Celulitis por Streptococcus equi: reporte de caso y revisión de la literatura / Streptococcus equi Cellulitis: Case Report and Literature Review

El Streptococcus equi es un coco gram positivo, perteneciente al grupo C de Lancefield, causa una enfermedad de gran relevancia en caballos, la gurma o adenitis equina (1-2); en humanos, estas infecciones son poco frecuentes, siendo más frecuentes las infecciones de piel y tejidos blandos, faringitis, neumonía, síndrome tóxico similar al shock y endocarditis. Cuando la infección está asociada a bacteriemia, la mortalidad reportada es del 25%.(3) Presentamos el caso de un hombre de 44 años que ingresa al servicio de urgencias de la Clínica universidad de la Sabana con un cuadro clínico de celulitis en mano derecha por Streptococcus equi .

Streptococcus equi is a gram-positive cocci, from group C of Lance 􀃀 eld. It causes an important disease in horses, strangles or equine adenitis (1-2). In humans, these infections are rare, and skin and soft tissue infections, pharyngitis, pneumonia, toxic shock-like syndrome and endocarditis are more frequently observed. When the infection is associated with bacteremia, the reported mortality is near 25% (3). We report the case of a 44-year old man who was admitted to the emergency department of the University of Sabana Clinic with cellulitis due to Streptococcus equi in his right hand.

Optimization of flask culture medium and conditions for hyaluronic acid production by a streptococcus equisimilis mutant nc2168

A mutant designated NC2168, which was selected from wild-type Streptococcus equisimilis CVCC55116by ultraviolet ray combined with60Co-γ ray treatment and does not produce streptolysin, was employed to produce hyaluronic acid (HA). In order to increase the output of HA in a flask, the culture medium and conditions for NC2168 were optimized in this study. The influence of culture medium ingredients including carbon sources, nitrogen sources and metal ions on HA production was evaluated using factional factorial design. The mathematical model, which represented the effect of each medium component and their interaction on the yield of HA, was established by the quadratic rotary combination design and response surface method. The model estimated that, a maximal yield of HA could be obtained when the concentrations of yeast extract, peptone, glucose, and MgSO4 were set at 3 g/100 mL, 2 g/100 mL, 0.5 g/100 mL and 0.15 g/100 mL, respectively. Compared with the values obtained by other runs in the experimental design, the optimized medium resulted in a remarkable increase in the output of HA and the maximum of the predicted HA production was 174.76 mg/L. The model developed was accurate and reliable for predicting the production of HA by NC2168.Cultivation conditions were optimized by an orthogonal experimental design and the optimal conditions were as follows: temperature 33ºC, pH 7.8, agitation speed 200 rpm, medium volume 20 mL.

Interpretación clínica de anticuerpos anti-estreptococo en fiebre reumática / Streptococcal antibody test clinical interpretation in rheumatic fever

La Fiebre Reumática es una complicación no supurativa de la infección por Streptocococus pyogenes. Es una enfermedad prevalente con una tasa importante de morbilidad y mortalidad en países en desarrollo. El diagnóstico de Fiebre Reumática tanto en el episodio agudo como en la recurrencia se apoya en criterios clínicos sumado a la evidencia serológica de infección previa por estreptococo beta hemolítico del grupo A. Los anticuerpos anti-estreptococo disponibles comercialmente son los anticuerpos anti-estreptolisina O (ASTO) y los anticuerpos anti- DNAasa B (anti-DNAasa B). Estos deben ser analizados teniendo en cuenta la edad del paciente, el tipo de infección, las comorbilidades asociadas, los títulos de anticuerpos, el tratamiento antibiótico previo y el momento en el cual se toman las muestras para la medición de estos. En este artículo se realiza una revisión de la literatura disponible con el objetivo de determinar la utilidad e interpretación de las pruebas de anti-estreptolisina O y anti-DNAsa B.

Diagnosis of Streptococcus pneumoniae meningitis by polymerase chain reaction amplification of the gene for pneumolysin

Diagnosis of bacterial meningitis has long been based on classical methods of Gram stain, serological tests, and culture of cerebrospinal fluid (CSF). The performance of these methods, especially culture and direct smear, is thwarted by failure to detect bacteria following administration of antimicrobial agents and reluctance to performance lumbar punctures at admission. Indeed, patients with meningitis frequently receive antibiotics orally or by injection before the diagnosis is suspected or established. Thus an alternative method has become necessary to help clinicians and epidemiologists to management and control of bacterial meningitis. We evaluate the application of a polymerase chain reaction-based (PCR) assay for amplification of pneumolysin gene (ply) to diagnosis of Streptococcus pneumoniae meningitis. The PCR assay sensitivity for CSF was 96 percent (95 percent confidence interval, CI, 90-99 percent) compared to a sensitivity of 59 percent for culture (95 percent CI 49-69 percent), 66 percent for Gram stain (95 percent CI 56-74 percent), and 78 percent for latex agglutination test (95 percent CI 69-86 percent); PCR specificity was 100 percent (95 percent CI 83-100 percent). PCR results were available within 4 h of the start of the assay. This molecular approach proved to be reliable and useful to identify this bacterium compared with other classical laboratory methods for identification of bacterial meningitis pathogens.

Novas doenças estreptocócicas de interesse reumatológico. Nossa experiência com a artrite reativa pós-estreptocócica / New streptococcal diseases of interest to rheumatology. Our experience with the arthritis reactivales powder-streptococci

Os autores realizaram uma revisão da clínica das doenças estreptocócicas no tocante ao interesse reumatológico, destacando-se a artrite reativa e outros quadros cutâneos/articulares.

Producción y purificación parcial de la hemolisina principal (Neumolisina) de Streptococcus pneumoniae / Production and partial purification of the main hemolysin (pneumolysin) of Streptococcus pneumoniae

The capacity of 36 Cuban strains of Streptococcus pneumoniae to produce pneumolysin was studied, and 94.4 of them were determined to be producers of that enzyme. One of the best producers was cultured at a great scale and the pneumolysin found in the supernatan was partially purified through an ion-exchange chromatography in mono-Q column. This method made it possible to recover the enzyme whose purity level increased by 4.39 with 100 output.

Detection of antibody isotypes to streptolysin O by dot ELISA

The presence of antibody isotypes (IgG, IgA and IgM) to streptolysin O was determined by dot ELISA in 222 serum samples from patients with different levels of anti-streptolysin O (SLO) antibodies as measured by the neutralizing assay (NA), from patients with diseases not related to nonsuppurative complications of Streptococcus pyogenes infection, and from clinically healthy individuals. Immunoglobulin G antibodies were found in 72 per cent of sera from patients with SLO antibodies higher than 333 Todd units (TU), and IgA antibodies were also detected in 53 per cent, but no IgM antibodies were demonstrable. High copositivity (0.94), conegativity (0.97), and positive (0.96) and negative (0.96) predictive values were observed when IgG and IgA findings were combined. The dot ELISA gave highly reproducible results. The present data suggest that the assay may be of practical value for routine detection of SLO antibodies when employed with an anti-human immunoglobulin light chain peroxidase conjugate.

Síndrome de shock tóxico estreptocócico asociado a faringitis no invasiva / Streptococcal toxic shock syndrome asociated to noinvasive pharyngitis

Se presenta el caso de un síndrome de shock tóxico asociado a faringitis estreptocócica no invasiva en un paciente de 16 años previamente sano. El diagnóstico por aumento del título de anticuerpos frente a la estreptolisina (ASTO) de 6,25 veces el valor basal a los 15 días de haber comenzado el cuadro clínico. El síndrome de shock tóxico fue precedido por síntomas de odinofagia 7 días antes de su aparición. A nuestro entender éste es el tercer caso comunicado de shock tóxico asociado a infección no invasiva por Streptococcus Beta Hemolítico Grupo A. La creciente frecuencia de infecciones severas por este microorganismo que se comunica en Norteamérica parece tener una evolución paralela en nuestro medio y tal vez sea un fenómeno epidemiológico universal

Streptococcus pyogenes: un nuevo desafío / Streptococcus pyogenes: a new challenger

Streptococcus pyogenes es una bacteria conocida desde hace más de un siglo por los médicos. En la última década se ha presentado con un nuevo rostro asociado a cuadros clínicos invasores con una alta mortalidad. En el presente artículo se describe al agente, se clasifican estos cuadros clínicos, se discuten su etiopatogenia, tratamiento y prevención

Estreptococos Beta-hemolíticos e níveis séricos de antiestreptolisina "O" em comunidade rural, Américo Brasiliense SP, 1981 / Beta hemolytic Streptococcus and serum levels of antistreptolysine \"O\" in a rural community, Américo Brasiliense, 1981

Investigou-se a presença de estreptococos beta-hemolíticos e os níveis séricos de antiestreptolisina "O" (ASO) em comunidade rural dividida em duas populaçöes; escolar e familial. O estudo da populaçäo escolar revelou a presença de 61,8% portadores de estreptococos beta-hemolíticos, com predominância do grupo A e do padräo T11/14 seguido do T4 e do T8/25/Imp.19. A dosagem da ASO revelou 64,6% escolares com títulos abaixo de 250UT; 27,7% com títulos entre 250 e 333UT e 17% acima de 500UT. A média encontrada foi de 262UT. A populaçäo familial revelou 47% de portadores de estreptococos com predominância do grupo G. Entre os protadores do grupo A houve predominância do padräo T8/25/Imp.19, seguido do T4 e T11/14. Nesta populaçäo 79,3% tiveram níveis de ASO abaixo de 250UT; 14,6% resultados entre 250 e 333UT e 6,1% de 500UT. A média encontrada foi de 187UT. Nas populaçöes em estudo houve simultaneidade de 60,8% entre grupos sorológicos de estreptococos e 43,2% entre sorotipos do grupo A. Verificou-se uma correlaçäo significativa entre os dados clínicos, respostas afirmativas ao questionário proposto, presença de estreptococos beta-hemolíticos e níveis séricos de ASO acima da anormalidade

Faringite estreptococica em populacao de escolares do Rio de Janeiro. Evidencias de infeccao subclinica. / Streptococcal pharyngitis in a school children population of Rio de Janeiro. Evidences of a subclinical infection

Os autores estudaram uma populacao de 96 escolares quanto a manifestacao clinica de faringite, presenca de estreptococo beta-hemolitico do grupo A, encontrando nesses casos 296UT como media de titulos de AEO contra 192UT de media para os controles (soros colhidos na ocasiao do exame clinico). Em 4 dos 8 casos de individuos sem clinica de faringite e com isolamento de estreptococo beta-hemolitico do grupo A, constataram uma duplicacao no titulo de EAO em um 2o. soro obtido, o que fica consistente com a presenca de infeccao subclinica nesses individuos. Enfatizam a necessidade de uma variacao mais ampla da relevancia das faringites estreptococicas assintomaticas no nosso meio