Cytotoxic lymphocytes and antibody-dependent complement-mediated cytotoxicity induced by administration of influenza vaccine.

Recently defined aspects of cellular and humoral antiviral immunity were evaluated in 10 young adults given influenza vaccines containing A/USSR/77 (H1N1) antigens. Cytotoxic lymphocytes were measured by using cryopreserved lymphocytes as effector cells and syngeneic, virus-infected lymphocytes as target cells. An assay previously developed in this laboratory was adapted for the measurement of antibody-dependent, complement-mediated cytotoxicity. Antiviral cytotoxic lymphocyte responses were detected in 5 of 10 volunteers between 3 and 10 days after the initial vaccination. These responses were found both in individuals who were previously primed and in individuals who were not primed to influenza A/USSR/77 antigens. The complement-mediated lysis assay was found to be more sensitive than the hemagglutination inhibition test and probably detected antibodies to both subtype-specific and cross-reactive antigenic determinants. These responses to influenza antigens are similar to those obtained in studies of murine influenza which indicate that cytotoxic lymphocytes and antibody-dependent, complement-mediated cytotoxicity have a role in the early response to acute infection.     

Survivor guilt after downsizing

Like it or not, workforce reduction has become a strategy to achieve or maintain financial solvency. As nurse leader, how can you move staff forward amidst restructuring?     

Interaction of Schistosoma japonicum with Salmonellae and other gram-negative bacteria

The in vitro and in vivo interaction of Schistosoma japonicum with salmonellae and other gram-negative bacteria was studied. In vitro, S. japonicum associated with salmonellae and other gram-negative bacteria, and more male than female schistosomes associated with the bacteria. By using the various strains and mutants of salmonellae, we showed that Salmonella typhimurium had a higher degree of association than did Salmonella enteritidis and that the piliated strains of S. typhimurium associated much more frequently than did the nonpiliated strains. However, in vivo studies demonstrated more frequent association of salmonellae with female than with male schistosomes and that the piliated and nonpiliated strains of salmonella did not differ in their association with the worms.     

Teichoic acids in pathogenic Staphylococcus aureus.

Twenty-six strains of Staphylococcus aureus obtained from patients with endocarditis were studied for the production of alpha- and/or beta-ribitol teichoic acid (TA), using highly specific anti-TA antibodies prepared in rabbits. A counterimmunoelectrophoretic assay was used. Beta-TA was the predominant residue produced by all strains; alpha-TA was found in all strains, but in smaller amounts and with much strain-to-strain variations. Antibodies in patients' sera were found against beta-TA in higher titers and for longer periods than were anti-alpha-TA antibodies. Antibodies against one or both TA residues were present in all but one of 26 patients.     

Antibody levels to bacterial peptidoglycan in human sera during the time course of endocarditis and bacteremic infections caused by Staphylococcus aureus.

Sera from patients with endocarditis and bacteremia due to Staphylococcus aureus were compared for peptidoglycan-binding capacity with those from normal blood donors. Those patients treated with beta-lactam antibiotics had higher antigen-binding levels than normal donors and patients treated exclusively with vancomycin (P less than 0.01). The factor responsible for this activity was purified by affinity chromatography from a normal donor and shown to be an immunoglobulin. Specificity studies indicated that the immunodominant determinant was a peptide sequence found in peptidoglycan precursors. Since soluble peptidoglycan molecules having the precursor peptide sequence are known to be secreted by some gram-positive bacteria like Micrococcus luteus when grown in the presence of beta-lactam antibiotics, these soluble molecules may constitute the "natural" immunogen. Such a hypothesis is consistent with the study of the peptidoglycan-binding capacities in the sera of these patients during the course of treatment. For most of the responding patients studied (four of four with bacteremia and seven of nine with endocarditis), a significant increase in peptidoglycan-binding capacity was observed in sera taken 1 to 5 weeks after the initiation of beta-lactam antibiotic therapy (compared with the initial serum studied). No such increase in the peptidoglycan-binding capacity over a similar time span was noted in the sera of people not receiving beta-lactam antibiotics (none of seven).     

Evidence for the secretion of soluble peptidoglycans by clinical isolates of Staphylococcus aureus.

Four isolates of Staphylococcus aureus from patients with endocarditis and bacteremia were capable of secreting high-molecular-weight soluble peptidoglycans when grown in a minimal cell wall medium containing penicillin G. Vancomycin was not able to substitute for penicillin G in triggering this secretion. Secretion reflected de novo synthesis of soluble peptidoglycan and was strongly dependent on time of incubation (30 to 60 min), and number of bacteria (2 X 10(8) to 5 X 10(8) colony-forming units per ml), but not on penicillin G concentration (10 to 250 micrograms/ml). The incorporation of alanine into the peptidoglycans secreted in vitro by these isolates incubated in the presence of penicillin G under optimal conditions was variable. The least incorporation of alanine into peptidoglycan occurred with an isolate from a patient treated with nafcillin who had no detectable antipeptidoglycan titer.     

In vitro correlation of platelet aggregation with occurrence of disseminated intravascular coagulation and subacute bacterial endocarditis

Platelet-bacterial interactions were examined in vitro by incubating organisms isolated from patients with septicemia with normal platelet-rich plasma. The potency of various species of gram-positive and gram-negative bacteria to induce irreversible platelet aggregation was then determined in an aggregometer. The aggregation curves produced by the bacteria resembled the normal platelet response to collagen and were impeded by the presence of aspirin. Strains of Staphylococcus aureus and Pseudomonas aeruginosa isolated from 25 different patients produced maximum increases in light transmission and irreversible platelet aggregation with relatively rapid mean aggregation times; six of these patients had clinical and laboratory evidence of disseminated intravascular coagulation. In contrast, isolates of alpha streptococcus and Staphylococcus epidermidis induced irreversible platelet aggregation much less commonly and were associated with considerably longer mean aggregation times. None of the latter group of patients had evidence of disseminated intravascular coagulation. Isolates of bacteria from a small number of patients with subacute bacterial endocarditis uniformly induced irreversible platelet aggregation. Addition of paired bacterial isolates to normal platelet-rich plasma demonstrated a synergistic aggregation response. These data suggest that a relative hierarchy exists in bacterial strain potency to induce irreversible platelet aggregation. The rapidity and degree of aggregation in vitro correlated well with the clinical and laboratory evidence for subacute bacterial endocarditis and disseminated intravascular coagulation in vivo. These observations may provide useful adjunctive laboratory information to help establish the diagnosis of subacute bacterial endocarditis, especially in the clinical setting where the classical findings of endocarditis are not obvious during initial presentation.     

Cardiovascular and bacteremic manifestations of Campylobacter fetus infection: case report and review

A case of bacteremia due to Campylobacter fetus subspecies fetus with concomitant pleuropericarditis in a previously healthy patient is presented. The organism is ubiquitous, but most commonly causes infection in patients with chronic underlying illnesses. The pathogenesis of human infection has not been definitively elucidated. Bacteremia is the most common clinical manifestation of this infection, although cases of thrombophlebitis, mycotic aneurysm, endocarditis, and pericarditis have also been reported. The treatment of choice for most infections is gentamicin, with chloramphenicol recommended for infection involving the central nervous system. Tetracyclines and erythromycin are alternative agents. Prolonged therapy is essential to the prevention of relapse. A high index of suspicion is necessary for the recognition of this organism in the appropriate clinical settings.