PubMed HealthSearch

Biomedical subjects

J Henrichsen

Publications and source records attributed to J Henrichsen.

At least 19 recordsLinked to original sources

[Prevention of pneumococcal infections in the elderly by vaccination].

Streptococcus pneumoniae still causes serious infections especially in elderly people, despite relevant antibiotic treatment and intensive therapy. At present, Statens Serum-institut annually receives about 650 pneumococcal strains isolated from blood and cerebrospinal fluid for typing from the departments of Clinical Microbiology in Denmark. Of these strains about 55% were isolated from persons aged 60 years or older. The incidence of pneumococcal pneumonia in elderly people is said to be 4-8/1000 persons/year in countries similar to Denmark. In the USA, pneumococcal vaccination is recommended for groups at risk including immunocompetent adults > or = 65 years old. Since 1978, pneumococcal vaccine has been available in Denmark, where the only indication for vaccination has been and still is intended or already performed splenectomy in persons older than two years of age. According to the literature, the protective efficacy of vaccination of elderly persons is 60-70%. Since vaccination is, furthermore, without risks we believe that vaccination of elderly people in Denmark should be advised.

Age Factors

Production of monovalent antisera by induction of immunological tolerance for capsular typing of Streptococcus pneumoniae.

Hyperimmune and high-titered polyclonal pneumococcal antisera, specific for cross-reactive types within groups, were produced in adult rabbits. Purified capsular polysaccharide was injected intravenously into adult rabbits. One week later, these rabbits were given multiple intravenous injections of formalin-inactivated pneumococci of the cross-reactive type by an established method. Each of the resultant antisera were specific for the cross-reactive type indicating that the previous injection of the polysaccharide had induced epitope-specific tolerance. This method was successful for production of antisera against pneumococcal types 6A, 6B, 9N, 9V, 19F and 19A. Polyclonal rabbit pneumococcal antisera have some advantages over murine monoclonal antibodies for serologic studies and this method should be applicable for producing type-specific antibodies to cross-reactive polysaccharides of clinical interest. Further, this method is simpler and generally produces higher titered monovalent (factor) reagents than absorbed antisera.

Animals

[Incidence and diagnosis of pneumococcal pneumonias requiring admission to hospital].

A prospective investigation of patients admitted to the local hospital during a period of one year was undertaken. A total of 107 patients participated. 50% of the cases of pneumonia were found by Streptococcus pneumoniae. The diagnosis was established partly by demonstration of antigens and increase in antibody titre and also employing the traditional methods: Blood culture, microscopic examination and culture of the expectorate or tracheal secretion. 70% of the patients were over the age of 60 years. The mortality was found to be 17%. The difficulties in etiological investigations of infections in the lower respiratory tract are discussed.

Adult

Capsular types of Streptococcus pneumoniae isolated from blood and CSF during 1982-1987.

Knowledge about the type distribution of Streptococcus pneumoniae is fundamental to ensure an effective formulation of pneumococcal vaccine, especially with the possibility of producing a polysaccharide-protein-conjugated vaccine for the prevention of invasive disease in children. During the 6-year period 1982-1987, we received and typed 10,298 isolates from patients with invasive pneumococcal disease: 7,812 (76%) from blood and 2,486 (24%) from CSF. Of all isolates, 81% were recovered from individuals in Europe and 23% were from children. In order of frequency, S. pneumoniae types 6A + 6B, 14, 18C, 19F, 1, 7F, 23F, 19A, 4, and 5 were most commonly isolated from children, and types 3, 1, 14, 7F, 4, 6A + 6B, 8, 23F, 9V, and 19F, from adults. The pneumococcal types in the currently available 23-valent vaccine represented 87% of all isolates in this study, but the proportion of vaccine types varied somewhat with age and source. In all pneumococcal groups included in the vaccine, the vaccine types represented > 80% of the isolates, except in groups 6, 15, and 18.

Adult

Serum antibody responses to Streptococcus mutans antigens in humans systemically infected with oral streptococci.

Sera from patients with subacute bacterial endocarditis (SBE) due to Streptococcus mutans or other oral streptococci and from normal subjects were assayed by enzyme-linked immunosorbent assay for antibodies to defined S. mutans antigens. Antibodies of IgG and IgA isotypes to Ag I/II and Ag III were greatly elevated in S. mutans-SBE sera, and the IgA antibodies in 3 sera included both polymeric and monomeric forms. Elevated IgM and IgG anti-lipoteichoic acid and IgG and IgA anti-serotype c polysaccharide antibodies were also found. The sera of 4 of 6 patients infected with other oral streptococci also displayed antibodies to S. mutans Ag I/II. Sera of 3 patients infected with Streptococcus mitis or Streptococcus oralis, but none of the S. mutans-infected cases, showed elevated antibodies to human heart sarcolemma, and all SBE sera had elevated rheumatoid factor. These results suggest that the known surface protein antigens of S. mutans are immunodominant in humans, and are not likely to be heart cross-reactive.

Antibodies, Bacterial

Genetic relationships of penicillin-susceptible and -resistant Streptococcus pneumoniae strains isolated on different continents.

Sixty-six strains of Streptococcus pneumoniae isolated in different parts of the world, 46 resistant and 22 susceptible to penicillin, were subdivided by multilocus enzyme electrophoresis into 28 distinct electrophoretic types (ETs). The ETs to which penicillin-susceptible strains were assigned differed from those containing resistant isolates of the same serotype. Five common clones could be recognized among the penicillin-resistant bacteria by combining the ETs, the antigenic properties of penicillin-binding proteins PBP 1a and 2b, and the tetracycline and chloramphenicol resistance profiles. Two clones were found in Finland and were associated with capsular serotypes 6B and 23F, respectively. Two clones were from Spain (type 6B and 9V, respectively). The fifth clone was isolated in South Africa and in Spain and contained both serotype 23F isolates and one type 19F strain. The other resistant strains were represented by rare isolates distributed among 12 other ETs, confirming that resistance to penicillin has evolved by multiple branches. Because capsular type was mixed in several ETs, the results also demonstrate that it may vary among very closely related pneumococci.

Bacterial Proteins

Novel coagglutination method for serotyping group B streptococci.

A group G streptococcal strain was coated with antibody against six different serotypes (Ia, Ib, II, III, IV, and V) of group B streptococci. The coagglutination patterns of 114 strains of group B streptococci were compared with the serotypes determined after immunoprecipitation. The specificity of the method was 100% and the sensitivity 97%. It was used for the typing of 89 invasive and 101 colonizing isolates. The new method is swift, specific, and highly sensitive. It consumes only minute amounts of antibody.

Agglutination Tests

[Pneumococcal vaccination of splenectomized patients. Recommendations based on a 10-year experience].

In 1978, pneumococcal vaccination in splenectomized patients over the age of two years was introduced in Denmark. Since then, no cases of pneumococcal bacteraemia or meningitis have occurred in splenectomized children. Prior to introduction of vaccination, infections of this nature occurred with an incidence of approximately 4%. We have investigated the duration of the vaccine-induced increase in antibodies in splenectomized children and adults and, on this basis, we recommend that all children vaccinated in the age group 2-14 years should have pneumococcal antibodies measured five years after vaccination because the antibodies in a number of the children will have decreased to such an extent that revaccination is necessary. All patients who were over 14 years on vaccination should, until further notice, have the pneumococcal antibodies measured after ten years although we have found that 2, 5, 7 and 10 years after vaccination, the antibody level had only decreased to 71, 69, 70 and 63% of the antibody concentrations obtained by pneumococcal vaccination.

Adult

The structure of the capsular polysaccharide from Streptococcus pneumoniae type 7B.

The capsular polysaccharide elaborated by Streptococcus pneumoniae type 7B is composed of the following heptasaccharide repeating-units. [formula: see text] The identities and modes of linkage of the constituents were established using sugar, methylation, and phosphorus analysis, together with 1D- and 2D-n.m.r. spectroscopy. The sequence was established from inter-residue n.O.e. data. The structure was corroborated by n.m.r. spectroscopy, f.a.b.-m.s., and methylation analysis of the oligosaccharides isolated after partial acid hydrolysis of the polysaccharide with aqueous 48% hydrogen fluoride. It is suggested that the structural basis for the common antigenic formula in the group 7 serotypes of S. pneumoniae is the disaccharide element alpha-D-GlcpNAc-(1----2)-alpha-L-Rhap-(1----.

Carbohydrate Conformation

Antibody response to pneumococcal vaccination in the elderly.

In order to evaluate the antibody response to primary pneumococcal vaccination in the elderly, 20 healthy persons aged 60 years or older, (mean age 62.8) were vaccinated with a 23-valent pneumococcal polysaccharide vaccine (Pneumovax 23). Blood samples were taken before and 4 weeks after vaccination and pneumococcal antibody concentrations were measured by ELISA and compared with those obtained after vaccination of younger persons (mean age 39 years). Significantly lower anti-type 2 antibody concentrations were found in the elderly after vaccination. Apart from this, no other significant differences were found neither in pre- and post-vaccination antibody concentrations nor in antibody fold increases between the two groups.

Adult

Diagnosis of pneumonia by cultures, bacterial and viral antigen detection tests, and serology with special reference to antibodies against pneumococcal antigens.

In a prospective study of the etiology of pneumonia 196 adult patients were included. One of the following criteria was required for diagnosis of pneumococcal pneumonia: isolation of pneumococci from blood; isolation from transtracheal aspirate; isolation from sputum or nasopharynx or detection of capsular antigen in sputum in combination with a significant increase in antibodies against at least one pneumococcal antigen (type-specific capsular polysaccharide, C-polysaccharide, pneumolysin); or increase in antibodies against two pneumococcal antigens. Pneumococcal pneumonia was diagnosed in 63 patients (32%). Other diagnoses were nonencapsulated Haemophilus influenzae isolated from transtracheal aspirates, 9; Mycoplasma pneumoniae diagnosed by serology, 17; Chlamydia psittaci, 6; and viral infections, 42. Twenty-two patients (11%) had evidence of infection with more than one agent. The pathogen could not be determined in 70 (36%). Many patients were given antibiotics before admittance to the study, and in some cases a convalescent serum sample was not available.

Adolescent

Pneumococcal infections in splenectomized children are preventable.

Through the Danish National Patient Registry we identified all children 0-15 years old who had been splenectomized during the period 1979-87 and all children of the same age who, during the same period of time, had been admitted to a hospital because of either meningitis or bacteraemia caused by Streptococcus pneumoniae. We wanted to see whether any of the splenectomized children had developed invasive pneumococcal infection during the observation period. A similar Danish study covering the period 1969-78, when pneumococcal vaccine was not available, has already been published (3). Four per cent of the children splenectomized during that period developed invasive pneumococcal infection in contrast to none of the children splenectomized and vaccinated during the period 1979-87. Since 1982 antibiotic treatment of splenectomized patients running a fever has been recommended, and we show that the program of pneumococcal vaccination and defined antibiotic prophylaxis has been highly efficacious in preventing post-splenectomy infections in children.

Adolescent

Influence of prevaccination immunity on the human B-lymphocyte response to a Haemophilus influenzae type b conjugate vaccine.

The purpose of this study was to investigate whether preexisting immunity to components of a polysaccharide-protein conjugate influences the B-lymphocyte response to vaccination with the conjugate. Thirty-two healthy adults were vaccinated once or twice with a conjugate (PRP-D) consisting of Haemophilus influenzae type b capsular polysaccharide (PRP) and diphtheria toxoid (DT), and the response was related to the prevaccination levels of PRP and DT antibodies. Positive correlations were found between increases in plasma PRP (median, 32.0 micrograms/ml) and DT (1.14 IU/ml) antibodies and numbers of circulating PRP and DT antibody-secreting cells (AbSC) (postvaccination days 6 to 9). The B-cell responses (antibody response and AbSC) to both PRP and DT correlated positively with prevaccination levels of anti-DT. DT AbSC appeared earlier (peak, day 7) than PRP AbSC (peak, day 8). Individuals whose PRP AbSC peaked early (day 7) had higher prevaccination anti-DT levels than those who peaked later (P less than 0.05). In contrast, the prevaccination levels of anti-PRP did not correlate significantly with the magnitude of the antibody or AbSC response and did not affect the kinetics of the AbSC. Following revaccination with PRP-D, small increases in the level of PRP antibodies (median, 2.9 micrograms/ml; n = 11) were found; no significant increase in the level of DT antibodies was seen. The numbers of PRP AbSC were lower (P = 0.04) and peaked earlier (day 7) than after the first vaccination. The isotype pattern of PRP AbSC, which was dominated by immunoglobulin A (IgA) after the first vaccination, now showed a more equal distribution between IgG and IgA AbSC. It is concluded that after immunization with PRP-D both the magnitude and the kinetics of the antipolysaccharide B-cell response are influenced by prevaccination immunity to the carrier molecule.

Adult

Characterization of six new capsular types (23 through 28) of Streptococcus suis.

Six new capsular types of Streptococcus suis (types 23 to 28) are described. All reference strains were isolated from diseased pigs and were morphologically and biochemically similar to previously described capsular types 1 to 22. Clear and specific reactions were obtained for each of the new capsular types with three different typing techniques; no cross-reactions were detected among them or with other S. suis capsular types. Their capsular material presented similar ultrastructural characteristics, as shown by electron microscopy, and fimbriae similar to those described for other capsular types of S. suis were observed. When untypeable field isolates were tested with antisera raised against the six new capsular types, capsular type 23 appeared to be the most prevalent, representing more than 50% of all these isolates. Most isolates were recovered from cases of pneumonia, septicemia, and meningitis. Presumptive biochemical identification described for S. suis capsular types 1 to 22 may also be used for capsular types 23 to 28.

Animals

Isolation and characterization of Streptococcus suis capsular types 9-22.

The incidence and biochemical patterns of Streptococcus suis capsular types 9-22 are presented. Of 148 untypeable (with types 1-8 antisera) isolates of S. suis recovered from diseased pigs, 10% were not capsulated. Of the remaining 134 isolates, only 53% belonged to capsular types 9-22; capsular types 22 and 9 were the most prevalent, representing 19% and 13%, respectively. Capsular type 15 (de Moor's group T Streptococcus) is reported here for the first time in North America since it was described in 1963 in Europe. Of 188 untypeable isolates recovered from clinically healthy pigs, 25% were noncapsulated. Of the remaining 141 isolates, 90% belonged to the new capsular types, and 87% were identified as 1 of 4 types: 17, 18, 19, and 21. Capsular types 12 and 20 were not detected among the Canadian isolates. Almost half of strains were arginine dihydrolase-negative, and 45% fermented mannitol, which is seldom a positive test with capsular types 1-8. Although some strains were negative with salicin or trehalose, none were negative for both sugars. Only 54% of isolates tested with 1 rapid multitest system were correctly identified as S. suis. A tentative biochemical profile that might be used with a microplate identification system is also presented. Biochemical identification using the conventional system instead of the rapid multitest system is preferable.

Agglutination Tests