A Bacteriological Study of Streptococci Isolated from the Genito-Urinary Tract

Abstract

100 strains of streptococci isolated from the genito-urinary tract were studied culturally and serologically to determine what type or types predominate in these infections, and whether there is any bacteriological basis for their remarkable resistance to treatment. In identifying these streptococcus strains, tests were limited to those most generally accepted as criteria for true enterococci: Hemolysis; Fermentation Reactions; Hydrolysis of aesculin in the presence of a bile salt; Reduction of Methylene Blue in milk; Heat Resistance; and Sero-logical Grouping. No [beta]-hemolytic streptococci were found in this series. 76 of the strains examined produced no changes on blood agar and were classified as [gamma] streptococci. 70 of these [gamma] strains were true enterococci of the [gamma] Strep. fecalis type; 3 were enterococci of the [gamma] Strep. liquefaciens type; 3 strains differed from the Strep. fecalis type in that they were serologically inert, and 1 of these was distinct in being heat labile. 24 strains were found to be [alpha] streptococci including the 4 types: Strep. mitis, Strep. salivarius, Strep, fecalis, and Strep, equinus. These were clearly differentiated from the [gamma] streptococci and none of them could be classified as enterococci. All of the [alpha] Streptococcus equinus strains were precipitated by the Lancefield Group D serum; 4 of 7 strains of [alpha] Strep, mitis were likewise precipitated by the Group D serum. The remaining [alpha] strains were serologically inert. Enterococci are evidently the predominant group of streptococci recovered from the genito-urinary tract, and therefore may be of pathogenic significance in infections of this nature. Their unusual resistance to treatment and the persistence of the clinical symptoms in infections associated with streptococci would further support this conclusion.