah A. Williamson ◽  
Paul G. Young ◽  
Edward N. Baker ◽  
...  
Keyword(s):  
Rheumatic Fever ◽  
Acute Rheumatic Fever ◽  
Group A Streptococci ◽  
Serological Evidence ◽  
Immune Priming ◽  
Group A

scholarly journals D8/17 and CD19 Expression on Lymphocytes of Patients with Acute Rheumatic Fever and Tourette's Disorder

2004 ◽  
Vol 11 (2) ◽  
pp. 330-336 ◽  
Author(s):  
Julie L. Weisz ◽  
William M. McMahon ◽  
Jill C. Moore ◽  
Nancy H. Augustine ◽  
John F. Bohnsack ◽  
...  
Keyword(s):  
B Cells ◽  
Rheumatic Fever ◽  
Acute Rheumatic Fever ◽  
Neuropsychiatric Disorders ◽  
Streptococcal Pharyngitis ◽  
Tourette’S Disorder ◽  
Compulsive Disorder ◽  
Tourette's Disorder ◽  
Group A ◽  
Normal Controls

ABSTRACT D8/17, an alloantigen found on B lymphocytes, has been reported to be elevated in patients susceptible to rheumatic fever and may be associated with autoimmune types of neuropsychiatric disorders. The pediatric-autoimmune-neuropsychiatric-disorders-associated-with-streptococci model is a putative model of pathogenesis for a group of children whose symptoms of obsessive-compulsive disorder and Tourette's disorder (TD) are abrupt and may be triggered by an infection with group A streptococci. As a test of this model, we have examined D8/17 levels on the B cells of patients with TD and acute rheumatic fever (ARF) along with those on the B cells of normal controls by flow cytometry. We have utilized several different preparations of D8/17 antibody along with a variety of secondary antibodies but have been unable to show an association with an elevated percentage of D8/17-positive, CD19-positive B cells in either ARF or TD. We did find, however, that the percentages of CD19-positive B cells in ARF and TD patients were significantly elevated compared to those in normal controls. Group A streptococcal pharyngitis patients also had an elevated percentage of CD19 B cells, however. These studies failed to confirm the utility of determining the percentage of B cells expressing the D8/17 alloantigen in ARF patients or our sample of TD patients. In contrast, the percentage of CD19-positive B cells was significantly elevated in ARF and TD patients, as well as group A streptococcal pharyngitis patients, suggesting a role for inflammation and/or autoimmunity in the pathogenesis of these disorders.

AN EPIDEMIOLOGICAL INVESTIGATION OF A STREPTOCOCCAL AND RHEUMATIC FEVER EPIDEMIC IN DICKINSON, NORTH DAKOTA

PEDIATRICS ◽  
1962 ◽  
Vol 30 (5) ◽  
pp. 712-719
Author(s):  
Robert A. Zimmerman ◽  
Alan C. Siegel ◽  
C. Patton Steele
Keyword(s):  
Rheumatic Fever ◽  
North Dakota ◽  
School Children ◽  
Epidemiological Studies ◽  
Group A Streptococci ◽  
Clear Cut ◽  
High Prevalence ◽  
Group A ◽  
Initial Survey ◽  
The Military

Data have been presented relating 11 cases of acute rheumatic fever to a high prevalence rate of Group A streptococci in a population of school children in Dickinson, North Dakota. The majority of cases of rheumatic fever did not have a clear cut antecedent streptococcal infection which came to the attention of the examining physicians. Carrier rates for beta-hemolytic streptococci approached 50 to 60% on the initial survey, and rapidly diminished over a 6-week period. Approximately 60% of the Group A streptococci were typeable, and one-third of these were Group A, Type 5. Convalescent antistreptolysin O titers obtained on a group of fifth grade school children, of two schools followed, clinically revealed significantly high titers above any described in previous civilian epidemiological studies but comparable to epidemic strains seen in the military. A virulent Group A, Type 5 streptococcus explosively spread through this community and undoubtedly was responsible for a high attack rate of rheumatic fever. Recommendation for civilian mass prophylaxis on the basis of the data obtained from this epidemic may be made for the first time.

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