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Fragestellung: Mit Hilfe eines Tiermodells der neonatalen B-Streptokokken-Pneumonie sollte der Einflus von Surfactant auf das pulmonale Entzundungsgeschehen und die Freisetzung von Elastase, einem proteolytischen Enzym neutrophiler Granulozyten, untersucht werden. Methode: Kaninchenfeten mit einer Tragzeit von 29,5 Tagen wurden intratracheal mit B-Streptokokken infiziert und uber einen Zeitraum von 5 h beatmet. 15 min nach der Infektion wurden Surfactant (Curosurf 200 mg/kg) bzw. ein identisches Volumen (2,5 ml/kg) NaCl 0,9 % verabreicht. Im Lungenhomogenisat der linken Lunge wurden die Bakteriendichte bestimmt sowie die Aktivitat der freien Elastase gemessen. Die rechte Lunge wurde lichtmikroskopisch im Hinblick auf entzundliche Veranderungen untersucht. Ergebnisse: Die mit Surfactant behandelten Tiere ( n = 11) wiesen ein signifikant niedrigeres Bakterienwachstum, geringer ausgepragte entzundliche Veranderungen bei der histologischen Beurteilung sowie eine verminderte Aktivitat der freien Elastase (Mittelwert ± SEM: 4,22 ± 0,95 vs. 8,02 ± 1,28 μg/g Lunge; p < 0,05) im Vergleich zu infizierten Tieren auf, die NaCl erhalten hatten (n = 12). Kontrolltiere, die nur NaCl erhalten hatten (n = 11) und eine weitere Gruppe von Tieren, die unmittelbar nach Infektionsbeginn untersucht wurden (n = 8), zeigten im Vergleich eine signifikant (p < 0,05) niedrigere Aktivitat der freien Elastase im Lungenhomogenisat (2,97 ± 0,57 bzw. 2,01 ± 0,45 μg/g Lunge). Schlusfolgerungen: Nach Surfactantbehandlung wurden bei experimenteller B-Streptokokken-Pneumonie eine verminderte Bakterienproliferation sowie eine verminderte Freisetzung von Elastase beobachtet. Surfactant scheint somit bedeutsam in die Regulation entzundlicher Vorgange in der Lunge einzugreifen.

The significance of bacterial findings in hidradenitis suppurativa (HS) is controversial. Interpretation of the results of bacteriological examinations from the surface of HS lesions is obscured by the possible contamination of resident skin bacteria. Bacteriological analysis of aspirates from deeper parts of HS is liable to show low sensitivity. We used a carbon dioxide (CO2) laser method to evaporate the diseased tissue level by level from the surface downwards, allowing concurrent sampling of bacteriological cultures from each level and thereby minimizing contamination with bacteria from the level above. In this study, 22 women and three men with a mean age of 35.3 years and a mean HS duration of 10.6 years were treated with this CO2 laser surgical method. Aerobic and anaerobic cultures from superficial and deep levels were taken during surgery. The regions treated were axillary in eight and perineal in 17 cases. Bacterial cultures were positive for one or more specimens from at least one level in all cases and from deep levels in all but three cases. Sixteen different species or sub-species were found. Staphylococcus aureus and coagulase-negative staphylococci (CNS) were the species most frequently found. Peptostreptococcus species and Propionibacterium acnes were not uncommon. S. aureus was detected in a total of 14 cases, six of which were from the deep levels. S. aureus was the sole bacterium isolated in two deep cultures. CNS were found in 21 patients and 16 of these isolates were from the deep levels. In nine of the 16 deep samples CNS were the only bacteria detected. These findings motivate a re-evaluation of the significance of bacteria in the progress of HS and in particular they suggest that CNS are true pathogens. It is known that foreign bodies aggravate the virulence of the CNS in surgical implants, and an environment which resembles that produced by a foreign body, as found in chronic HS tissue, serves to intensify the pathogenic properties of CNS in HS.

Activation of polymorphonuclear leucocytes (PMN) was investigated after incubation of adult human PMN and group B streptococci (GBS) type la with a type-specific polyclonal antiserum and a modified porcine surfactant (Curosurf). The level of oxidative metabolism of PMN was studied using a micromethod modification of the nitroblue tetrazolium (NBT) reduction test. GBS alone did not stimulate significant oxygen metabolite release from PMN, and incubation of PMN with surfactant alone resulted in decreased NBT reduction. After opsonization of GBS with a specific antibody, PMN were activated and the increased oxygen metabolite release was not suppressed when surfactant was added to the system. We conclude that the encapsulated GBS strain investigated needs opsonization with specific antibody to increase oxidative metabolism of PMN, and that incubation of PMN and opsonized GBS with surfactant does not interfere with NBT reduction.Antibodies, nitroblue tetrazolium, polymorphonuclear leucocytes, pulmonary surfactants, streptococcus group B E Herting, Research Unit for Experimental Perinatal Pathology, Department of Woman and Child Health, Karolinska Hospital LI/01, S-171 76 Stockholm, Sweden