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Research notes
88 Infectious Diseases Newsletter
IgG and IgA deficiency. The organism was ampicillin-resistant but did not produce ~-lactamase. This is the second clinical isolate and only fourth report of nonlactamase resistance to ampicillin. (Pediatr 69:230, 1982) Editorial note: This is a disturbing phenomon as many laboratories and physicians are relying on 8-1actamase testing of isolates to determine continuation of ampicillin. If it becomes a widespread ~rganism, we will have to rely on sensitivity testing alone or yield to those who believe chloramphenicol should be used from the start. (VAF) CDC: Bartlett and colleagues~report 13 cases of toxic shock syndrome occurring in both men and ~omen following infection of surgical wounds with S. aureus. The median interval between surgery and onset of TSS was two days and no correlation with menstruation or tampon usage was evident in the five menstruating females. JAMA 247:1448, 1982 Boston: As expected, the article by Teele, et al, re: lumbar-puncture induced meningitis (previously discussed in IDN, volume i, number 8) generated a spate of articles to the editor printed in the volume 306 issue of New England Journal of Medicine (March ii, 1982). Correspondents were concerned with: (i) the continued need to be vigilant in the face of a negative LP in a suspect infant; (2) the need to continue to do LPs in suspect infants, even if bacteremic; (3) the clinical dilemma feared if all infants ]i year old who had an LP performed had to be hospitalized; and (4) dispute with the methodology used and interpretation of data. Teele, et ak respond to each of the correspondents and reaffirm the conclusions in their original report. New Engl J Med 306:608, 1982 United States: In 1981, human plague affected 13 persons, 4 of whom died, in 5 states (Arizona, California, Colorado, Oregon, and New Mexico). Patients were 2-72 years old, 7 male and 6 female, 6 were American Indian. Infection occurred from flea bites (5), skinning a bobcat (1), rabbit contact (i), bite of a cat (i), and unknown (5). Prairie dogs and ground squirrels suffer from enzootic plague in 12 western states. From 1970-1981, 136 cases of plague have occurred in the United States. New Mexico, Arizona, California, and Colorado have had most of the cases (123/136, 90.4%). MMWR 31:74, 1982 Geor@ia and New Mexico: Two cases of tularemia presumably acquired from pet cats have recently been reported. This is an uncommon source and can be acquired
from a bite or scratch of an asymptomatic cat. MMWR 31:39, 1982 Seattle: Two infants with chronic diarrhea studied by Clausen and Christie were found to harbor E. coli (0.11:K58:H-) in their smaTl bowel. These organisms were capable of dense adherence to tissue culture cells in vitro suggesting to the authors that thi-~ was an explanation of their capacity to produce disease. J Pediatr 100:358, 1982 RESEARCH NOTES Antibiotics and WBC: Probesch and Hand studied the uptake of 13 radioactive antibiotics into polys obtained from peripheral blood. Penicillin G, cephalexin, cefamandole and cefazolin penetrated WBC's poorly in ratios of <0.01 to 0.5 (cell to extracellular concentration). Gentamicin and INH were slightly better (0.8 to 1.0) but chloramphenicol, rifampin, and lincomycin were concentrated two-fold. Erythromycin, its esters, and clindamycin achieved 5- to 13-fold concentration in the polys. The authors speculate on the use of such data in clinical application. Antimicrob Agents Chemother 21:373, 1982 scrapie: In a fascinating and easily readable report in Science (216:136, 1982), Prusiner details the mounting evidence that scrapie, a degenerative CNS disease in sheep and goats analagous to slow virus infection in man, is caused by a novel and unique infectious agent. The agent is not a virus, plasmid or viroid and the term prion is proposed (representing proteinaceous infectious particle). A review of the evidence thus far establishes the agent as containing protein, probably without nucleic acid, and of small molecular size (50,000 daltons or less). It is possible that nucleic acid may be at the interior, but also possible that the prion is an infectious protein alone. Understanding of this agent may enhance our knowledge of some of the puzzling, possibly infectious degenerative CNS diseases of man. RSV Vaccine? A double-blind placebo-controlled trial of a human diploid fibroblast-grown, attenuated, live RSV vaccine given parenterally was conducted among 510 children 6 to 47 months of age. Despite evidence for some degree of antigenicity in children older than 12 months (68 of 98 initially seronegatives developed antibody), the vaccine did not protect against RSV infection through two epidemics. Children less than 12 months did not respond, suggesting to the authors that maternal immunity persisted. J Infect Dis 45:311, 1982
9 1982 by Elsevier Science Publfsl~ine Co.. Inc.
IgG and IgA deficiency. The organism was ampicillin-resistant but did not produce ~-lactamase. This is the second clinical isolate and only fourth report of nonlactamase resistance to ampicillin. (Pediatr 69:230, 1982) Editorial note: This is a disturbing phenomon as many laboratories and physicians are relying on 8-1actamase testing of isolates to determine continuation of ampicillin. If it becomes a widespread ~rganism, we will have to rely on sensitivity testing alone or yield to those who believe chloramphenicol should be used from the start. (VAF) CDC: Bartlett and colleagues~report 13 cases of toxic shock syndrome occurring in both men and ~omen following infection of surgical wounds with S. aureus. The median interval between surgery and onset of TSS was two days and no correlation with menstruation or tampon usage was evident in the five menstruating females. JAMA 247:1448, 1982 Boston: As expected, the article by Teele, et al, re: lumbar-puncture induced meningitis (previously discussed in IDN, volume i, number 8) generated a spate of articles to the editor printed in the volume 306 issue of New England Journal of Medicine (March ii, 1982). Correspondents were concerned with: (i) the continued need to be vigilant in the face of a negative LP in a suspect infant; (2) the need to continue to do LPs in suspect infants, even if bacteremic; (3) the clinical dilemma feared if all infants ]i year old who had an LP performed had to be hospitalized; and (4) dispute with the methodology used and interpretation of data. Teele, et ak respond to each of the correspondents and reaffirm the conclusions in their original report. New Engl J Med 306:608, 1982 United States: In 1981, human plague affected 13 persons, 4 of whom died, in 5 states (Arizona, California, Colorado, Oregon, and New Mexico). Patients were 2-72 years old, 7 male and 6 female, 6 were American Indian. Infection occurred from flea bites (5), skinning a bobcat (1), rabbit contact (i), bite of a cat (i), and unknown (5). Prairie dogs and ground squirrels suffer from enzootic plague in 12 western states. From 1970-1981, 136 cases of plague have occurred in the United States. New Mexico, Arizona, California, and Colorado have had most of the cases (123/136, 90.4%). MMWR 31:74, 1982 Geor@ia and New Mexico: Two cases of tularemia presumably acquired from pet cats have recently been reported. This is an uncommon source and can be acquired
from a bite or scratch of an asymptomatic cat. MMWR 31:39, 1982 Seattle: Two infants with chronic diarrhea studied by Clausen and Christie were found to harbor E. coli (0.11:K58:H-) in their smaTl bowel. These organisms were capable of dense adherence to tissue culture cells in vitro suggesting to the authors that thi-~ was an explanation of their capacity to produce disease. J Pediatr 100:358, 1982 RESEARCH NOTES Antibiotics and WBC: Probesch and Hand studied the uptake of 13 radioactive antibiotics into polys obtained from peripheral blood. Penicillin G, cephalexin, cefamandole and cefazolin penetrated WBC's poorly in ratios of <0.01 to 0.5 (cell to extracellular concentration). Gentamicin and INH were slightly better (0.8 to 1.0) but chloramphenicol, rifampin, and lincomycin were concentrated two-fold. Erythromycin, its esters, and clindamycin achieved 5- to 13-fold concentration in the polys. The authors speculate on the use of such data in clinical application. Antimicrob Agents Chemother 21:373, 1982 scrapie: In a fascinating and easily readable report in Science (216:136, 1982), Prusiner details the mounting evidence that scrapie, a degenerative CNS disease in sheep and goats analagous to slow virus infection in man, is caused by a novel and unique infectious agent. The agent is not a virus, plasmid or viroid and the term prion is proposed (representing proteinaceous infectious particle). A review of the evidence thus far establishes the agent as containing protein, probably without nucleic acid, and of small molecular size (50,000 daltons or less). It is possible that nucleic acid may be at the interior, but also possible that the prion is an infectious protein alone. Understanding of this agent may enhance our knowledge of some of the puzzling, possibly infectious degenerative CNS diseases of man. RSV Vaccine? A double-blind placebo-controlled trial of a human diploid fibroblast-grown, attenuated, live RSV vaccine given parenterally was conducted among 510 children 6 to 47 months of age. Despite evidence for some degree of antigenicity in children older than 12 months (68 of 98 initially seronegatives developed antibody), the vaccine did not protect against RSV infection through two epidemics. Children less than 12 months did not respond, suggesting to the authors that maternal immunity persisted. J Infect Dis 45:311, 1982
9 1982 by Elsevier Science Publfsl~ine Co.. Inc.