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Biomedical subjects

C M Wilfert

Publications and source records attributed to C M Wilfert.

At least 73 records · Page 4Linked to original sources
PubMed1979

Vertical transmission of group B Streptococcus. Relation to intrauterine fetal monitoring.

A prospective study of 70 mother-infant pairs was designed to evaluate vertical transmission of group B Streptococcus (GBS) in relation to the use of intrauterine fetal monitors (IUFMs). Multiple-site cultures obtained from mothers during the intrapartum interval and those obtained from infants on day 1 and at discharge or day 4 were plated on a selective medium. Thirteen (27.1%) of 48 IUFM-exposed women vs seven (31.8%) of 22 non-IUFM-exposed women had GBS at one or more sites. The GBS colonization with maternally concordant serotypes occurred in eight (61.5%) of 13 infants born to GBS-colonized, IUFM-exposed women vs two (28.6%) of seven infants born to GBS-colonized, non-IUFM-exposed women. While this suggests that vertical transmission of GBS is enhanced by IUFM placement, the differences in these infant rates were not statistically significant.

Cervix Uteri↗
PubMed1979

ECHOvirus 33 replication in human peripheral white blood cells.

ECHOvirus 33 isolated from the cerebrospinal fluid of a patient with agammaglobulinemia was shown to replicate in vitro in peripheral leukocyte suspensions from a normal antibody negative donor. Replication was demonstrated by use of sequential dilution experiments. Washed glass adherent mononuclear cell cultures from a normal antibody negative donor were also capable of supporting ECHOvirus 33 replication in vitro. Leukocyte suspensions from the infected agammaglobulinemic patient extinguished detectable infectious virus in vitro.

Agammaglobulinemia↗
PubMed1978

Nasal colonization of infants with group B Streptococcus associated with intrauterine pressure transducers.

The rate of nasal colonization with group B Streptococcus in infants cultured at the time of discharge from the nursery rose significantly during a four-month interval. Investigation of this trend resulted in detection of group B streptococci in the domes of two intrauterine pressure transducers (IPTs). Subsequent routine sterilization of IPT domes after each maternal use was associated with a decline in infant group B streptococcal colonization to the usual endemic rate in the nursery. Retrospective evaluation demonstrated that colonization in infants born to IPT-monitored women had increased significantly during the study interval and that no increase in colonization occurred in infants born to non-IPT-monitored women. From epidemiologic evidence it appears that use of contaminated IPTs during labor was a nosocomial source of group B streptococcal colonization.

Cross Infection↗
PubMed1978

E. coli meningitis: K1 antigen and virulence.

It is clear from the preceding material that bacterial infection is a significant threat to the newborn infant. The most common gram-negative organism causing meningitis in the neonate is E. coli, and the invasive capacity of this organism is correlated with its polysaccharide antigen, K1. Careful studies of supportive care and antimicrobial therapy of these infections are continuing. If antibodies could be generated which protect the infant, it would be theoretically possible to guard against infasive disease by conferring antibody positivity to the mother and hence to the infant. Investigations along these lines are continuing.

Adult↗
PubMed1977

Persistent and fatal central-nervous-system ECHOvirus infections in patients with agammaglobulinemia.

We observed persistent ECHOvirus infection of the central nervous system, as defined by continued presence of isolatable virus in cerebrospinal fluid, in five patients with agammaglobulinemia. The immunologic deficit in each was characterized by absence of surface-immunoglobulin-bearing B lymphocytes and of lymph-node cortical follicles, but normal T-cell function. ECHOviruses 30, 19, 9 and 33 were recovered from cerebrospinal fluid for periods varying from two months to three years. The patients had few signs of acute central-nervous-system infection. Three of the five patients had a dermatomyositis-like syndrome, with peripheral lymphocytes that reacted with anti-human leukemia-specific primate and rabbit serums in a cytotoxicity assay. These data suggest that intact B-cell function is essential for eradication of ECHOvirus infection of the central nervous system.

Adult↗
PubMed1977

Antibiotic use at Duke University Medical Center.

A study of antibiotic use at Duke University Medical Center in June 1973 showed that 34.2% of all patients received antibiotics (43.6% surgical, 21.4% medical patients). Cephalothins were most frequently ordered for surgical patients, ampicillin sodium and penicillin G or penicillin V with potassium for other patients. A retrospective analysis of 50 randomly selected patients, according to the Kunin's categories of use, showed 64% of total antibiotic therapy as not indicated or inappropriately administered in terms of drug or dosage. These results are similar to previous reports of antibiotic surveillance and further establish the need for continuing education of prescribing physicians.

Anti-Bacterial Agents↗
PubMed1977

Single-dose trials of monovalent A/New Jersey/76 (Hsw1N1) influenza virus vaccine in children in Durham, North Carolina.

Ninety-two children received single doses of one of 13 monovalent vaccines derived from influenza virus strain A/New Jersey/8/76 (A/NJ), and 18 children received placebo. Five influenza virus vaccines were whole-virus vaccines, and eight were split-product vaccines. Samples of sera were taken once three weeks after vaccination. All of the 29 children receiving whole-virus vaccines developed a titer of antibody to A/NJ virus of greater than or equal to 1:20, and the geometric mean titers were 1:14-1:45. One of the 60 children who received split-product vaccines developed a titer of antibody to A/NJ of greater than or equal to 1:20, and geometric mean titers were all less than 1:10. There was a trend toward correlation between titers of hemagglutination-inhibiting (HAI) antibody to A/NJ and titers of HAI antibody to A/Victoria/3/75 viruses, with a correlation coefficient of 0.40 for children who received whole-virus vaccines. Three of 60 recipients of split-product vaccines and two of 20 recipients of whole virus developed a fever of greater than or equal to 38 C. One of the two febrile children who had received whole-virus vaccine had otitis media. Therefore, reactogenicity of whole-virus vaccines and split-product vaccines appeared to be similar in these children.

Antibodies, Viral↗
PubMed1976

Varicella gangrenosa due to group A beta-hemolytic Streptococcus.

Varicella is usually a well-tolerated disease in normal children. Pyogenic infections involving the skin are the commonest complications and their potential severity is emphasized by our recent experience with two children who suffered from gangrene as a result of cutaneous superinfection with group A beta-hemolytic streptococci. We present the recognition and management of these patients in an effort to reacquaint physicians with this potentially fatal infection.

Chickenpox↗
PubMed1975

Pharmacokinetics of trimethoprim-sulfamethoxazole in children.

The present report extends experience with the use of trimethoprim-sulfamethoxazole (TMP-SMX) in children aged 3 months to 10 years. The regimen was TMP (200 mg)--SMX (1000 mg)/m-2d given in two equal doses. The drug was easily administered, well tolerated and efficacious in the treatment of a variety of infections in 12 children. A steady state had been achieved by the third dose of medication and accumulation of either component during days 1 through 4 did not occur. Serum concentrations of TMP were slightly lower in children aged less than 3 years compared with those aged 3 to 6 years but the differences were small and these results are preliminary. Peak mean serum TMP concentration was highest at day 3 when it reached 1.63 mug/ml. It is concluded that this regimen may be suboptimal for some major parenchymal infections even though the therapeutic result was excellent in most children.

Administration, Oral↗
PubMed1975

Enhanced bactericidal activity of phagocytes from patients with chronic granulomatous disease in the presence of sulphisoxazole.

The decrease in the frequency and severity of bacterial infections in four of five children with chronic granulomatous disease (C.G.D.) on long-term sulphonamide therapy was out of proportion to demonstrable direct antibacterial effects of the drug. In an attempt to determine the mechanism for this apparent protective effect, the killing of sulphisoxazole-resistant Escherichia coli and Staphylococcus aureus by leucocytes from five patients with C.G.D. was studied in the presence or absence of 5-50 mug. per ml. sulphisoxazole. With leucocytes from all five patients there was a modest but reproducible enhancement of bactericidal activity in the presence of the sulphonamide. Studies of phagocytosis-associated oxidative metabolism in patients' cell have not revealed a metabolic basis for improved killing.

Blood Bactericidal Activity↗
PubMed1975

An epidemic of echovirus 18 meningitis.

The first reported outbreak of echovirus 18 meningitis in the United States occurred during the summer of 1972 in Durham, North Carolina. One hundred three cases of aseptic meningitis were seen at Duke University Medical Center over a period of four months. Most of the patients were less than 25 years old, black, and residents of Durham County or nearby counties.. Symptoms included headache (92%), fever (76%), nuchal rigidity (67%), and nausea and/or vomiting (51%). In contrast to previously published reports of echovirus 18 infection, diarrhea and rash were infrequent (6% and 5%, respectively). There were no deaths. Counts of white blood cells in the cerebrospinal fluid ranged from 0 to 1,540 cells/mm-3, but 90% of the patients had less than 500 cells/mm-3. Echovirus 11 was recovered from the cerebrospinal fluid of 55 of 78 patients, and echovirus 11 was isolated from two patients. Virus was recovered from the cerebrospinal fluid of 12 patients despite white blood cell counts in cerebrospinal fluid of less than 10 cells/mm-3.

Adolescent↗
PubMed1975

Nocardiosis in children: report of three cases and review of the literature.

The clinical illnesses observed in three adolescents with Nocardia asteroides infection are described. The organism has been classified as a bacterium and placed in the Actinomycetaceae family. Sulfonamides remain the first choice for chemotherapy but alternative drugs are available and may be essential in successful therapy. Nocardial infections in children indicate the need for evaluation for an underlying immunological deficiency. Nocardia species should be considered as possible causative agents in immunocompromised patients with infection.

Adolescent↗
PubMed1975

Recurrence of skin disease in a nursery: ineffectuality of hexachlorophene bathing.

An outbreak of streptococcal and staphylococcal skin disease was discovered in a full-term nursery after the discontinuation of bathing infants with hexachlorophene. The epidemic was only temporarily controlled by conventional means and recurred despite reinstitution of hexachlorophene bathing. Measures that decreased infants' exposure to visitors and hospital personnel and enforced aseptic techniques in the nursery were more important than use of hexachlorophene soap in achieving and maintaining control.

Anti-Bacterial Agents↗