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At least 19 recordsLinked to original sources
PubMed1979

Risk of pneumococcal infections in renal transplant patients.

Because of the recent licensing of pneumococcal vaccine, the risk of pneumococcal infections on a renal transplant service was determined. The overall risk of infection was 7% (14 of 197 patients) over a six-year period, or 1% per year. In patients with functioning allografts, this represented a risk of 28 infections per 1,000 patient-years of follow-up. Clinically, the major presentations of pneumococcal infection were pneumonia in the patient who was rejecting his kidney and pneumococcemia of sudden onset that was often fatal. Five of the pneumococci isolated from bacteremic patients were typed; three of the isolates were types that are in the vaccine. The frequency and seriousness of pneumococcal infections in renal transplant patients suggest that pneumococcal vaccine should be given to these patients, probably before transplantation.

Bacterial Vaccines↗
PubMed1979

Pneumonia and pneumococcal infections, with special reference to pneumococcal pneumonia. The 1979 J. Burns Amberson lecture.

An etiologic classification of acute pneumonia was presented and the relative importance of some of the causative agents was briefly reviewed. The early developments of the therapy of pneumococcal pneumonia with type-specific antisera, sulfonamide drugs, and antimicrobial drugs were reviewed, mostly from the experiences of the author at Boston City Hospital. Changes in the occurrence and relative importance of the pneumococcus as a cause of infections associated with bacteremia, empyema, and meningitis were demonstrated, based on cases observed at Boston City Hospital during 12 selected years between 1935 and 1972. These findings, among others, indicate that the pneumococcus is still one of the most important causes of serious bacterial infections and of mortality from such infections, particularly in the elderly. Some possible indications for polyvalent pneumococcal capsular polysaccharide vaccine were discussed, and the need for further extensive clinical and field trials to demonstrate its range of effectiveness was stressed.

Age Factors↗
PubMed1979

[Contribution of the counter-immunoelectrophoresis for the diagnosis of pneumococcal infections (author's transl)].

Using counter-immunoelectrophoresis (CIE), the authors have looked for pneumococcal antigens in biological fluids in 141 pneumococcal infections cases (70 meningitis, 25 empyema, 40 pneumonia, 5 peritonitis, 1 pericarditis). The best results (superior to bacteriological results) were obtained with CSF and pleural fluid. Testing sputum by CIE seems to have a real interest in pneumonia. CIE associated with bacteriology, gives more than 20% increase in aetiological diagnosis in pneumococcal infections and permits to set accurate aetiological diagnosis in less than two hours.

Cerebrospinal Fluid↗
PubMed1976

Latex agglutination in the diagnosis of pneumococcal infection.

A latex agglutination (LA) method for detection of pneumococcal antigens was evaluated and compared with counterimmunoelectrophoresis (CIE). LA was 2 to 10 times more sensitive than CIE for the detection of purified capsular polysaccharides in defined media, but only when a 1+ or 2+ agglutination reaction was interpreted as positive. LA was much less sensitive than CIE with clinical samples. In 50 cases of pneumococcal pneumonia, antigen was detected in the serum almost twice as often with CIE (40%) as with LA (22%). LA was positive in six cases of pneumonia where CIE was negative; however, in three of these cases, antigen was detected only in undiluted sera, which raised some question about the specificity of the result. With 18 samples of cerebrospinal fluid (CSF) from 11 patients with pneumococcal meningitis, the CIE test was positive more frequenlty (14 samples) than was LA (11 samples). Moreover, antigen was detected in CSF by LA in only one additional patient than was positive by CIE alone. There was one false-positive LA reaction among 45 samples of CSF from patients without pneumococcal infection. Although LA is a less complicated method than CIE, it is not a sensitive test for pneumococcal antigens and would be of little value as a routine diagnostic method.

Antigens, Bacterial↗
PubMed1979

Clinical aspects and importance of pneumococcal infections.

Annualy in the USA, the estimated occurence of pneumococcal disease exceeds 500 000 cases of pneumonia (50 000 deaths), 1 200 000 cases of otitis media and 5 000 cases of meningitis. The pneumococcus remains the single most important pathogen which can cause pneumonia. When bacteremia accompanied pneumococcal pneumonia (one-fifth of these), the case fatality rate is approximately of 25% and exceeds 50% in individuals over 50 years of age. Most of the deaths (60%) occur within the first five days of illnesses, despite prompt antibiotic treatment of these patients. Emergence of pneumococcal strains with diminished sensitivity for penicillin, or resistant to tetracycline and other antibiotics is also a factor which lend increasing support to the concept that high risk patients should be protected from pneumococcal infection by immunoprophylaxis. A change of capsular types associated with bacteriemic disease has occured, in the USA, during the past three decades. The types 1 and 3 are less common than in the pre-antibiotic era, and the types 4, 8, 12, and 14 have become more prevalent. Infections with type 2, an epidemic type, have occured infrequently in the past 20 years. In the USA, at the present time, nearly four-fifths of bacteremic cases are associated with only 14 of the 84 pneumococcal capsular type ; in descending frequency : 8, 4, 1, 14, 3, 51, 12, 6, 56, 9, 19, 23, 5 and 20 (American system of nomenclature). The predominant capsular types of otitis media are : 1, 3, 6, 7, 14, 18 and 23. The polyvalent pneumococcal polysaccharide vaccine newly developed in the USA, is safe, antigenic and effective. Its widespread use can be expected to reduce the number of deaths attribuable to pneumococcal bacteremia.

Adolescent↗
PubMed1979

Pneumococcal infections and the possible need for a vaccine.

Antibiotics and chemotherapeutics have been available for about 40 years, but still bacterial infections constitute some of the greatest problems in medicine. Pneumococci causing pneumonia, bacteremia, meningitis and otitis are a leading cause of illness and death. The exact incidence and lethality of pneumococcal infections is not known, however, since they are not reportable diseases in most countries and since microbiological diagnosis is difficult. In the latest years some significant progresses have been made for the diagnosis of infections caused by pneumococci, especially pneumonia. This is for example the counterimmunoelectrophoresis (CIE) for antigen determination, the transtracheal aspiration (TTA) for direct bacterial cultivation from trachea, and serological assays like radioimmunoassay (RIA) and enzyme-linked immunosorbent assay (ELISA) for pneumococcal capsular antibody determination. These techniques have further emphasized the significance of pneumococcal infections. The recent finding of pneumococci resistant to penicillin and some other antibiotics also emphasizes the need for immunological prophylaxis. In recent years a vaccine consisting of the purified, most common pneumococcal polysaccharides has been introduced. It has been shown to protect against pneumonia, pneumococcal infections in splenectomized individuals and people with spherocytosis and probably partly against otitis media. Indications for the vaccine are suggested.

Adult↗
PubMed1979

Pneumococcal infections after human bone-marrow transplantation.

Seven of 26 long-term survivors (greater than 7 months post-transplant) of bone-marrow transplantation developed penicillin-sensitive pneumococcal infections more than 7 months after transplantation. One patient had two infections. Six of eight infections were associated with pneumococcal bacteremia, and Streptococcus pneumoniae type 6A was isolated in three cases. Two infections were fatal. All patients had normal nematopoietic function, and none was receiving immunosuppressive therapy. The development of pneumococcal infection was significantly associated with males and with abnormally low or high serum IGG and IgM levels but not with graft-versus-host disease. Serum opsonic activity for S. pneumoniae type 6A was decreased in six of the seven patients when compared to normal pooled serum in an in-vitro bactericidal assay. Four of the six patients with impaired opsonic activity had low serum antibody levels for S. pneumoniae type 6A capsular polysaccharide, while the other two patients had low serum CH100 complement activity. Bone-marrow transplant recipients have an increased susceptibility to pneumococcal infections and should be evaluated for prophylactic penicillin or pneumococcal vaccination.

Adolescent↗
PubMed1979

[Pneumococcal infections and pediatric intensive care (author's transl)].

During the period 1965 to 1978, 62 cases of severe pneumococcal infection were admitted in Saint-Vincent de Paul pediatric intensive care unit. Recovery without sequelae was observed in only 17 of 49 meningitis. 5 fulminant pneumococcal infections after splenectomy or other disorders were observed. This late condition may be preventable by vaccination.

Adolescent↗
PubMed1977

Serotypes of pneumococci in pneumonia, meningitis and other pneumococcal infections.

During a five-year period, 1965 to 1969 inclusive, pneumococci from 294 patients with acute pneumococcal infections were serotyped. Pneumococci of 33 serotypes were encountered, of which types 3 and 19 were most frequent. The spectrum of infections included pneumonia, meningitis, peritonitis, otitis media and mastoiditis, wound infection and conjuctivitis. At least 17 infections were fatal, all of which, with one exception, occurred either in infants or in adults over 50 years of age. In pneumonia, type 3 pneumococcus was predominant, being isolated from 21 of 101 patients. In 67 cases of pneumococcal meningitis, most of which were in children, the commonest type was 14. If a pneumococcal vaccine is produced for use in Australia, inclusion of serotypes 1, 3, 4, 6, 9, 14, 19 and 23 should be considered. These eight types caused 52% of the cases of pneumonia and 67% of the cases of meningitis in this study.

Acute Disease↗
PubMed1977

Prevention of pneumococcal infection by immunization with capsular polysaccharides of Streptococcus pneumoniae: current status of polyvalent vaccines.

Because of the continuing morbidity and mortality resulting from pneumococcal infection, a program was instituted to redevelop polyvalent vaccines consisting of capsular polysaccharides of Streptococcus pneumoniae. Vaccines containing 50 microgram each of the capsular polysaccharides of as many as 13 pneumococcal types have been shown to be safe, antigenic, and 78.5% effective in the prevention of type-specific putative pneumococcal pneumonia and of type-specific pneumococcal bacteremia in adults. In a population in which pneumococcal pneumonia predominated, the total incidence of radiologically confirmed pneumonia, irrespective of cause, was reduced by 54.3% by use of a tridecavalent vaccine. The efficacy of vaccine in the prevention of infection during the first two years of life is under investigation. The vaccine is recommended for those at high risk of pneumococcal infection or of a fatal outcome from such illness.

Adult↗
PubMed1979

[Severe pneumococcal infections of adults. 100 cases collected in three years (Claude Bernard Hospital, Paris) (author's transl)].

After retrospective in intensive care unit of 100 severe cases of pneumococcal infection in three years, the authors analyse the circumstances of onset (occurring in autumn of winter), the general status (without evident high risk population), the symptomatology (84% of meningitis, 30% of pneumonia), the origin of infection (essentialy otitis media in meningitis). The case fatality rate is 39%. Frequency of multiple visceral localisations and of bacteremias is emphasized.

Adolescent↗
PubMed1979

[The pneumococcal infection in a general hospital of a parisian suburb: a prospective study in Villeneuve-Saint-Georges hospital (author's transl)].

The authors have carried during one year, in the hospital of Villeneuve-Saint-Georges, a prospective study on 229 cases of pneumococcal infections with bacteriological findings. They emphazise the frequency, the high-exposed groups and the gravity of these infections despite of the antibiotherapy. The emergence of multiply resistant pneumococcus makes out another argument for proposing a preventive vaccination taking notice of the most frequent serotypes found in France.

Adolescent↗
PubMed1979

[Pneumococcal infections in military quarters (author's transl)].

A retrospective study on prevalence of pneumococcal in French military recruits of two military districts has been made in 1976 and 1977. Among 185,000 adults, 19 pneumococcal diseases were registered (0,1%). 15 were respiratory infections (10 acute pneumonia). The agent has been isolated of blood (the half) and of others samples : expectoration... (the half). In despite of geographical and climatic differences of two districts, the incidence of pneumococcal pneumonia is the same. The low prevalence of that infection results from the age, selection, and medical surveillance of the population studied.

Adult↗
PubMed1978

Gingivitis and cellulitis in diffuse pneumococcal infection.

Gingivitis occurring with a cystic lesions in young patients with facial cellulitis is highly suggestive of a pneumococcal etiology. Two cases of pneumococcal cellulitis and gingivitis with bacteremia are reported, and the pertinent literature is reviewed.

Cellulitis↗