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Journal of Clinical Microbiology, February 2003, p. 877-879, Vol. 41, No. 2
0095-1137/03/$08.00+0 DOI: 10.1128/JCM.41.2.877-879.2003
Copyright © 2003, American Society for Microbiology. All Rights Reserved.
Novel Observation of Hot-Cold-Hot Hemolysis Exhibited by Group B Streptococci
Norio Okazaki,1 Ro Osawa,2* Rieko Suzuki,1 Takayasu Nikkawa,1 and Robert A. Whiley3
Department of Bacteriology and Pathology, Kanagawa Prefectural Public Health Laboratory, Nakao 1-1-1, Asahi-ku, Yokohama 241-0815,1
Department of Bioscience, Graduate School of Science and Technology, Kobe University, Rokko-dai 1-1, Nada-ku, Kobe 657-8501, Japan,2
Department of Oral Microbiology, St. Bartholomew's and Royal London School of Medicine and Dentistry, London E1 2AD, United Kingdom3
Received 16 September 2002/
Returned for modification 23 October 2002/
Accepted 17 November 2002

ABSTRACT
Six human isolates of group B streptococci (GBS) were cultured
on blood agar anaerobically at 37°C for 18 h and then at
4°C for 6 h and reincubated anaerobically at 37°C for
6 h. Three of the strains showed a marked enlargement of the
hemolysis zone compared with that obtained after hot-only (37°C
for 18 h) or hot-cold (37°C for 18 h and then 4°C for
6 h) treatment. Subsequent broth culture experiments revealed
that enhanced hemolytic activity due to hot-cold-hot treatment
was observed in all 6 GBS strains when cultured in the presence
of starch.

TEXT
Group B
Streptococcus (GBS) is a major etiological agent causing
serious infection in human newborns (
1). The disease symptoms
include pneumonia, sepsis, and meningitis with high mortality,
especially for those born prematurely (
18,
20). GBS is serotyped
into seven types (I to VII) on the basis of the status of the
capsular polysaccharide, with type III GBS being the most prevalent
in isolates from neonatal infections (
6). The majority of GBS
are beta-hemolytic (
4), but it has been suggested that the hemolysin
is not an essential virulence factor in GBS infections (
14).
Nevertheless, continuing research interests are directed toward
a possible link between beta-hemolysin produced by GBS and its
virulence (
5,
11,
13). Although the hemolysin was apparently
cytolytic to a broad range of host cells (
16), its role as a
virulence factor remains obscure. Little is known also about
the molecular properties of the hemolysin due to its instability
(
9). In the course of characterizing beta-hemolysis of GBS isolates,
we have obtained results in which several GBS isolates cultured
at 37°C demonstrated a marked enlargement in the zone of
hemolysis on blood agar after a period of low temperature (0
to 4°C) followed by reincubation at 37°C. This phenomenon
resembled that of hot-cold hemolysis as reported elsewhere for
several toxin- or hemolysin-producing bacterial species such
as
Staphylococcus aureus (
15) and
Clostridium perfringens (
10).
Here we report a novel observation of hot-cold-hot hemolysis
exhibited by GBS.
A total of six GBS strains were used in the present study. These included four isolates from the vaginas of healthy pregnant women, one isolate from the pharynx of a neonate with a GBS infection, and one isolate from the blood of a neonate with a GBS infection (Table 1). The isolates were serotyped by the Lancefield capillary precipitin method described elsewhere (8), and the results are shown in Table 1.
The GBS isolates were incubated in Todd-Hewitt broth (THB)
(Difco
Laboratories, Detroit, Mich.) at 37°C for 18 h, and then
the exponential phase culture was diluted to 1/10 with phosphate-buffered
saline (PBS), pH 7.2. The diluted cultures were then stabbed
by needle into the following plate media: (i) THB with 1.5%
Bacto agar (Difco) and defibrinated 5% sheep blood (THBA); (ii)
THBA with 5% sheep red blood cells that had been washed and
suspended in PBS to the original concentration (RBC); (iii)
RBC supplemented with 5% sheep serum (RBC+serum); and (iv) RBC
with 1% soluble starch (RBC+starch). Triplicate plates of the
above three plate media were incubated and treated as follows:
(i) anaerobic incubation at 37°C (hot-only treatment) using
AnaeroPack (Mitsubishi Gas Chemical Co., Inc., Tokyo, Japan);
(ii) anaerobic incubation at 37° for 18 h and subsequently
at 4°C for 6 h (hot-cold treatment); and (iii) anaerobic
incubation at 37° for 18 h and subsequently at 4°C for
6 h, with reincubation anaerobically at 37°C for 6 h (hot-cold-hot
treatment). At the end of the treatments, the plates were examined
for the presence of hemolysis zones surrounding GBS colonies.
Three strains (KB-6, KB-7, and KB-8) showed a marked enlargement of the hemolysis zone on THBA with the hot-cold-hot treatment compared to that obtained with either hot-only or hot-cold treatment (Fig. 1). Meanwhile, such enlargement of the hemolysis zone was also observed for the same three strains after hot-cold-hot incubation on RBC+serum and RBC+starch but not RBC (Fig. 1). These observations suggest that serum and starch play an important role in activating GBS hemolysin in this process.
The hemolytic activity of GBS hemolysin was subsequently quantified
in a liquid phase. Briefly, an appropriately diluted suspension
(0.1 ml) of overnight culture containing 3.0
x 10
3 cells of
each GBS strain was inoculated into 10 ml of (i) THB, (ii) THB
supplemented with 5% sheep serum (THB+serum), and (iii) THB
with 1% soluble starch (THB+starch). The media were then incubated
anaerobically at 37°C for up to 18 h. A portion of each
culture was collected at 6, 9, 12, 15, and 18 h of incubation
and centrifuged (4°C, 10,000
x g) for 10 min. After centrifugation,
twofold serial dilutions of the cell-free supernatants were
made in PBS or PBS supplemented with 1 mM MgSO
4 and 1 mM CaCl
2.
The serial dilutions of the supernatants were then mixed with
an equal volume of 1% sheep blood cells suspended in PBS. The
mixtures were treated as follows: (i) incubation at 37°C
for 2 h (hot-only treatment); (ii) incubation at 37°C for
1 h and subsequently at 4°C for 6 h (hot-cold treatment);
and (iii) incubation at 37°C for 1 h and subsequently at
4°C for 6 h, followed by reincubation at 37°C for 1
h (hot-cold-hot treatment). After treatment, the mixtures were
centrifuged (3,000
x g, 15 min) and the absorbance at 540 nm
of released hemoglobin in the supernatant was read to determine
the highest dilution producing 50% hemolysis. The assay described
above was performed in triplicate.
As the highest hemolytic activity in the broth media was recorded at 9 h for all strains tested, only these results are presented in Table 2. The culture supernatants of all strains grown in THB showed little hemolytic activity through all of the temperature treatments, whereas those of KB-6, KB-7, and KB-8 grown in THB+serum showed appreciable hemolytic activity through the treatments, with the hemolytic activity through the hot-cold-hot treatment being marginally higher. These observations were consistent with those obtained on solid medium (i.e., RBC+serum). Furthermore, the supernatants of all six strains grown in THB+starch showed marked hemolytic activity in which the hemolytic activities through hot-cold-hot treatment were approximately two- to fourfold higher than those through hot-only and hot-cold treatments. The evidence suggests that starch enhances production or activity of hemolysin by GBS strains. Alternatively, the starch is capable of stabilizing the hemolysin, thereby prolonging hemolytic activity, since the GBS hemolysin was reported to be short lived in its hemolytic activity and to bind readily to a carrier molecule like starch (9). The above possibilities should be evaluated in future study. It should be also noted that the observed phenomenon did not require the presence of Mg2+ or Ca2+.
Enhanced hemolysis with the hot-cold treatment has been reported
in several bacterial species such as
S. aureus (ß-toxin)
(
15),
C. perfringens (alpha-toxin) (
10),
Leptospira interrogans (
2), and
Bacillus cereus (
7). The hemolytic activities of these
bacterial strains was known to involve phospholipase C, which
acts on sphingomyelin of blood cell membranes in the presence
of Mg
2+ or Ca
2+ (
17). In contrast, the GBS hemolysin required
an additional hot treatment but did not require the presence
of Mg
2+ or Ca
2+ for its enhancement. Although the GBS hemolysin
has been reported to exhibit hemolysis in response to hot-only
treatment (
3,
19) which was independent of the presence of carrier
molecules (
9,
12), the hot-cold-hot hemolysis exhibited by the
GBS was apparently pronounced in the presence of starch. The
evidence indicates that the hot-cold-hot treatment results reflect
yet another hemolytic property of the GBS which may be associated
with its pathogenicity. Further investigation is in progress.

FOOTNOTES
* Corresponding author. Mailing address: Department of Bioscience Graduate School of Science and Technology, Kobe University, Rokko-dai 1-1, Nada-ku, Kobe City, Japan 657-8501. Phone and fax: 81-78-803-5804. E-mail:
osawa{at}ans.kobe-u.ac.jp.


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Journal of Clinical Microbiology, February 2003, p. 877-879, Vol. 41, No. 2
0095-1137/03/$08.00+0 DOI: 10.1128/JCM.41.2.877-879.2003
Copyright © 2003, American Society for Microbiology. All Rights Reserved.