Response to Type III polysaccharide in women whose infants have had invasive group B streptococcal infection
Article Abstract:
Since infants may become seriously ill and even die as a result of group B streptococcal infection, especially the Type III sort, vaccination of pregnant women has been proposed. (Increasing maternal antibody may confer greater immunity against the infection to the newborn.) However, some women do not appear to be able to manufacture antibodies to group B streptococcus, and vaccination would not produce an adequate antibody response. To determine the antibody responses of women whose infants were born with group B streptococcal infection of early or late onset, a vaccination program was undertaken. Twenty-two women with nonimmune (low) levels of antibody to Type III polysaccharide served as a control group. Blood was obtained prior to Type III streptococcal polysaccharide vaccination and four weeks later; in addition, antibody levels for the mothers at the time of delivery (on average, 7.3 years prior to the study) were known. Thirty of the infants had Type III streptococcal infection (13 in the early-onset group, 17 in the late-onset group); 22 of these infants had meningitis (6 in the early-onset group and 16 in the late-onset group). The remaining 10 infants had non-Type III infection. Very low levels of antibody were found in six of eight blood samples from women whose infants had early-onset Type III infection, and in all samples from mothers of the late-onset Type III group. At the time of the study, 77 percent and 41 percent of mothers whose infants had early-onset or late-onset disease, respectively, had high (more than two micrograms per milliliter) levels of antibody. Immunization with Type III streptococcal polysaccharide vaccine led to a detectible increase in antibody levels in all women; the women with higher antibody levels prior to vaccination increased their levels the most. This was true for both the experimental and control groups. However, the women with the lowest antibody levels (below two micrograms per milliliter) increased their response by only 57 percent. Overall, vaccination increased the immunity of mothers whose infants were infected with group B streptococcus from 48 percent to 75 percent. These findings indicate that the mothers of the infected infants were capable of producing antibody to this form of infectious agent (the vaccine), in contrast to the conclusions of other published reports. The reasons for the relative non-responsiveness to the vaccine by mothers with low levels of antibody are not known. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: The New England Journal of Medicine
Subject: Health
ISSN: 0028-4793
Year: 1990
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Patterns of immune response among survivors of group B streptococcal meningitis
Article Abstract:
Specific antibody responses to type III, group B streptococci (GBS) may vary depending on the age of the patient and the form of the disease. Infants at an average age of 24 hours who recover from bacteremia (bacteria in the blood) without meningitis do not produce an antibody response. Those recovering from late-onset meningitis, at an average age of 24 days, produce variable antibody responses. Patients with osteomyelitis (bone infection) produce a greater concentration of type-specific antibodies. Long-term immune responses were studied with a group of 10 infant survivors of non-fatal type III GBS meningitis, one half with early-onset disease and one half with late-onset disease. Blood was collected from each infant shortly after admission, during early convalescence, and monthly thereafter until the age of six months; at least six blood specimens per child were collected. Positive type III GBS isolates were obtained from both blood and cerebrospinal fluid (CSF) in eight infants, and one each from blood and CSF in two additional infants. Antibody responses and persistence were variable and transient, lasting for only 4 to 12 weeks. These results confirm the findings of other investigators. Functional competence of infant serum for opsonocytophagocytosis of type III GBS did not fully develop with low levels of complement and specific antibodies. (Opsonin is a factor that enhances phagocytosis; opsonocytophagocytosis pertains to the increased efficiency of phagocytic activity of white blood cells containing specific opsonins. Phagocytosis results in destruction of bacteria.) Other specific immunologic findings are described. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Journal of Infectious Diseases
Subject: Health
ISSN: 0022-1899
Year: 1990
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Group B streptococcal breast abscess in a mother and mastitis in her infant
Article Abstract:
Infections due to to Group B Streptococcus bacteria are common after birth, but this is the first reported case of the bacteria causing a breast abscess in a woman secreting milk (lactating). Seven days after giving birth, one breast of the woman became inflamed (mastitis), due to the streptococcal infection. She received oral antibiotics for one week and appeared to be cured. She continued breast feeding, and most of the time used the unaffected breast. Two days later, the inflammation returned, and the breast abscess had to be drained. Five days after the mother had first developed an inflamed breast, the infant developed the same type of breast inflammation. It is likely that the infection was passed from the mother to infant and back again. Continued breast-feeding after detection of a maternal breast abscess is ill-advised, since it puts the infant at serious risk for infection.
Publication Name: Obstetrics and Gynecology
Subject: Health
ISSN: 0029-7844
Year: 1989
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