NATURAL HISTORY STUDIES: GBS AND PNEUMOCOCCAL INFECTION

该计划的主要目标是研究群体的自然历史 B链球菌（GBS）和肺炎球菌感染。 完成这些 一个由7名主要调查员、13名共同调查员和2名 合作者已经从儿科学科组织起来， 产科、医学和微生物学。 更多的努力是 致力于GBS研究，其中包括广泛的流行病学 孕妇、产妇、新生儿和年轻人的调查 婴儿。 城市和郊区GBS携带率和患病率 将对人群进行比较，并进行临床、细菌和免疫学检查 确定易感染的因素。 早期和晚期GBS 婴儿的疾病进行了研究。 格林-巴利综合征在脑出血发病中的作用 新生儿呼吸窘迫和肺炎以及尿路感染 还将对孕妇进行前瞻性研究。 计划正在 为预防早发性GBS的母体预防研究而开发 疾病 使用纯化的GBS抗原的免疫学研究将 确定抗体的类别以及体液和 粘膜抗体在宿主防御GBS中的作用。 方法包括ELISA， 中性粒细胞碘化和RIA。 GBS抗原的生化特性 将得到进一步表征。 将开发小鼠模型来研究 粘膜免疫GBS和评估潜在的口服 接种疫苗。 另一个使用新生羔羊的动物模型将 可用于研究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 疾病：肺炎、败血症、脑膜炎和中耳炎。 基本和 特异性和非特异性宿主防御机制的临床研究 将被追捕。 后者包括CRP和磷酸胆碱抗体。 类似的免疫学方法用于GBS和肺炎球菌 调查事务所 血小板功能的改变和特异性 导致休克的介质也将在重病患者中进行研究。 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，包括高危疫苗接种 科目

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.