Search

A bacteriologic survey was performed to estimate the prevalence and duration of meningococcal carriage in children in Montreal, Canada. Infants and children with proven meningococcal infection, or with asymptomatic meningococcal nasopharyngeal (NP) carriage, and their household contacts, were also studied to define communicability. N. meningitidis was present in 30 (2.4%) of the NP cultures from 1238 asymptomatic infants and children in this civilian population during a non-epidemic period. Meningococcal carriage was not found in 278 subjects 1--60 days of age; there was no difference in carriage rates between the sexes and between hospitalized and non-hospitalized children in all age groups. Meningococci were initially isolated from 11 of 106 household contacts of 29 ill index cases and from 15 of 104 contacts of 29 asymptomatic carriers; 35% of all contacts (index cases and carriers) were colonized by the eighth week of surveillance. Duration of NP carriage was longer (mean 15.2 weeks) in disease-free families than in families of ill patients (mean 5.5 weeks). Serogroups B and C were most commonly isolated from both ill and asymptomatic subjects. Resistance to sulfadiazine (MIC greater than or equal to mg/100 ml) was present in 6.5% and 39.4% of group B and group C strains, respectively. Although chemoprophylaxis was not used, there were no secondary cases among the 29 families of index cases.

Thirty hospitalized children with Gram-negative bacillary urinary tract infections were treated with oxolinic acid for 14 to 21 dyas. Fifteen of 17 patients with uncomplicated and 11 of 13 with complicated urinary infections had favorable bacteriologic responses. Resistant organisms developed in four treatment failures. Oxolinic acid urine concentrations were well above the minimal inhibitory concentration for most strains of Escherichia coli, Klebsiella, Enterobacter, Proteus mirabilis, P vulgaris, P morganii, and P rettgeri. Approximately half of these patients experienced mild symptoms possibly related to oxolinic acid therapy; in no instance did they require cessation of therapy. Our experience indicates that if the urine is not sterile by the end of five days of treatment, bacterial resistance to oxolinic acid is likely to have developed, and therapy with another agent should be considered and antibiotic susceptibility tests repeated.

Immunization practices are frequently changing as our understanding of the basic concepts of host-parasite interactions grows and research in the area of new vaccines continues. The present review attempts to summarize current practices and the scientific data on which they are based. A complete historical review of the subject is beyond the scope of this report which is only intended to survey developments in the field over the past few years and up until October 1972.

A 10-year retrospective study was made to determine the spectrum of underlying disease in, and the capsular types of pneumococci isolated from, blood and body fluids of 140 hospitalized patients. Fifteen serotypes were found among 82 typed isolates, 53% of which were types 8, 14, or 23. There was a predominance of males and a high incidence of underlying pneumonia, chronic liver disease, nephrotic syndrome, cerebrospinal fluid rhinorrhea, and malignancy. Mortality rates were higher among the very young and aged, and the immunologically comprised host at either extreme of life was more susceptible to disseminated pneumococcal infection. Pneumococci of the higher capsular types were prominent in children, and those of the lower types in adults, a finding in agreement with other recent studies.