ISSN:0891-3668    

出版商:OVID    

年代:1990

数据来源: OVID

ISSN:0891-3668    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

In a prospective study 225 (35%) of 640 pregnant women who delivered at term had vaginal colonization with Ureaplasma urealyticum at the thime of delivery. One hundred ninety-three full term infants born to U. urealyticum-colonized mothers were cultured from the throat, eyes and vagina within the first 3 days of life. One hundred seven infants (55%) had at least one culture site positive for U. urealyticum (throat 41%, eyes 20%, vagina 40%). Rupture of membranes for 12 hours and the mode of delivery did not affect vertical transmission of U. urealyticu. We were able to follow 108 infants during the first 3 months of life. Sixty-eight, 33 and 37% of the infants who were initially colonized with U. urealyticum in the throat, eyes and vagina, respectively, were still colonized when the follow-up cultures were obtained 3 months later. Fourteen of the 108 infants whom we followed developed a lower respiratory tract illness. In the pharyngeally colonized infants there was no increase risk for lower respiratro ytract illness during early infancy compared with the pharyngeally noncolonized infants.

ISSN:0891-3668    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

Mycoplasma hominis or Ureaplasma urealyticum have previously been isolated from cerebrospinal fluid (CSF) in 13 of 100 newborn infants tested from a high risk university hospital populaton where the mothers were of predominantly lower income and socioeconomic status and had often received little or no prenatal care. We sought to determine whether such infections occur in neonates born to women cared for mainly through private obstetric practices and who delivered in 4 suburban community hospitals. CSF cultures where done in 318 infants during an 8-month period. M. hominis was isolated from 9 and U. urealyticum from 5 CSF cultures. Four infants infected with U. urealyticum and 3 infected with M. hominis were born at term. One infant infected with U. urealyticum had a birth weight of <1000 g. In 5 inftants clearance of the infecting organism was documented without specific treatment. Tweleve infants had good perinatal outcomes regardless of treatment and 2 died. One death in a 2240-g infant infected with M. hominis was associated with Haemophilus influenzae sepsis and pneumonia. The other death occurred 3 days after birth in a 630-g infant infected with U. urealyticum who had evidence of meningitis and intraventricular hemorrhage. Results of this study suggest that mycoplasmas are common causes of neonatal CSF infections, not only in high risk populations, but also in the general population.

ISSN:0891-3668    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

A cost-benefit analysis of Haemophilus influenzae type b disease preventive strategies was updated to consider evaluation of the H. influenzae type b polysaccharide-diphtheria toxoid cojugate vaccine (PRP-D) and H. influenzae type b oligoasacharide-mutant diphtheria toxin conjugae vaccine (HbOC) for children at 18 months of age. The analysis was done from the perspective of society as a whole. The economic costs of H. influenzae type b disease in the 1988 United States bith cohort would be $2.546 billion (1988 U.S. dollars) in the absence of preventive efforts. If 60% of all children could be vaccinated with PRP-D or HbOC at 18 months of age, this strategy would save $207.1 million (88.22 savings/vaccinee; $43.605 cost/case prevented; 3.57/1 benefit-to-cost ratio) under base case model assumptions. Universal PRP-D or HbOC vaccination at 18 months of age would prevent 1845 cases of invasive H. influenzae type b disease. The break-even efficacy for universal PRP-D or HbOC vaccination at 18 months of age is sufficiently efficacious so that the costs of vaccination would be more than offset by decrease medical care costs for treating H. influenzae type b disease.

ISSN:0891-3668    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

Invasive Haemophilus influenzae type b (HIB) infections occurring from 1985 to 1987 in children younger than 16 years of age living in the state of Victoria were reviewed. Ther were 547 cases which fulfilled the case definition, including 231 cases of meningitis, 219 of epiglottitis and 97 other infections; 14 (2.6%) children died, 8 with meningitis, 5 with epiglottitis and 1 with pneumonia. Ninety-five percent of cases occurred in children younger than 5 years of age, in whom the case attach rate was 58.65/100000/annum. Nealy two-thirds of cases (46% of meningitis; 91% of epiglottitis; 45% of other infections) occurred in children more than 18 months of age (the age at which vaccine is presently given in the United Staes). Compared

ISSN:0891-3668    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

Forty-three Danish splenectomized children received a single subcutaneous dose of a 14-valent pneumococcal vaccine (Pneumovaxw23; Merck). Blood samples were taken before, 4 weeks after and 5 years after vaccination. Total pneumococcal antibody concentrations as well as antibodies against each of the 14 pneumococcal capsular polysaccharide antigens were measured by the enzyme-linked immunosorbent assay method. Depending on the pneumococcal antibody status 5 years after primary vaccination, the children were either prevaccinated with a new23-valent pneumococcal vaccine or scheduled for reexamination later. The antibody concentrations found 5 years after vaccination showed a strong correlaton with the prevaccination antibody concentrations. Revaccination of children with low antibody concentrations 5 years after primary vaccination is safe, is without significant side effects and leads to a satisfactory antibody response.

ISSN:0891-3668    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

The antibody responses and reactogenicity of a measles, mumps and rubella vaccine in 9-month-old and 15-month-old black children in South Africa were compared. The antibody response to the measles component was marginally better in the older group, but no differences were observed in the response to the mumps and rubella components. Reactogenicity was similar in the two age groups. Therefore it is possible that a trivalent measles, mumps and rubella vacine can safely and effectively replace routine measles immunization at 9 months of age in this population. Whether routine immunization policy should incorporate such a vaccine depends on the extent of acceptance of measles vaccination. In urban populations of developing countries with high rates of measles immunization, routine vaccination at 9 months might interrupt circulating wild type rubella and provide sufficient herd immunity to protect susceptible women of childbearing age. It also should decrease significantly the complications associated with wild type mumps infection. The replacement of measles vaccine by a trivalent vaccine may be very cost-effective.

ISSN:0891-3668    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

We investigated an outbreak of erythromycinresistant Staphylococcus aureus conjunctivitis in a hospital newborn nursery that used erythromycin eye ointment to prevent ophthalmia neonatorum. Cases occurred in 2 clusters; 20 (14%) of 146 infants in the nursery developed conjunctivitis from July through October, 1987; and 5 (7%) of 69 infants in the nursery developed conjunctivitis during April and May, 1988. A case-control study of the first cluster demonstrated that culture-confirmed cases were more likely than controls to have received prophylactic erythromycin eye ointment or their initial bath from one nure (odds ratio, 9.0; P = 0.01) or to have been delivered by one physician (odds ratio, 12.7; P = 0.03). The nurse was the only staff person to have a nasopharyngeal culture which yielded erythromycin-resistant S. aureus. Control measures, instituted in October, 1987, included using silver nitrate drops instead of erythromycin eye ointment for prophylaxia; however, in Januray, 1988, the hospital resumed use of erythromycin eye ointment. No additional cases were identified until mid-April, 1988, when the second cluster of cases occurred. At that time the hospital reinstituted the use of silver nitrate and no additional cases were identified. This investigaton illustrates the potential for conjunctival infection with an antimicrobial-resistant pathogen when antimicrobials are used to prevent ophthalmia neonatorum.

ISSN:0891-3668    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

To determine whehter changing needles during the collection of blood cultures to 1 of 3 groups: no needle changes (blood instilled directly into culture media through the needle used for venipuncture); 1 needle change (before inoculation into the first of 2 culture bottles); and 2 needle changes (before inoculation into each of 2 culture bottles). Each patient's skin was cleansed with povidoneiodine for 60 seconds before venipuncture. We found similar rates of contamination among the 3 groups: no change, 2 of 92 (2.2%); 1 change, 0 of 106 (0.0%); 2 changes, 2 of 105 (1.9%). The combined contamination rate of all 3 groups (1.3%) was significantly lower than the prestudy rate of contamination (4.4%), based on 315 blood cultures (P = 0.04). These data suggest that careful skin preparation is a more important factor than changing needles in reducing contamination during blood culture collection.

ISSN:0891-3668    

出版商:OVID    

年代:1990

数据来源: OVID