We evaluated the effectiveness of 5-day antibacterial therapy for bacterial meningitis in children. The study group included 26 children from 2 months to 15 years of age, admitted with microbiologically confirmed bacterial meningitis in 1990-1993 and treated for 5 days. A historical comparison group of 49 patients treated for 8 to 15 days was used. Penicillin monotherapy (300 mg/kg body weight) was used for meningococcal and pneumococcal meningitis and ampicillin (300 mg/kg body weight) for Haemophilus influenzae b meningitis. On day 5 of therapy the activity of aspartate aminotransferase (AST), lactic dehydrogenase (LDH), creatine phosphokinase (CPK) and gamma-glutamyl-transpeptidase (gamma GT) in the CSF was determined by photocolorimetric assay and the concentration of creatine kinase BB (CK-BB) by ELISA. IL-6 was analysed using EIA technique and a cerebral ultrasound was performed at the time of the termination of the antibacterial therapy. The mean follow-up time was 1.3 years for children in the study group and 3.2 in the control group. The time of hospitalisation was shorter in children treated for 5 days (p < 0.005). Complete clinical recovery was 81% in the study group and 66% in the comparison group at the time of the termination of antibacterial therapy. No relapses occurred. The activity of AST, CPK, LDH, and gamma GT in the CSF had returned to normal by the 5th day of therapy, but almost a 7-fold higher concentration of CK-BB was registered. The concentration of IL-6 in the CSF decreased with the therapy from 1,800 pg/ml to 685 pg/ml but still remained high.(ABSTRACT TRUNCATED AT 250 WORDS)

We prospectively studied the role of MP in childhood LTRI. Children aged 3 months to 12 years with a chest X-ray infitrate were included. Excluded were immunodeficiency disorders, aspiration, congenital malformations, nasogastric tube feeding, cystic fibrosis and severe retardation. A complement fixation test and an IF assay measuring IgM and IgG antibodies on day I and 14 were performed to confirm infection with MP. A four-fold rise in IgG titers or a positive IgM titer were considered diagnostic. On day 1 a nasopharyngeal aspirate was taken for culture of MP and PCR analysis. The primers used in PCR analysis were: Myc 16s and Myc PI. Over a period of 11 months 34 children (ISF, 19M) with a mean age of 5.5 years were included. In 10 patients (29%) MP infection was detected. The results of serologic testing(SER.). culture(CULT.) and PCR are shown below:PCR+ PCR-PCR n.d. CULT+ CULT-SER: 0 20 4 SER: 0 24 When using SER as a gold standard, sensitivity of CULT was 30% and specificity was loo%, whereas sensiti\ity of PCR was 100% and specificity 100% This shows tl~at PCR niay be a useful test in the early diagnosis of childhood LRTl by MP. THE ADHESIONOF STREPTOCOCCUS PNEUMONIAE TO K i , W EPITHELIAL CELLS. * A . I r m a v a n ' t Hoog, M a r c e l S l u y t e r , W i l H . F . G o e s s e n s , P e t e r W.M. H e r m a n s , T h e 0 H o o g e n b o e z e m a n d R o n a l d d e G r o o t . E r a s m u s U n i v e r s i t y a n d U n i v e r s i t y H o s p i c a l R o t t e r d a m / S o p h i a C h i l d r e n ' s H o s p i t a l , R o t t e r d a m .T h e a d h e s i o n o f 3 2 S t r e p t o c o c c u s p n e u m o n i a e i s o l a~e s t o human n a s o p h a r y n g e a l a n d b u c c a l e p i t h e l i a l c e l l s w a s i n v e s t i g a t e d . One h i g h l y a d h e r e n t s t r a i n , FT231, w a s u s e d f o r t r a n s p o s o n T n 9 1 6 m u t a g e n e s i s . T h e a d h e r e n c e o f i n d i v i d u a l m u t a n t s w a s s c r e e n e d u s i n g i m m o b i l i z e d b u c c a l e p i t h e l i a l c e l l s . T h e a d h e r e n c e o f s e l e c t e d , p u t a t i v e l y l o w l y a d h e r e n t m u t a n t s w a s i n v e s t i g a t e d b y c o u n t i n g t h e n u m b e r o f b a c t e r i a a t c a c h e d t o n a s o p h a r y n g e a l a n d t o b u c c a l e p i t h e l i a l c e l l s . We d e t e c t e d 6 m u t a n t s t h a t h a d l o s t t h e a b i l i t y t o a d t e r e t o human e p i t h e l i a l c e l l s .T h e g e n e t i c l o c a l i z a t i o n o f t h e t r a n s p o s o n i n t h e s e m u t a n t s w a s d e t e r m i n e d u s i n g S o u t h e r n h y b r i d i s a t i o n a n d p u l s e d f l e l d e l e c t r o p h o r e s i s . S e q u e n c i n g o f t h e g e n e ( s ) i n v o l v e d i n p n e u m o c o c c a l a d h e s i o n i s c u r r e n t l y i n p r o g r e s s .Irja Lutsar*. Margit Narska", A a s a Gontmacher*, Bengt Wretlind**. *Tartu University Children's Hospital, Tartu, Estonia. **Danderyd Hospital, Stockholm. S w e d e n . H i g h l...