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Biomedical subjects

W J Rodriguez

Publications and source records attributed to W J Rodriguez.

At least 19 recordsLinked to original sources

Escherichia coli virulence factors and 99mTc-dimercaptosuccinic acid renal scan in children with febrile urinary tract infection.

Correlation of virulence factors of Escherichia coli with renal inflammation documented by 99mTc-dimercaptosuccinic acid renal scan was undertaken in 59 children with febrile urinary tract infections to identify more accurately the role of bacterial virulence factors in the development of pyelonephritis. P fimbriae were present in 63% of isolates from the positive scan group and 83% of those from the negative scan group (P = 0.126). Multivariate regression analysis showed no significant role for established E. coli virulence factors in the development of pyelonephritis. The pap genome was independently associated with negative scan (P less than 0.007) and with the absence of reflux (P = 0.031). E. coli pyelonephritogenic clone O16:K1:H6 was isolated from negative scan patients and did not produce hemolysin. We conclude that P fimbriae are important in the development of febrile urinary tract infection regardless of the level of infection. Virulent E. coli clones described in prior Scandinavian urinary tract infection studies were not common causes of pyelonephritis in our patient population.

Adolescent

Differentiation between two distinct classes of viruses now classified as human herpesvirus 6.

Human herpesvirus 6 (HHV-6) causes exanthem subitum (ES, roseola infantum), a childhood disease characterized by high fever and skin rash. We have analyzed restriction enzyme cleavage patterns of the DNAs of ES virus isolates from Japan and the United States. The patterns of all the ES viral DNAs were highly conserved, except for variable sequences within the terminal repeat sequences. They resembled closely the restriction enzyme patterns of the Z29 strain of HHV-6 but were distinct from those of the U1102 strain. That all ES isolates were closely related whereas the U1102 patterns were very different suggests that the U1102 strain represents a distinct virus. Moreover, the ES isolates all resembled the Z29 strain and not the U1102 strain with respect to reactivity with HHV-6 monoclonal antibodies. These findings provide evidence for the existence of two distinct classes of viruses previously classified as HHV-6. Whereas the Z29-like viruses are involved in ES infections, the association of the U1102-like viruses with human disease has yet to be determined.

Antigens, Viral

Human herpesvirus 7: antigenic properties and prevalence in children and adults.

The recent isolation of human herpesvirus 7 (HHV-7) from activated CD4+ T lymphocytes of a healthy individual raises questions regarding the prevalence of this virus in humans and its immunological relationship to previously characterized human herpesviruses. We report that HHV-7 is a ubiquitous virus which is immunologically distinct from the highly prevalent T-lymphotropic HHV-6. Thus, (i) only two of six monoclonal antibodies to HHV-6 cross-reacted with HHV-7-infected cells, (ii) Western immunoblot analyses of viral proteins revealed different patterns for HHV-6- and HHV-7-infected cells, (iii) tests of sequential serum samples from children revealed seroconversion to HHV-6 without concomitant seroconversion to HHV-7, and (iv) in some instances HHV-7 infection occurred in the presence of high titers of HHV-6 antibodies, suggesting the lack of apparent protection of children seropositive for HHV-6 against subsequent infection with HHV-7. On the basis of the analyses of sera from children and adults it can be concluded that HHV-7 is a prevalent human herpesvirus which, like other human herpesviruses, infects during childhood. The age of infection appears to be somewhat later than the very early age documented for HHV-6.

Adult

The nasopharyngeal culture in acute otitis media. A reappraisal of its usefulness.

Simultaneous cultures of the nasopharynx and middle ear exudate (obtained by tympanocentesis) were obtained from 225 children (mean age, 34 months; median age, 41 months) with suppurative otitis media. A 72% prediction rate for middle ear pathogens was obtained by examining the nasopharyngeal cultures after the strict observance of two essential prerequisites: (1) the nasopharyngeal culture was immediately plated on appropriate solid agar and (2) a semiquantitative method for bacterial enumeration was employed in the reading of the nasopharyngeal culture plates. The technique was most valuable where 2+ (greater than 25% up to 50% of total number of colonies was a single pathogen) or greater of a single pathogen was recovered from the nasopharynx. In only one instance, the semiquantitative nasopharyngeal culture incorrectly predicted the middle ear pathogen if one was recovered. Quantitative nasopharyngeal cultures were particularly useful in predicting the presence of ampicillin-resistant Haemophilus influenzae and group A streptococci as causative agents in otitis media.

Acute Disease

Common exposure outbreak of gastroenteritis due to type 2 rotavirus with high secondary attack rate within families.

A sharp outbreak of gastroenteritis associated with human rotavirus type 2 involved not only all of nine infants and young children in a playgroup but also seven of 10 parents and grandparents studied. The source of the outbreak appeared to be two non-playgroup siblings. Six of 11 individuals studied shed human rotavirus type 2, and each of seven from whom paired sera were obtained developed a type 2 sero-response. Overall, evidence of infection with rotavirus type 2 was demonstrated in 10 of 11 individuals by detection of virus in stools and/or a serologic response in an enzyme-linked immunosorbent assay.

Antibodies, Viral

Comparative epidemiology of two rotavirus serotypes and other viral agents associated with pediatric gastroenteritis.

Human rotavirus (HRV) type 1 or 2, adenovirus, or non-cultivatable 27 nm virus-like particles were demonstrated by electron microscopy and/or rotavirus ELISA in fecal samples from 45.5% of 604 gastroenteritis inpatients, 25.0% of 200 gastroenteritis outpatients and 6.0% of 812 control subjects, all sampled at Children's Hospital National Medical Center. Washington, DC. Rotaviruses were the most common pathogens detected as 39% and 22% of gastroenteritis inpatients and outpatients, respectively, shed HRV. About three-fourths of the rotaviruses were type 2, which was prevalent during five successive epidemic years from January, 1974, through June, 1978. HRV type 1 was detected in the last four successive epidemic years and represented nearly half of the HRV infections observed among gastroenteritis inpatients during the year 1977--1978. Both rotavirus serotypes were detected most often in the month of January, when 71% of 123 gastroenteritis inpatients and 62% of 34 gastroenteritis outpatients shed one of these viruses. Uncultivatable adenoviruses were detected significantly more frequently in stools from patients with gastroenteritis (3.9%) than from control subjects (0.6%), suggesting that these viruses played a role in acute enteric disease. The frequency of detection of 27 nm particles was not significantly different in gastroenteritis and control patients. Numerically, HRV infection was detected most often in gastroenteritis inpatients who were 10 through 12 months of age. The group of gastroenteritis inpatients with the highest percentage of HRV infection was 13 through 15 months of age. The excess of type 2 HRV infection relative to type 1 infection was especially large in those aged 7 through 24 months. Lower socioeconomic status or greater crowding appeared to be associated with the occurrence of rotavirus infection earlier in life and earlier in the epidemic year.

Adenoviridae

Cefaclor in the treatment of susceptible infections in infants and children.

Cefaclor is a new oral cephalosporin with in vitro activity against a wide variety of organisms including S. aureus, S. pneumoniae, S. pyogenes and H. influenzae (including ampicillin-resistant strains). Seventy-nine patients ranging in age from 2 months to 14 years with soft tissue infections (17 cases), otitis media (17), and streptococcal pharyngitis (45) were studied. They received cefaclor orally at a dose of 40 mg/kg per day in three or four divided doses for a minimum of five days. Results were generally good with favourable clinical and bacteriological responses obtained in 90% of cases. Most patients became afebrile within 48 hours after starting cefaclor. Two patients with H. influenzae cellulitis and bacteraemia defervesced within 24 hours and their blood cultures became negative promptly. Hepatic, renal and haematopoietic studies showed no adverse reactions except for an occasional increase in the eosinophil count with no clinical counterpart of hypersensitivity. Pharmacokinetic studies revealed that following a 10 mg/kg oral dose, peak serum levels of 8 micrograms/ml were observed at one hour, followed by a rather rapid tapering off so that at the end of four hours, virtually no cefaclor was detectable in serum.

Adolescent

Epidemiology of human rotavirus Types 1 and 2 as studied by enzyme-linked immunosorbent assay.

To determine the relative importance of two known serotypes of human rotavirus, we developed an enzyme-linked immunosorbent assay to differentiate serotype-specific rotavirus antigen and antibody. Using this technic, we studied the epidemiology of the two serotypes in acute gastroenteritis. Seventy-seven per cent of 414 rotavirus isolates were Type 2, and the remainder were Type 1. The serotype distribution was similar in specimens from children in Washington, D.C., and other parts of the world. Sero-epidemiologic studies revealed that most children living in the Washington, D.C., area acquired antibody to both types by the age of two years. An analysis of children who were reinfected indicated that sequential infections usually involved different serotypes and that illness caused by one serotype did not provide resistance to illness caused by the other serotype. These results suggest that, to be completely effective, a vaccine must provide resistance to both serotypes.

Antibodies, Viral

Clinical and laboratory evaluation of cefamandole in infants and children.

Fifty-three infants and children, aged three months to 15 years, were treated with an average daily dose of 100 mg of cefamandole/kg intravenously. Of these patients, 47 had soft tissue cellulitis and six had pneumonia. Primary pathogens, including Staphylococcus aureus, Streptococcus pyogenes, Streptococcus pneumoniae, and Haemophilus influenzae, were isolated from 43 of the 53 patients. Bacteremia was documented in six of the 53 patients. A satisfactory clinical and bacteriologic response to cefamandole was achieved in all cases except on (98%). The only treatment failure occurred in an infant with both periorbital cellulitis and bacteremia due to H. influenzae who developed meningitis while receiving cefamandole; no extravasation of the drug across the blood-brain barrier could be detected in spite of inflamed meninges. In general, the only aberrant effects of cefamandole were the appearance of eosinophilia in 28% of patients and a positive indirect Cooms' test without hemolysis in one patient. Cefamandole showed excellent in vitro activity against 87 ampicillin-resistant strains of H. influenzae. Because it has greater activity than any of the other cephalosporins against this important pediatric pathogen, cefamandole may have particular pertinence in the treatment of infections in infants and young children.

Adolescent

Differential binding of penicillin by membrane fractions from penicillin-susceptible and -resistant gonococci.

An inverse relationship between binding of [(14)C]penicillin to cells of Neisseria gonorrhoeae and the minimal inhibitory concentration of penicillin was recently reported by us. Herein we report a similar relationship in binding by cytoplasmic membranes derived from 10 strains of gonococci. Membranes were extracted after Braun homogenization and differential centrifugation of the resulting extracts. Membranes derived from penicillin-susceptible cells bound 140 to 200 nmol of [(14)C]penicillin per g of enzyme, whereas relatively nonsusceptible strains bound 18 to 59 nmol. Binding by cell walls was only a small fraction of the total binding and probably represents contamination of the walls by membrane. Pretreatment of cell membranes with either unlabeled penicillin or cephalothin prior to [(14)C]penicillin exposure markedly decreased (14)C binding. Slab gel electrophoresis of membranes revealed 13 protein bands, 8 of which were labeled.

Cell Membrane

Acute purulent otitis media in children older than 5 years. Incidence of Haemophilus as a causative organism.

It is generally believed that Haemophilus influenzae is not commonly a causative agent of otitis media in children older than 5 years of age. We recently studied cases of 58 children, aged from 5 to 9 years, who had acute otitis media. Haemophilus species were the causative agents in 36% of cases. This high incidence of Haemophilus isolation from the middle ear exudate of these children has important therapeutic implications; antibiotics effective against H influenzae should be employed when dealing with otitis media in this older age group.

Acute Disease

Human reovirus-like agent infection. Occurrence in adult contacts of pediatric patients with gastroenteritis.

Sixty-four adult family contacts of 61 young patients with gastroenteritis were included in a study for evidence of concurrent infection with the human reovirus-like agent (HRVLA) of infantile diarrhea. Evidence of infection was detected in 26 (41%) of the adult contacts. The HRVLA infection occurred significantly more often among adult contacts of pediatric patients infected with HRVLA (55%) than among contacts of young patients not infected with the agent (17%). Mild cases of gastroenteritis developed in only three of the contacts infected with HRVLA.

Adolescent

Clinical features of acute gastroenteritis associated with human reovirus-like agent in infants and young children.

Between January, 1974, and June, 1975, infection with a human reovirus-like agent was detected in 47% of 152 infants and children hospitalized with acute gastroenteritis. Certain epidemiologic, clinical, and laboratory findings appear to be helpful in distinguishing gastroenteritis due to HRVLA from other causes in those children sick enough to require hospitalization. Age: 76% of infants and children seven through 12 months of age and 76% of those 13 through 24 months of age had infection with the HRVLA, whereas such infection was found in only 21% of infants under six months of age and 23% of children 25 through 60 months of age. Time of Year: 61% of patients studied during the cooler months had HRVLA infection and such infection was not found from June to October. Frequency of vomiting and dehydration: Twice as many patients infected with HRVLA as those who were not had vomiting (92%) and significant dehydration (83%).

Acute Disease