NATURAL HISTORY STUDIES: GBS AND PNEUMOCOCCAL INFECTION

这个项目的主要目标是研究群体的自然历史 乙型链球菌(GBS)和肺炎链球菌感染。要实现这些目标 Goals，一个由7名首席调查员、13名联合调查员和2名 来自儿科学科的合作者被组织起来， 产科、医学和微生物学。相应地，更多的努力是 致力于GBS研究，其中包括广泛的流行病学 对孕妇、产妇、新生儿和青年的调查 婴儿。城市和郊区的GBS携带率和发病率 将对人口和临床、细菌和免疫学进行比较 定义了易感染的因素。GBS的早期和晚期形式 对婴儿的疾病进行了研究。GBS在糖尿病发病机制中的作用 新生儿呼吸窘迫、肺炎与尿路感染 对怀孕妇女也将进行前瞻性研究。计划正在进行中 为预防早发性GBS的孕产妇预防研究而开发的 疾病。免疫学研究，使用提纯的GBS抗原，将 确定抗体的类别以及体液和抗体各自的作用 粘膜抗体在宿主抵抗GBS中的作用。方法包括酶联免疫吸附试验， 中性粒细胞碘化和放射免疫分析。GBS抗原的生化特性 将被进一步定性。将开发一种小鼠模型来研究 对GBS的黏膜免疫和评价一种口服的潜力 注射疫苗。一个单独的动物模型，使用新生的羔羊，将 可用于研究慢性阻塞性肺疾病致心肺功能障碍的机制 GBS。 肺炎球菌感染和免疫的研究将集中在特定的 病种：肺炎、败血症、脑膜炎、中毒性胸膜炎。基本和 特异性和非特异性宿主防御机制的临床研究 将会被追查。后者包括C反应蛋白和抗磷胆碱抗体。 类似的免疫学方法也被用在球状芽孢杆菌和肺炎球菌上。 调查。血小板功能的改变和特异性的释放 导致休克的中介物也将在重症患者中进行研究 婴儿。我们将继续发展当代流行病学数据， 儿童和成人肺炎球菌病，包括接种高危疫苗 研究对象。

Major objectives of this program are to study the natural history of group B streptococcal (GBS) and pneumococcal infections. To accomplish these goals, a team of 7 principal investigators, 13 co-investigators and 2 collaborators has been organized from the disciplines of pediatrics, obstetrics, medicine and microbiology. Proportionately more effort is devoted to GBS studies, which include extensive epidemiological investigations in pregnant women, parturients, newborns, and young infants. GBS carriage and disease rates in an urban and suburban population will be compared and clinical, bacterial and immunological factors predispoding to infection defined. Early and late forms of GBS disease in infants are studied. The role of GBS in pathogenesis of respiratory distress and pneumonia in newborns and urinary tract infection in pregnant women will also be prospectively studied. Plans are being developed for a study of maternal prophylaxis to prevent early onset GBS disease. Immunological studies, using purified GBS antigens, will determine the class of antibody and the respective roles of humoral and mucosal antibody in host defense against GBS. Methods include ELISA, neutrophil iodination and RIA. Biochemical characteristics of GBS antigen will be further characterized. A murine model will be developed to study mucosal immunity to GBS and to evaluate potential for an orally administered vaccine. A separate animal model, using newborn lambs, will be used to investigate mechanisms of cardiopulmonary dysfunction induced by GBS. Studies of pneumococcal infection and immunity will focus on specific diseases: pneumonia, sepsis, meningitis and othitis media. Basic and clinical investigations of specific and nonspecific host defense mechanisms will be pursued. The latter includes CRP and antibody to phosphocholine. Similar immunologic methods are used in GBS and pneumococcal investigations. Alterations in platelet function and release of specific mediators that contribute to shock will also be studies in seriously ill infants. We will continue to develop contemporary epidemiological data on pneumococcal disease in children and adults, including high-risk vaccinated subjects.