Treatment of human granulocytic ehrlichiosis during pregnancy and risk of perinatal transmission.

A pregnant woman from Nantucket Island, MA was diagnosed with human granulocytic ehrlichiosis at 34 weeks gestation. We describe the diagnostic and therapeutic dilemmas involved and discuss the risks of perinatal transmission.

Group B streptococcal colonization and serotype-specific immunity in pregnant women at delivery.

Objective: To describe the relationship between serum concentration of group B streptococcal capsular polysaccharide-specific immunoglobulin (Ig) G, colonization status, race or ethnicity, and age in pregnant women.

Methods: Pregnant women (n = 3307) were enrolled from geographically and ethnically diverse populations. At the time of admission for delivery, swabs of the lower vagina and rectum were obtained for isolation of group B streptococci.

Invasive disease due to group B Streptococcus in pregnant women and neonates from diverse population groups.

From 1993 through 1996, surveillance for invasive disease due to group B Streptococcus (GBS) in neonates aged <7 days and in peripartum pregnant women was performed in a racially and ethnically diverse cohort in 4 cities in the United States. In a birth population of 157,184, 130 neonatal cases (0.8 per 1000) and 54 maternal cases (0.

Resource utilization associated with initial hospital stays complicated by early onset group B streptococcal disease.

Background: The epidemiology of early onset neonatal group B streptococcal (GBS) disease has changed appreciably, but there are no recent assessments of the in-hospital resource utilization it incurs.

Study Design: We performed a retrospective cohort study of infants delivered from 1987 through 1995 at Massachusetts' largest obstetrics hospital. A matched cohort design was used to assess care occurring after transfer to another acute care hospital.

Structural characteristics of polysaccharides that induce protection against intra-abdominal abscess formation.

Bacteroides fragilis is the anaerobe most commonly isolated from clinical cases of intra-abdominal sepsis. In a rodent model of this disease process, intraperitoneal injection of the capsular polysaccharide complex (CPC) from B. fragilis provokes abscess formation, while subcutaneous administration of this complex confers protection against B.

The appropriateness of oral fluoroquinolone-prescribing in the long-term care setting.

Objective: To evaluate the appropriateness of ciprofloxacin-prescribing in the long-term care setting.

Design: Retrospective chart review.

Setting: A large academically oriented long-term care facility.

Perioperative antibiotic prophylaxis and wound infection following breast surgery.

The effectiveness of perioperative antibiotic prophylaxis against wound infections following breast surgery was investigated by meta-analysis of published data from a randomized clinical trial and an observational data set, which included a total of 2587 surgical procedures, including excisional biopsy, lumpectomy, mastectomy, reduction mammoplasty and axillary node dissection. There were 98 wound infections (3.8%).

Prophylaxis against wound infection following herniorrhaphy or breast surgery.

The effect of perioperative antibiotic prophylaxis on definite wound infections was assessed for 3202 herniorrhaphies or selected breast surgery procedures. Patients were identified preoperatively and monitored for greater than or equal to 4 weeks. Thirty-four percent of patients (1077/3202) received prophylaxis at the discretion of the surgeon; 86 definite wound infections (2.

Perioperative antibiotic prophylaxis for herniorrhaphy and breast surgery.

We assessed the efficacy of perioperative antibiotic prophylaxis for surgery in a randomized, double-blind trial of 1218 patients undergoing herniorrhaphy or surgery involving the breast, including excision of a breast mass, mastectomy, reduction mammoplasty, and axillary-node dissection. The prophylactic regimen was a single dose of cefonicid (1 g intravenously) administered approximately half an hour before surgery. The patients were followed up for four to six weeks after surgery.

Effect of subinhibitory doses of clindamycin on the virulence of Bacteroides fragilis: role of lipopolysaccharide.

The capsular polysaccharide (CP) of Bacteroides fragilis is an important virulence factor in the formation of experimental intraabdominal abscesses. Incubation of this organism with subinhibitory doses of clindamycin induced morphological changes in the bacteria, including elongation and loss of CP, detected by ferritin-labeled antibody to capsule. Pretreatment of bacteria with subinhibitory doses of clindamycin, however, did not affect the ability of live or heat-killed organisms to produce intraabdominal abscesses in a mouse model of intraabdominal sepsis.

Cellular control of abscess formation: role of T cells in the regulation of abscesses formed in response to Bacteroides fragilis.

Although abscesses are a major sequela of infection, little is known about which cellular events initiate and which prevent this pathologic response. These studies are the first to indicate a role for T cells in the important pathogenic process of abscess development and also in immunity to abscesses induced by Bacteroides fragilis. We have shown that T cells initiate the formation of abscesses in mice after i.

A soluble suppressor T cell factor protects against experimental intraabdominal abscesses.

This paper describes a suppressor T cell factor which protects mice against intraabdominal abscesses caused by Bacteroides fragilis. This soluble cell-free factor (ITF) is derived from splenic T cells from mice immunized with capsular polysaccharide (CP) of B. fragilis.

Use of a model of intraabdominal sepsis for studies of the pathogenicity of Bacteroides fragilis.

Over the past eight years, a Wistar rat model for intraabdominal sepsis has been developed and used to document the role of obligate anaerobes in this infections. The ability of Bacteroides fragilis alone to provoke abscesses in this model system is due to a species-specific capsular polysaccharide. It has been shown that active immunization of rats with capsular polysaccharide of B.

Evidence for T cell-dependent immunity to Bacteroides fragilis in an intraabdominal abscess model.

It has been shown that active immunization of rats with the capsular polysaccharide of Bacteroides fragilis protects these animals against abscess development following intraperitoneal challenge with this species. Passive transfer of hyperimmune globulin from immunized animals to nonimmune recipients provided protection against B. fragilis bacteremia in challenged animals, but did not confer protection against abscess development.