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The candidates for new types proposed by the laboratories of H. W. Wilkinson, J. Jelinkova, B. Perch, and S. Rabinowitz were antigenically compared and found to be distinct from the established types. On the other hand, identity between some of the candidates was found: three belonged to the new type IV and two shared the NTi antigen. Strains with NT1 antigen were given the working label "provisional type V." A distribution study identified 102 type IV strains and 53 provisional type V strains among isolates from 15 countries.

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Summary. New serotypes were sought among 165 clinical isolates of group-B streptococci that were untypable by antisera for the conventional types Ia, Ib, I1 and 111. The strains were tested for sialic acid, an integral component of the group-B streptococcal type-polysaccharides; trypsin-treated bacteria were tested by slideagglutination with the sialic-acid-specific lectin from the snail Cepaea hortensis. Sialic acid was detected in 96 of the strains; in 95 of these, new type antigens were identified serologically (type IV, 52; provisional type V, 34; candidate type NT6, seven;' provisional type V and candidate type NT6, one; candidate type 7271, one); the remaining strain was found to possess a small amount of Ia antigen. Sialic acid was not detected in 69 strains, and none of these possessed a polysaccharide type-antigen. Chemical measurement of the sialic-acid content of cultures by Aminoff's method gave results in conformity with the lectin-agglutination test and the presence of polysaccharide type-antigens.

The immunochemistry of capsular type polysaccharide and virulence characteristics of group B streptococci (GBS), type VI, were studied. By high-pressure anion-exchange chromatography and pulsed amperometric detection, as well as by 13C nuclear magnetic resonance analysis, both extracellular and cell-bound polysaccharides were found to contain glucose, galactose, and N-acetylneuraminic acid in the molar ratio of 2:2:1, respectively. At variance with all other GBS serotypes described to date (Ia, Ib, II, III, IV, and V), no N-acetylglucosamine was present, whatever the source of the material (secreted or cell bound; reference or clinical isolate). Sialic acid was probably involved in the immunodeterminant structure of this new serotype since cleavage of this sugar from the polysaccharide gave rise to an antigen which reacted very weakly with type VI antiserum and to a precipitation line in immunodiffusion with no identity with the native type VI polysaccharide. By using type VI antiserum and the protein A-gold technique, a large capsule was observed in the type VI GBS reference strain by electron microscopy. All type VI strains examined were lethal for CD-1 mice, the 50% lethal dose after intraperitoneal challenge ranging from 1.0 (+/- 0.9, standard deviation) x 10(5) to 2.5 (+/- 1.5, standard deviation) x 10(5) CFU per mouse. A rabbit antiserum against capsular type polysaccharide exhibited both protective activity for mice injected intraperitoneally with type VI reference strain or with clinical isolates and opsonic activity in a phagocytosis assay.