[Changes in sensitivity to penicillin and an increase in virulence in beta-hemolytic streptococci followed by changes in the clinical picture of streptococcal syndrome].

According to reports from different geographic areas, the last decade has been characterised with an increasing number of streptococcal diseases. The new streptococcal "pathomorphosis" is presented by alteration of adhesive properties and distribution of various serotypes (domination of M1 and M18 serotypes). It is also expressed by an increased production of pyrogenic exotoxin and necrotic factor. As a consequence, apart from increasing incidence of streptococcal infections, it is observed that the streptococcal syndrome has often grave prognosis followed with a high percentage of mortality. Also a new clinical entity is also described; that of Toxic Shock Like Syndrome. The results of investigation concerning the susceptibility of beta-haemolytic streptococci to penicillin are encouraging. Penicillin resistant strains are not discovered among clinical isolates so far. However, the increased percentage of penicillin tolerant strains, and possibility of induction of penicillin resistance, can be considered as a serious warning. For that reason, further investigation of the mechanisms of developing penicillin tolerance and resistance appears to be highly recommended.