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Cytomegalovirus (CMV) is the most common congenital viral infection, but little is known about the protective immune mechanisms. The guinea pig (gp) model of congenital CMV was used to evaluate the effects of passive antibody given to pregnant dams on pup survival. Dams received three doses of high-titer gpCMV or control antibody on days -3, -1, and +7, or +1, +3, and +7, in relation to gpCMV challenge. gpCMV was inoculated in the late second to early third trimester at three different doses. Compared with controls, gpCMV antibody begun before gpCMV challenge significantly increased pup survival from 14% to 52%, 21% to 84%, and 51% to 77%, respectively, for the three challenge doses. gpCMV antibody started after viral challenge increased pup survival after only the lowest challenge dose (51% to 81%). Antibody did not protect against CMV infection of the pups. CMV antibody appeared to improve survival in congenital CMV infection but did not affect vertical transmission.

Streptococcus gallolyticus subsp. pasteurianus, previously known as Streptococcus bovis biotype II.2, is known to cause multiple infectious complications, including bacterial meningitis, in adults. Only sporadic individual case reports have identified this pathogen as a cause of meningitis in infants. This study is the first to longitudinally document S. gallolyticus subsp. pasteurianus as a cause of meningitis in four epidemiologically unrelated infants less than 2 weeks of age. The 16S rRNA gene sequences of all 4 isolates were identical, and further were identical to 3 central nervous system (CNS) strains (two adults and one child) reported in existing literature. S. gallolyticus subsp. pasteurianus is an increasingly recognized cause of meningitis and bacteremia in the newborn period, and it merits further study with respect to etiology of infection.

Objectives After completing this article, readers should be able to: 1. Describe the mechanism of action of cephalosporins. 2. Delineate the two most common mechanisms of resistance to penicillins. 3. Discuss the most common adverse effects of common cephalosporins. 4. List which cephalosporins have activity against Pseudomonas. Oral Cefaclor 20 to 40 8 to 12 Cefadroxil 30 12 Cephalexin 25 to 100 6 to 8 Cefprozil 15 to 30 12 Cephradine 25 to 100 6 to 12 Cefuroxime, PO 20 to 30 12 Cefdinir 14 12 to 24* Cefpodoxime 10 12 Cefixime 8 12 to 24 Ceftibuten 9 24 Parenteral Cefazolin 50 to 100 8 Cefoxitin 80 to 160 4 to 6 Cefuroxime, IV 100 to 240 † 6 to 8 Ceftriaxone 50 to 100 12 to 24 Cefotaxime 100 to 300 † 6 to 8 Ceftazidime 100 to 150 8 Cefepime 150 8 to 12 §

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