Hyaluronidase production in Streptococcus milleri in relation to infection.

One hundred and seven (41%) of 262 isolates of Streptococcus milleri, from human sources, produced hyaluronidase. Hyaluronidase production was commoner in beta haemolytic isolates 32 of 39 (82%), many of which were of Lancefield group F. But hyaluronidase was also found in alpha and non-haemolytic isolates, and in groups A, C, G, and non-groupable isolates. There was a strong association between hyaluronidase production and isolation from known internal abscesses (48/58, 83%) compared with isolates from the normal flora of uninfected sites (24/97, 25%). Isolates from 15 patients with endocarditis were uniformly negative, although 13 of 25 (52%) isolates from dental plaque produced the enzyme. Production of hyaluronidase may therefore be an important determinant in the pathogenicity of infection by S milleri and could be helpful in predicting the likelihood of deep purulent lesions in isolates from blood culture.