[Severe staphylococcal infection in children. Study of 28 cases].
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A solid-phase radioimmunoassay (SPRIA) for determination of antibodies against S. aureus peptidoglycan was used for serological diagnosis of staphylococcal infections. Elevated IgG antibody levels were found in 21/21 patients with S. aureus endocarditis and in 10/24 patients with S. aureus septicemia. Two patients with streptococcal and one patient with pneumococcal septicemia showed elevated antibody levels as well, probably due to cross reactions between peptidoglycans of different bacterial species. In cases of chronic osteomyelitis caused by S. aureus, 12/33 patients showed elevated antibody levels while all patients with recurrent furunculosis had normal antibody levels. Anti-peptidoglycan antibodies were also found in all healthy controls (n = 160) but at lower levels. This might explain the rapid booster response of IgG antibodies found in 73 per cent of patients with S. aureus endocarditis already within 10 days after the first symptoms. The best clinical value of the assay seems to be in separating S. aureus endocarditis from uncomplicated septicemia.
Mitomycin C, an antineoplastic antibiotic, and gentamicin showed a dose-related protective effect in mice against a lethal staphylococcal infection when used singly. A combination of these two drugs was shown to be synergistic in the mouse model. A specific logistic regression analysis method confirmed that a synergistic bactericidal effect was obtained with the combination.
Clinical and bacteriological effectiveness of the fosfomycin-cefotaxime combination is reported in four cases of serious staphylococcal infections in neonates (1 meningitis, 2 osteomyelitis, 1 superinfection of congenital varicella). Owing to the strong synergistic effect of this combination on methicillin-resistant staphylococcal strains, the authors suggest that the fosfomycin-cefotaxime combination should be considered for anti-staphylococcal therapy in neonates with deep tissue and/or methicillin-resistant infections.
Pathogenic staphylococci were found to persist in the focus of dormant infection in guinea pigs till day 100 of the experiment without changing their biological properties and sensitivity to antibiotics. The latent period of dormant staphylococcal infection was characterized by the increasing titers of antibodies to staphylococcal autostrains, by the positive results of the intradermal allergic test and the macrophage migration inhibition test with hemolytic staphylococcal allergen, as well as by the suppression of serum lysozyme activity. No changes in the content of complement and the total bactericidal activity of blood serum were detected.
A woman with an intracellular killing defect in the neutrophils had neutrophil pyruvate kinase deficiency. She had had recurrent staphylococcal infections throughout her life. The enzyme present was unstable and its kinetics were abnormal.
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