VIRIDANS STREPTOCOCCAL ISOLATES FROM PATIENTS WITH SEPTIC SHOCK INDUCE TUMOR-NECROSIS-FACTOR-ALPHA PRODUCTION BY MURINE MACROPHAGES

Viridans streptococci are an important cause of bacteremia and septic shock in neutropenic patients, especially patients receiving chemother apeutic agents that induce severe mucositis. The mechanisms by which v iridans streptococci cause septic shock are unclear. We hypothesized t hat septic shock due to viridans streptococci is attributable to host cytokine production, Three clinical isolates of viridans streptococci were evaluated for their ability to induce production of tumor necrosi s factor-alpha (TNF-alpha) by RAW 264.7 murine macrophages. These thre e strains of viridans streptococci induced TNF-alpha in a dose-depende nt fashion, and the kinetics of TNF-alpha induction were similar to th ose observed with a clinical isolate of Escherichia coli.