822 Passive Immunization Against Group B Streptococci With Human Gamma Globulin in the Chick Embryo

Abstract

Chronic abdominal pain, c o n s t i p a t i o n , d i a r r h e a , and anorexia arm.often d i f f i c u l t symptoms f o r a p e d i a t r i c i a n t o e v a l u a t e . These c h i l d r e n a r e o f t e n thought t o have psychosomatic complaint It h a s been noted t h a t s t o o l s f o r ova and p a r a s i t e s obtained on some of t h e s e c h i l d r e n have demonstrated p a r a s i t e s o f t e n thought t o be nonpathogenic.Thus, a r e t r o s p e c t i v e e v a l u a t i o n was performed of c h i l d r e n seen a t UCLA during t h e time period from June 1976 through November 1977 i n whom t h e p a r a s i t e Dientamoeba f r ag i l l s (DF) was i s o l a t e d from s t o o l specimens. DF was p r e s a n t i n 14% of 350 c h i l d r e n who had s t o o l s analyzed f o r ova and p a r a s i t e DF was t h e only p a r a s i t e obtained i n 9% of t h e 350 c h i l d r e n . H i t o r y was a v a i l a b l e from 28 of t h e s e 37 p a t i e n t s i n whom DF was t h e only pathogen. Children were aged 10 months t o 17 y e a r s ; malea predominated 1.6 t o 1. Forty-eight percent of c h i l d r e n had been born i n t h e U.S. and had no h i s t o r y t o f o r e i g n t r a v e l ; 39% were from Mexico o r South America. Ninety-three p e r c e n t (26128) had g a s t r o i n t e s t i n a l symptomatology (abdominal pain, d i a r r h e a , anorexia o r c o n s t i p a t i o n ) ; 2 (7%) were asymptomatic.The most common symptom i n t h e s e c h i l d r e n was d i a r r h e a (57%) which was o f t e n i n t e r m i t t e n t . Abdominal pain, o f t e n vague and l o c a l i z e d t o t h e lower abdominal quadrants was p r e s e n t i n 54%; anorexia and f e v e r were p r e s e n t i n 39% and 29% r e s p e c t i v e l y . Children were t r e a t e d with e i t h e r diiodyhydroxyquin, metronidaz o l e o r t e t r a c y c l i n e and a l l but one were asymptomatic on follow Sci. C n t r . , Dept. o f Ped.. San Antonio. Few d a t a a r e a v a i l a b l e about t h e antibody response t o Epstein Barr virus(EBV) and t h e r a t e o f i s o l a t i o n o f t h i s v i r u s i n c h i l d ren with a n IM-like d i s e a s e . Twenty-five c h i l d r e n p r e s e n t i n g with a c l i n i c a l p i c t u r e suggesting t h i s d i a g n o s i s a r e t h e subjec o f t h i s r e p o r t .Fourteen c h i l d r e n were 4 mo t o 5 y r s o f age, eleven were 6 t o 16 y r s .High antibody(1gG) titers(f.160) t o v i r a 1 capsid a n t i g e n o f EBV were d e t e c t e d i n t h e s e r a o f 15(60%) o f t h e c h i l d r e n . Antibodies t o e a r l y a n t i g e n , predominately t o t h e d i f f u s e component, were found i n 22(88%). S p e c i f i c IgM t o EBV was d e t e c t e d i n 17(81%) o f 21 c h i l d r e n ' s s e r a examined. The i n i t i a l s e r a o f 14(56%) c h i l d r e n contained a n t i b o d i e s t o v i r a l capsid a n t i g e n but lacked a n t i b o d i e s t o nuclear a n t i g e n o f EBV. The l a t t e r was f u r t h e r evidence o f a primary EBV i n f e c t i...

Modified Human Immune Serum Globulin for Intravenous Administration: In Vitro Opsonic Activity and in Vivo Protection Against Group B Streptococcal Disease in Suckling Rats

“…Some of the problems associated with the use of whole blood in neonates could be avoided by using a purified immunoglobulin preparation. The present studies showing that commercially available ISG is not protective against type 111 GBS are in agreement with the findings of Vogel et al (18). However, an ISG preparation which has been modified for intravenous use is opsonic and protective not only against strains of type IIIGBS, which are responsible for 60% of neonatal GBS disease, but also strains la and 11.…”

Controversies in the Use of Passive Immunotherapy for Bacterial Infections in the Critically Ill Patient

“…Since the immunoglobulin preparation contains the antibodies present in the pool, it has high titers of antibody against hundreds of bacterial strains [13][14][15]. Immunoglobulins for intravenous administration (IVIG) have a good opsonic activity against various bacteria [16,17] and have been shown to be protective against various infections in animals [15,[18][19][20][21][22][23]. The storage in lyophilized form makes IVIG availableon a large scale.…”

“…Undetectable or low levels of typespecific antibodies to group B streptococci correlate with susceptibility to infection with this organism [31]. Various IVIG preparations have been shown to have functional activity against group B streptococci in vitro and in animal experiments [20][21][22][23]. These findings suggest, therefore, that IVIG could be effective when administered prophylactically to highrisk neonates or therapeutically to neonates with established infections.…”