Low morbidity in the surgical patient with group B streptococci.

Non-Group A or D beta hemolytic streptococci were identified in the vaginas of 5-11% of prenatal patients. More than 97% of organisms so identified have been found to be specifically Group B beta hemolytic streptococci (GB-BHS). The differences may have been related to seasonal changes. These organisms were found in 5% of preabortion patients--none of whom developed any infectious morbidity even though no therapy was used prior to the abortion. Of 100 gynecologic patients undergoing major gynecologic surgery, 17% had preoperative cultures positive for GB-BHS. However, the morbidity (18%) was the same for the culture-positive and culture-negative patients.

Salpingitis-perihepatitis in a patient with cervical Shigella sonnei.

A case of perihepatitis-salpingitis syndrome is described in a woman from whose cervix Shigella sonnei was isolated. Her sexual practices included anal, then vaginal, intercourse, which may account for the pathogenesis.

Is penicillin G a better choice than ampicillin for prophylaxis of neonatal group B streptococcal infections?

A review of the pharmacokinetics and the narrow spectrum of action of penicillin G favors this antibiotic over ampicillin for the prophylaxis of early neonatal group B streptococcal (GBS) disease. Penicillin G provides good placental transfer and fetal and neonatal tissue levels. Group B streptococcal disease has a narrower range of sensitivities to penicillin G than to ampicillin, and the potential for selecting more resistant organisms may be greater with the broader spectrum of ampicillin than with penicillin G.

Puerperal infection due to group A beta hemolytic streptococcus.

A cluster of 5 patients with puerperal infection due to group A beta hemolytic streptococcus (GABHS) is described. The most striking clinical signs included the early onset of uterine tenderness followed by an abrupt temperature elevation to greater than or equal to 102 F. At the time of uterine tenderness (Day 2, postpartum), 4 of 5 patients had gram-stained lochial smears showing a predominance of gram-positive cocci. The cluster of cases occurred with no source of the infection identified after 365 culture attempts. Therapy was rapidly successful with intravenous penicillin.

Effect of povidone-iodine on herpesvirus type 2, in vitro.

Povidone-iodine solution (Betadine) at concentrations of 0.167% (v/v) reduced the end-point titers of Strain E.M. herpesvirus, type 2, by more than 99.99%. Even at concentrations of 0.0167% (v/v), povidone-iodine solution reduced the titers by 92%. The iodine solution, per se, had no effect on cultured human fibroblasts in concentrations of 1.67% (v/v).

Septicemia due to multiple biotypes of Escherichia coli.

BACKGROUND: Polymicrobial bacteremias with different biotypes of the same organism have not been reported as a cause of bacteremia in any patient. CASE: A 37-year-old gravida had a cesarean delivery performed after a failed vacuum extraction. On the second postoperative day, she developed a septicemia with temperature to 39.4C. Three different biotypes of Escherichia coli with different antibiotic susceptibilities were isolated from her blood. A fourth biotype was isolated from the urinary and genital tracts; therefore, the source of her bacteremia was not apparent. She was treated successfully with cefoxitin and gentamicin. CONCLUSION: Accurate selection of colonies from microbiological isolation plates allowed identification of four different E. coli biotypes (three in the blood) from a bacteremic patient. Rapid identification of antibiotic susceptibility is important in such patients.

Herpesvirus infection in the newborn. Its treatment by exchange transfusion and adenosine arabinoside.

A case is reported of herpesvirus infection in the newborn following maternal genital herpesvirus infection. The rationale for treating a newborn infant with signs of disseminated herpesvirus infection by exchange transfusion in addition to adenosine arabinoside is discussed. Because of the lack of data concerning therapy for a disease with a 50 to 100% mortality rate, it is important to present material such as this in order to provide information about possible new therapeutic modalities.

Neonatal passive immunization by maternal vaccination.

An old concept--passively immunizing a fetus by actively immunizing (vaccinating) its mother--is reevaluated in light of 50 years of data. The history and data reviewed here suggest that this concept is one whose time has come for active modern research and clinical use. In Third World countries, this concept already has provided significant reduction in morbidity and mortality from neonatal infections such as tetanus. Some other neonatal and infant infections--heretofore life-threatening--may now have a practical method for prevention. These include group B beta-streptococcal sepsis and Hemophilus influenzae meningitis.

The political history of syphilis and its application to the AIDS epidemic.

The history of syphilis control from the mid-19th century through the present time is a strong argument for the need to enhance the public health efforts to find cases of human immunodeficiency virus (HIV) infection and to notify the partners of infected individuals. To do this, public policy must be changed to allow better case-finding (mandatory testing) and partner notification (mandatory reporting). The history of syphilis is such that one person in 22 was infected in this country in 1918. If we are to use this history to control the current HIV epidemic, control measures used for syphilis (before penicillin) are needed; these are equal attention to education, available health care, case-finding, and partner notification.

Hemophilus influenza septicemia and midtrimester abortion.

A case of midtrimester septic abortion due to Hemophilus influenza is discussed on the basis that the pathogeneses of the septic abortion was due to the hematogenous spread of the organism orginating from upper respiratory infection. The absence of ruptured membranes and the elevated antibody titer at the onset of the pelvic infection were in keeping with this hypothesis. Additional data on the bacteriology of this organism and the probability of the occurrence of a type b organism with original ampicillin resistance are presented.