Further studies of some "nontypable" group A streptococci

Thirty-two strains of group A hemolytic streptococci which could not be M typed with the available typing sera in Nashville, Tenn., were reinvestigated at the Streptococcus Reference Laboratory in Colindale, England, in order to estimate the efficacy of other antisera not available in Nashville and newer techniques (the opacity factor inhibition test) of typing strains not isolated in England. Fifty percent were eventually typed and all but four contained enough M protein to suggest that they would have been typed had the appropriate typing sera been available. The results indicate that group A streptococci truly lacking M protein were seldom isolated from the Nashville children from whom the streptococci were cultured. Several factors responsible for nontypability were considered, including the nonavailability of the necessary type-specific antisera and loss of M protein due to a change from Matt to glossy colonial types in the laboratory.