In order to investigate the statistical relation between numbers of patients with streptococcal infectious disease and meterological data in Yamagata, Miyagi, Osaka, Kumamoto and Ehime Prefectures, we carried out a multiple regression analysis on numbers (dependent variable) of the patients per hospital and per week and meteorological data (independent variables) of mean temperature (°C), max. temperature (°C), min. temperature (°C), relative humidity (%), mean vapor presure (mb), wind speed (m/sec), no. of hours with sunshine (h), total radiation on a horizontal surface (MJ/m²) and precipitaion (mm) per a week during the period from January in 1982 through October in 1986 in the above districts, respectively. Namely, weekly data from the 1st week to the 52nd week of a year, that were averaged by no. of years of above period, respectively, were used in the analysis. Meteorological data were also analyzed after numerical or logarithmical transformations. The personal computers of Canon types CX-1 and AS-300 and their programs for the analysis were used in the studies.
As the result of the analysis, five multiple regression equations with multiple correlation coefficients of 0.564-0.802 and proportions of 0.318-0.644 were obtained. Common meterological valiables selected in these equations were 1. temperature, 2. relative humidity or mean vapor pressure and 3. no. of hours with sunshine or total radiation on a horizontal surface, but these variable tended to be partially different from each other in the equations from six districts including Akita. It was also supposed that temperature and then mean vapor pressure might give some severer effects than other variables to the outbreak of streptococcal infectious disease, because standard partial regression coefficients of these two variables were large values.

View full abstract

In order to investigate the meteorological effects on changes of outbreak of streptococcal infectious disease in Akita, Yamagata, Miyagi, Osaka, Kumamoto and Ehime by period, no. of patients with streptococcal infectious disease and meteorological data per ten days or a week in the 3rd report of Akita and the 4th report of Yamagata, Miyagi, Osaka, Kumamoto and Ehime were divided into two periods from April to August and from September to March or from the 16th week to the 34th week and from the 35th week to the 15th week of a year, and then they were analyzed by multiple regression analysis using the personal computers of Canon types CX-1 and AS-300.
Twelve multiple regression equations with multiple correlation coefficients of 0.669-0.978 and proportions of 0.448-0.956 were obtained by the analysis in six districts and two periods. Although 1. temperature, 2. relative humidity or mean vapor pressure, 3. no. of hours with sunshine or total radiation on a horizontal surface tended to be selected in the equations from the period centering around summer, the equations from the period centering around winter tended to include temperature and total radiation on a horizontal surface. High standard partial regression coefficients revealed a tendency to be observed in temperature, mean vapor pressure, no. of hours with sunshine and total radiation on a horizontal surface of the equations from the summer and in temperature of the equations from the period around winter. Meteorological variables in the equations from six districts and two periods tended to be partially different from each other.

View full abstract

In April 1986, we observed 14 cases of scarlet fever in an institution for mentally retarded children in Sapporo. Throat cultures from 76 children and 67 staff members in this institution for β-hemolytic streptococci were carried out. Those throat cultures took place 4 times for the children, and 3 times for the staff members, in the period from April 30 to August 29. Antibiotics for 7 days were administrated to those who carried β-hemolytic streptococci on each examination. Type T3 strains were detected from 9 out of 14 cases of scarlet fever. Including these patients with scarlet fever the isolation rates of β-hemolytic streptococci on the 1st examination were 52.6% in the children and 24.2% in the staff members. By serotyping type T3 strains were observed in 92.5% and 53.3% respectively. On the final examination the isolation rate of β-hemolytic streptococci fell to 7.9% in the chilren. T-antibody titers to different T-antigens were examined by agglutination method in 14 patients with scarlet fever. At the time of admission, T3 antibody was detectable from 3 out of 9 patients caused by type T3 streptococci. Both positive rates and mean titers of T-antibodies to predominant types (T12, T4, T1) were generally higher than those of T3 antibody. However, the mean titer was highest in T18 antibody. It was suggested that elevation of T antibody titers was later than that of ASO titers.

View full abstract

Three hundred and eighty three strains of streptococci were isolated from both patients and carriers in Chiang Mai, Thailand from 1985 to 1986. The strains were serologically identified by grouping, T-typing and M-typing and tested by Opacity Factor (OF) test. Immunization tests were also carried out with isolated strains.
The results were as follows:
1) Of the isolated strains, 74.9% were determined to be group A streptococci; 15.4% were group G; 6.3% were group C; and 3.4 % were group B. Prevalent T-types of group A streptococci were [14, 49], [3, 13, B3264], and there were 16 NT (non-typeable) strains (5.6%) and 83 (28.9%) T-complex types of strains, whose combinations have not yet been published. These results were quite different from the prevalent groups and types of streptococcus found in Japan.
2) A total of 76 out of 287 strains (26.5%) of group A streptococci were M-typeable with classical M-typing sera available in our laboratory. Specifically, the M-types of strains were M49, M44, M11, Ml and M60.
3) OF test of the isolated strains were undertaken with HC1 extracts, and some of the results did not completely correspond to T-types already confirmed by other investigators.
4) By immunization test, typing sera of T-Thai 15, T-Thai 16, M-Thai 15 and M-Thai 16 could successfully be prepared. Using M-typing sera, including the newly-prepared antisera against the isolated strains, M-typeability of all strains was slightly increased to 31.0%.
5) Many discrepancies were observed between the results of T-typing and M-typing, such as those of the Thai 15 strain, which was finally typed as T-Thai 15, M-Thai 15, but was originally typed as T23, M44. Some of the strains typed as M49 were originally typed as Imp. 19 by T-typing method, and there were many other cases of discrepancy.
From these results, we can see that it is important to pay attention to the appraisal of T-typing results of strains isolated in Asian countries, where streptococcus prevalences have not yet been clearly understood.

View full abstract

An epidemic of the upper respiratory tract infection by group A type 3 streptococcus started to occur among children in Toyama Prefecture from the beginning of 1985. This report deals with the movement, thereafter, of the causative agent, type 3 organisms, in Toyama Prefecture. Streptococcus isolates from clinical specimen in 1986 were serogrouped, those belonging to groups A and B being further serotyped, and the relationship between the serogroups or types and the patterns of antibiotic sensitivity was investigated.
1. Grouping of 461 isolates by both agglutination (antisera produced by Denka Seiken) and gel diffusion (antisera self-produced) revealed that 277 (60.1%) belonged to group A, 132 (28.6%) to group B, 41 (8.9%) to group G, 8 (1.7%) to gorup C and 3 to groups unknown. The ratio of group B strains decreased, while that of groups G and C increased, in comparison to the group distribution of the isolates in the previous year. Similarly to the situation when group B strains were isolated, most of group G strains were isolated from adults or older generations, the mean age of the patients being 58. Approximately one half of the group C strains too, isolated from adults.
2. As to type distributions of group A strains by agglutination (antisera produced by Denka Seiken), the ratio of type 3, which had been dominating in Toyama Prefecture in 1985, decreased in 1986, 64 (23.1%) out of 277 group A isolates belonging to this type. In turn, type 12, which had been the second dominant type among isolates in 1985, became most dominant in 1986. From the data of monthly type distributions, very few type 3 strains were isolated in the latter half of 1986. Thus, the epidemic in Toyama Prefecture by this type, started at the beginning of 1985, seems to have ended in the first half of 1986. Type 12 strains, in turn, were prevailing at the peak season (in relation to streptococcus infection) of 1986, November and December, approximately 60% of the group A isolates during this period belonging to this type. These type 12 organisms possessed type specific M protein by gel diffusion analysis against anti-group A M12 serum (self-produced).
3. With regard to the relationship between serotypes and patterns of antibiotic sensitivity, the ratio of antibiotic resistant strains among type 12 isolates decreased in comparison to that among isolates in 1985, 18 among 73 type 12 isolates in 1986 being resistant to TC, only 1 to CP and none to EM. On the contrary, most of type 3 isolates in 1986, as well as those in 1985, were sensitive to these antibiotics, not to mention penicillin and cephalosporin. Almost all of type 4 isolates in both 1985 and 1986, however, were resistant only to TC.

View full abstract

The throat carrier rates of group A streptococci of school children in Osaka were followed up every two months from September, 1980 to November, 1987. All strains isolated were serologically grouped into A, B, C & G and then typed. The overall detection rates of group A, B, C & G streptococci were 42.2% throughout the present study period.
In the early period of this study, the predominant type was varied every year; i.e. T-12 the first, T-6 and T-B3264 the following. But the epidemic trend was all changed since July, 1983. Group A type T-1 was most dominated successively for over 3 years from July, 1983 to January, 1987. The high carry rate (70-90%) of type T-1 was maintained especially for 13 months since November 1983. The rate of detection for the type T-1 was significantly increased among every school class in November in 1983. The freshmen who entered in April in 1984 were found to have a 85.7% detection rate for type T-1 during only. one month of their school life.

View full abstract

During the 7 years from September, 1980 to November, 1987, epidemiological study on hemolytic streptococci isolated from throat of schoolchildren in Osaka was carried out every two months. Group A streptococcus type T-1 strains were successively the most predominant type for the 3 years and 8 months since July, 1983.
The beginning of these epidemia for type T-1 was the strain isolated from a girl in the third schoolclass on May, 1982. She became a long term carrier (two years) for type T-1 strain after this month. The infection was spread as follows; from her to her classmate, a boy, from him to his sister and from her to her classmate, a boy. Thus, the epidemia was spread throughout classmates, brothers and sisters. The long term carrier were distributed in every class in early 1983. Among those long term carriers, there were eight children who carried type T-1 strains during two years. As a result, the epidemic trend for type T-1 was further extended.
Among the 62 pupils who were followed in every academic year since their entrance into the school, there were 34 or 36 cultures per child. Fourty-four of the 62 subjects had 5 or more group A positive cultures and nineteen had 3 or more type T-1.
Twenty-four pair of brothers and sisters were compared with serotypes of group A. Coincidence of the serotypes among the pair was found in 21 pairs (87.5%). Seventeen of those 21 pairs were typed into type T-1.

View full abstract

Determinations of T-serotype for a total of 157 strains of S. pyogenes (Group A hemolytic streptococci) isolated from clinical specimens (throat swab) of pediatric patients in Fukuoka Prefecture duing one year for 1986 were performed and susceptibilities of 9 antibiotics against 153 strains among them were studied. Strains were classified 10 T-serotypes (T-1, 3, 4, 8, 11, 12, 13, 22, 28, B3264) and the unclassified-type. The most dominant strain was T-12 (57 strains, 36.3%) and following ones were T-4 (32 strains, 20.4%) and T-28 (30 strains, 19.1%). The total of these three strains was 75.8% of all strains and T-3, which tended to increase in recent years, was only 3 strains (1.9%). In susceptibility-tests, no strain was resistant to β-lactams. Resistant strains (MIC≥25μg/ml) to erythromycin (EM), tetracycline (TC) and chloramphenicol (CP) were (2.6%), 51 (33.3%) and 1 strain (0.7%), respectively. As for relationship to T-serotype and antibiotic resistance, multiple resistant strains to EM·TC·CP and TC·Macrolides were each one strain; T-12 and T-28, resepctively. Thirtyone (63.3%) of 49 resistent strains to only TC were T-4.

View full abstract

During the five-year period between 1982 and 1986, 145 strains of group B streptococci isolated from patients with streptococcal infection, mostly neonatal sepsis and meningitis in various districts in Japan were typed by the Lancefield precipitin test. We investigated the relationship between the difference in the source of specimen, and the distribution of serological types.
The results were summarized as follows:
1. The most popular types of 145 group B streptococci were; type III/R (35.2%), type Ia (23.4%), type III (20.7%), and type Ib/c (9.0%). More than half of the predominant type possessed polysaccharide antigen III.
2. Forty percentage of the group B strains from the cerebrospinal fluid, 37% were from the blood, and the remaning 15% were from other variated sources. The type distribution of group B was invaiable regardless of the source of the specimen, among the group B, type III/R, type III and type Ia were most frequently detected.
3. The clinical condition of the patients from whom these organisms were isolated included neonatal meningitis and sepsis. Eighty-two percent of the CSF and blood culture from patients with meningitis or sepsis, or complication were type III/R, type III and type Ia, whereas the overall percentage of this type was 62.8%.
4. Out of 46 cases with sepsis and/or meningitis in those with a clear case history of infection, the early onset type were 18 cases, and the late onset type were 28 cases. Sixty-two percent of type Ia were found in the early onset, and 71% of the strains possessing polysaccharide antigen III were detected in the late onset.

View full abstract

In order to prevent the neonatal infection of group B streptococcus (GBS), vaginal cultures and anti-GBS type III antibody in sera were investigated in pregnant women. Antibodies in sera of the cases with GBS infection were also measured.
Vaginal cultures were carried out in 1199 cases. GBS was isolated in 129 cases and the colonization rate was 10.8%. GBS type III was isolated in 18 cases (14.0%), type Ia in 30 (23.3%) and type IIIR in 16 (12.4%).
Antibody levels to GBS type III were detected with the enzyme linked immunosorbent assay (ELISA) in sera of 3548 pregnant women in the first or second trimester. The antibody levels ranged from 0 to 47.8μg/ml and the mean±SD was 4.9±4.4μg/ml.
Antibody levels of GBS type III colonized women were not so high as expected. We experienced 3 cases of GBS type III neonatal systemic infection, and measured antibody levels in the sera of these patients at the onset. These were low and all cases under 10μg/ml.
We suggest that on the full term neonates whose mother's antibody levels are more than 10μg/ml, GBS infections will be preventable.

View full abstract

The 138 strains of viridans streptococci derived from periodontal lesions collected from 19 dental institutions in Osaka during the period from April 1979 to January 1980 were examined. 74 were from alveolar abscess, 12 from periodontitis, 5 from gingival abscess, 4 from osteomyelitis maxillaris, 13 from other oral abscess, 1 from other oral infection, and 28 were unknown oral origine. Species classification was performed according to Facklam's scheme. Strains of S. sanguis II was the highest in order, i.e., 81 (58%) followed by S. mitis with much less figure, 18 (13%). S. sanguis I was the third, i.e., 6 (4.3%). Other species isolated and their numbers were as follows: anginosus constellatus, 4; MG-intermedius, 2; and morbillorium, 1. The rest 26 strains were unclassifiable since their physiological activities were lowest, suggesting partial disruption of the characters.

View full abstract