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Biomedical subjects

Kathryn M Edwards

Publications and source records attributed to Kathryn M Edwards.

At least 37 records · Page 2Linked to original sources
PubMed2005

Combined tetanus, diphtheria, and 5-component pertussis vaccine for use in adolescents and adults.

CONTEXT: Increasing reports of pertussis among US adolescents, adults, and their infant contacts have stimulated vaccine development for older age groups. OBJECTIVE: To assess the immunogenicity and reactogenicity of a tetanus-diphtheria 5-component (pertussis toxoid, filamentous hemagglutinin, pertactin, and fimbriae types 2 and 3) acellular pertussis vaccine (Tdap) in adolescents and adults. DESIGN, SETTING, AND PARTICIPANTS: A prospective, randomized, modified double-blind, comparative trial was conducted in healthy adolescents and adults aged 11 through 64 years from August 2001 to August 2002 at 39 US clinical centers. INTERVENTIONS: A single 0.5-mL intramuscular dose of either Tdap or tetanus-diphtheria vaccine (Td). MAIN OUTCOME MEASURES: Antibody titers to diphtheria and tetanus toxoids for Tdap and Td were measured in sera collected from subsets of adolescents and adults, before and 28 days after vaccination. For pertussis antigens, titers in sera from Tdap vaccinees were assessed vs those from infants who received analogous pediatric diphtheria-tetanus-acellular pertussis vaccine (DTaP) in a previous efficacy trial. Safety was assessed via solicited local and systemic reactions for 14 days and adverse events for 6 months following vaccination. RESULTS: A total of 4480 participants were enrolled. For both Tdap and Td, more than 94% and nearly 100% of vaccinees had protective antibody concentrations of at least 0.1 IU/mL for diphtheria and tetanus, respectively. Geometric mean antibody titers to pertussis toxoid, filamentous hemagglutinin, pertactin, and fimbriae types 2 and 3 exceeded (by 2.1 to 5.4 times) levels in infants following immunization at 2, 4, and 6 months with DTaP. The incidence of solicited local and systemic reactions and adverse events was generally similar between the Tdap and Td groups. CONCLUSIONS: This Tdap vaccine elicited robust immune responses in adolescents and adults to pertussis, tetanus, and diphtheria antigens, while exhibiting an overall safety profile similar to that of a licensed Td vaccine. These data support the potential routine use of this Tdap vaccine in adolescents and adults.

Adolescent↗
PubMed2005

Differential regulation of granzyme and perforin in effector and memory T cells following smallpox immunization.

Primary immunization of healthy adults with vaccinia virus induces a local vesicle or "take" in the majority of vaccinees that previously has been shown to correlate with protection against smallpox. However, the immunologic mechanisms underlying this protective response in humans are not well characterized. We have studied human CD8+ T cells for the expression patterns of phenotypic markers and cytolytic effector molecules before and after primary smallpox immunization using nine-color polychromatic flow cytometry. One month after immunization, vaccinees developed vaccinia virus-specific CD8+ T cells with an effector cell phenotype containing both granzyme A and granzyme B. One year after immunization, we found a significant decrease in granzyme B containing cells and an increased memory cell phenotype in virus-specific CD8+ T cells. Perforin was rarely expressed directly ex vivo, but was highly expressed after Ag-specific activation in vitro. Together, these data suggest an important role for effector CD8+ T cells in controlling poxvirus infection, and have implications for our understanding of human CD8+ T cell differentiation.

Adult↗
PubMed2005

Prevalence of reovirus-specific antibodies in young children in Nashville, Tennessee.

Although reovirus infections are thought to be common in adults, there have been few assessments of the seroprevalence of reovirus in young children. We developed an indirect enzyme-linked immunosorbent assay to measure levels of total antireovirus immunoglobulin A, G, and M in serum specimens collected from otherwise healthy infants and children (1 month to 5 years of age) in Nashville, Tennessee. Of the 272 serum specimens evaluated, 64 (23.5%) tested positive for reovirus-specific antibodies. We observed an age-dependent increase in reovirus-specific antibodies in children 1 year of age and older, peaking at 50.0% in children 5-6 years of age. These findings suggest that reovirus infections are common during early childhood.

Age Distribution↗
PubMed2005

Smallpox vaccination does not elevate systemic levels of prothrombotic proteins associated with ischemic cardiac events.

BACKGROUND: During the recent smallpox vaccination campaigns, ischemic cardiac complications were observed after vaccination. To examine a possible association between the smallpox vaccine and postvaccination ischemic events, we investigated alterations in levels of prothrombotic proteins (plasminogen activator inhibitor type 1 [PAI-1] and soluble CD40 ligand [sCD40L]) in recently vaccinated individuals. METHODS: Vaccinia-naive (cohort N; aged 18-32 years) and vaccinia-experienced (cohort E; aged 33-49 years) healthy adults were vaccinated with a 1 : 5 dilution of the Aventis Pasteur smallpox vaccine. Plasma levels of PAI-1 and sCD40L were measured in 30 subjects (cohort N, n=15; cohort E, n=15) at baseline and twice after vaccination (between days 7 and 9 and between days 26 and 30). RESULTS: Baseline mean PAI-1 levels significantly differed between cohorts N and E (P=.04). Within each exposure cohort, mean PAI-1 levels did not significantly change after vaccination. Baseline sCD40L levels did not differ between cohorts N and E. In cohort N, sCD40L levels significantly decreased after vaccination but returned to baseline levels within 1 month. Vaccination did not significantly alter levels of sCD40L in cohort E. CONCLUSIONS: Levels of PAI-1 and sCD40L did not significantly increase after smallpox vaccination. Vaccine-induced alterations in levels of these prothrombotic proteins do not appear to play a role in ischemic events observed after smallpox vaccination.

Adolescent↗
PubMed2005

Seasonality of invasive pneumococcal disease: temporal relation to documented influenza and respiratory syncytial viral circulation.

BACKGROUND: Seasonal fluctuation in the incidence of invasive pneumococcal disease has been attributed to winter virus exposure (e.g., influenza and respiratory syncytial virus [RSV]). Evidence of a direct correlation of invasive pneumococcal disease with laboratory-confirmed virus seasons, however, is limited. Using two prospective surveillance networks, the temporal relation between invasive pneumococcal disease and isolation of circulating winter viruses was explored. METHODS: Episodes of invasive pneumococcal disease in five Tennessee counties were collected prospectively from January 1995 through June 2002. Virus seasons were defined using prospective laboratory-based surveillance. Correlation between weekly identification of invasive pneumococcal disease and laboratory isolation of RSV and influenza, as well as comparisons of the frequencies of invasive pneumococcal disease episodes during viral and nonviral seasons were determined. RESULTS: A total of 4147 invasive pneumococcal disease episodes were identified. Weekly frequency of invasive pneumococcal disease correlated directly with the weekly frequency of isolation of RSV (r = 0.56, P <0.001) and influenza (r= 0.40, P <0.001). The average weekly frequency of invasive pneumococcal disease during RSV and influenza seasons was higher than during the nonviral seasons (P <0.001 for each year). CONCLUSION: Weekly episodes of invasive pneumococcal disease correlated temporally with laboratory-confirmed weekly isolation of RSV and influenza, and the incidence of invasive pneumococcal disease was increased when these viruses were circulating in the community.

Adolescent↗
PubMed2005

Differences in antibiotic prescribing among physicians, residents, and nonphysician clinicians.

PURPOSE: State legislatures have increased the prescribing capabilities of nurse practitioners and physician assistants and broadened the scope of their practice roles. To determine the impact of these changes, we compared outpatient antibiotic prescribing by practicing physicians, nonphysician clinicians, and resident physicians. METHODS: Using the National Ambulatory Medical Care Survey (NAMCS) and the National Hospital Ambulatory Medical Care Survey (NHAMCS), we conducted a cross-sectional study of patients >/=18 years of age receiving care in 3 outpatient settings: office practices, hospital practices, and emergency departments, 1995-2000. We measured the proportion of all visits and visits for respiratory diagnoses where antibiotics are rarely indicated in which an antibiotic was prescribed by practitioner type. RESULTS: For all patient visits, nonphysician clinicians were more likely to prescribe antibiotics than practicing physicians for visits in office practices (26.3% vs 16.2%), emergency departments (23.8% vs 18.2%), and hospital clinics (25.2% vs 14.6%). Similarly, for the subset of visits for respiratory conditions where antibiotics are rarely indicated, nonphysician clinicians prescribed antibiotics more often than practicing physicians in office practices (odds ratio [OR] 1.86, 95% confidence intervals [CI]: 1.05 to 3.29), and in hospital practices (OR 1.55, 95% CI: 1.12 to 2.15). In hospital practices, resident physicians had lower prescribing rates than practicing physicians for all visits as well as visits for respiratory conditions where antibiotics are rarely indicated (OR 0.56, 95% CI: 0.36 to 0.86). CONCLUSION: Nonphysician clinicians were more likely to prescribe antibiotics than practicing physicians in outpatient settings, and resident physicians were less likely to prescribe antibiotics. These differences suggest that general educational campaigns to reduce antibiotic prescribing have not reached all providers.

Adult↗
PubMed2005

Duration of virus shedding after trivalent intranasal live attenuated influenza vaccination in adults.

OBJECTIVE: To characterize the probability and duration of viral shedding among adults given trivalent live attenuated influenza vaccine (LAIV). DESIGN: Prospective surveillance study. METHODS: Nasal wash samples were collected from adult volunteers at baseline and on days 3, 7, and 10 and between days 17 and 21 following intranasal LAIV vaccination. The presence, titer, and identification of each specific strain of influenza virus shed were determined by standard methodology. RESULTS: Twenty subjects received LAIV. No samples were positive for influenza virus at baseline. After LAIV vaccination, influenza virus was recovered from 10 of 20 vaccinees on day 3, from 1 of 18 vaccinees on day 7, and from none of the samples on days 10 or 17 through 21. Vaccinees who shed vaccine virus were significantly younger than those who did not (mean age, 26.4 vs 38.6 years; P < .01). Although the presence of specific mucosal immunoglobulin A to influenza B was associated with significantly less shedding of influenza B after vaccination (P = .02), associations of shedding with other measures of immunity were not detected. CONCLUSION: The duration of shedding of vaccine virus after LAIV in adults i s limited and may be associatedwith an individual's prior influenza vaccination history.

Administration, Intranasal↗
PubMed2005

Overview of pertussis: focus on epidemiology, sources of infection, and long term protection after infant vaccination.

BACKGROUND: Pertussis, or whooping cough, is a bacterial disease characterized by paroxysmal cough often accompanied by inspiratory whoop and posttussive emesis. Although the introduction of whole-cell pertussis vaccine in the 1940s led to a significant decline in the incidence of pertussis, there has been a gradual increase in reported pertussis cases since 1980. Some of these cases are in infants too young to have received routine pertussis vaccination, and many are in adolescents immunized previously as young children. METHODS: Based on a literature review, an overview of pertussis is provided, focusing on epidemiology, sources of infection, and trends in incidence patterns, particularly among adolescents. Issues surrounding long-term protection after infant vaccination are also discussed. RESULTS: The most dramatic increase in pertussis incidence has been among adolescents and young adults. Waning vaccine-induced immunity and refinements in the diagnosis of pertussis have contributed to the rise in the occurrence of pertussis in older age groups. Disease rates in infants have also increased. Determining the source of infection in infants can be challenging, but studies have demonstrated that many infant cases are attributable to infections in adolescent or adult family members. CONCLUSIONS: Pertussis is on the rise, particularly in adolescents. Booster vaccination of adolescents with less-reactogenic acellular pertussis vaccines appears to be the most logical approach to disease prevention in adolescents and reduced transmission to young infants.

Adolescent↗
PubMed2005

Increasing rates of nasal carriage of methicillin-resistant Staphylococcus aureus in healthy children.

BACKGROUND: Prior studies, including one from our institution performed in 2001, suggest that nasal colonization with methicillin-resistant Staphylococcus aureus (MRSA) occurs infrequently in the healthy pediatric population (0.2-2.2%). However, infections caused by community-associated MRSA have increased remarkably in recent years. As a result, we restudied the prevalence of MRSA nasal colonization in healthy children, comparing results from 2001 and 2004. PATIENTS AND METHODS: Nasal swabs were collected from 500 children presenting for health maintenance visits. Samples were cultured quantitatively, and MRSA isolates were confirmed by growth on selective media, coagulase testing and the presence of the mecA resistance gene. MRSA isolates were further analyzed for antibiotic susceptibilities, genetic relatedness by pulsed field gel electrophoresis and polymerase chain reaction for the detection of the gene encoding Panton-Valentine leukocidin. RESULTS: There were 182 children (36.4%) colonized with S. aureus, and 46 (9.2%) colonized with MRSA. This is significantly higher than the MRSA colonization rate in 2001 (0.8%; P < 0.001). There were no significant associations between potential risk factors and MRSA colonization except for having a family member work in a hospital (odds ratio, 2.0; 95% confidence interval, 1.03-4.1). Pulsed field gel electrophoresis revealed heterogeneity of circulating strains, and the Panton-Valentine leukocidin gene locus was detected in 10 of 46 MRSA isolates (22%). CONCLUSION: Nasal MRSA colonization in healthy children in Nashville has increased significantly in the past 3 years. As colonization typically precedes infection, this increase may be a major factor in the emergence of community-associated MRSA as a pathogen of healthy children.

Adolescent↗
PubMed2005

Trends in antibiotic prescribing for adults in the United States--1995 to 2002.

CONTEXT: The impact of national efforts to limit antibiotic prescribing has not been fully evaluated. OBJECTIVES: To analyze trends in outpatient visits associated with antibiotic prescription for U.S. adults. DESIGN: Cross-sectional study of data (1995 to 2002) from the National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey. PARTICIPANTS: Adults > or =18 years with an outpatient visit to an office- or hospital-based medical practice or to an emergency department. All visits were classified into 1 of 4 diagnostic categories: (1) acute respiratory infection (ARI)-antibiotics rarely indicated, (2) ARI-antibiotics often indicated, (3) nonrespiratory infection-antibiotics often indicated, and (4) all others. MEASUREMENTS: Trends in: (1) Proportion of outpatient visits associated with an antibiotic prescription; (2) proportion of antibiotic prescriptions that were broad spectrum; and (3) number of visits and antibiotic prescriptions per 1,000 U.S. adults > or =18 years of age. RESULTS: From 1995-1996 to 2001-2002, the proportion of all outpatient visits that generated an antibiotic prescription decreased from 17.9% to 15.3% (adjusted odds ratio [OR] 0.84, 95 % confidence interval [CI] 0.76 to 0.92). The entire reduction was because of a decrease in antibiotic prescriptions associated with visits for ARIs where antibiotics are rarely indicated from 59.9% to 49.1% (adjusted OR 0.64 95% CI 0.51 to 0.80). However, the proportion of prescribed antibiotics for these visits that were classified as broad-spectrum antibiotic prescription increased from 41.0% to 76.8%. Overall outpatient visits increased from 1693 to 1986 per 1,000 adults over the 8 years studied, but associated antibiotic prescriptions changed little, from 302 to 304 per 1,000 adults. CONCLUSION: During the study period, outpatient antibiotic prescribing for respiratory infections where antibiotics are rarely indicated has declined, while the proportion of broad-spectrum antibiotics prescribed for these diagnoses has increased significantly. This trend resulted in a 15% decline in the total proportion of outpatient visits in which antibiotics were prescribed. However, because outpatient visits increased 17% over this time period, the population burden of outpatient antibiotic prescriptions changed little.

Adult↗
PubMed2005

[Oropharyngeal carriers in Venezuelan children in two child care settings, vaccinated or not with Haemophilus influenzae type b tetanus toxoid conjugate vaccine (PRP-T)].

The objective was to estimate the oropharyngeal carrier rate of Haemophilus influenzae type b (Hib) and non typeable (NTHi) in unvaccinated and vaccinated children, with PRP/T vaccine, both cared at home and attending day care centers. Healthy children of either sex, younger of 7 years, excluding those that received antibiotics one month prior to the inclusion, were recruited from control clinics for healthy babies, and assigned to Group I fully immunized and Group II unimmunized. Both, children cared at home and attending day care centers were included. Parents provided an informed consent. Specimens were obtained from the oropharynx for culture, identification and serotyped by slide agglutination (Phadebact Haemophilus test). P values were obtained with Chi-square, Fisher's and Z test. Odds ratio was obtained when appropriated. Results were as following: a total of 320 children were enrolled, 99 in group I (49 cared at home, 50 attending day care) and 221 in group II (94 cared at home, 127 attending day care) the percentage of carriers was 22.8% (17.8% NTHi and 5% Hib). The carriage rate of NTHi was similar in groups I and II cared at home (18% vs 19%), and for those attending day care were 16% vs 17%. Carriage rate of Hib in children attending day care of group II was 12% vs 1% of those cared at home (p = 0.002). None of the children in group I was colonized by Hib. The Hib carrier rate was more similar to that of industrialized countries in the pre vaccine era in children cared at home, however, attendance to a day care center significantly increases its risk. The PRP/T vaccine appears to prevent the carrier state in both care settings.

Carrier State↗
PubMed2004

Tolerance to vancomycin in pneumococci: detection with a molecular marker and assessment of clinical impact.

BACKGROUND: Vancomycin is often added to therapy for meningitis caused by Streptococcus pneumoniae. Tolerant bacteria without classic resistance that escape killing by multiple antibiotics have been reported sporadically. We determined the prevalence of tolerance to vancomycin in pneumococci and its effect on the outcome of meningitis. METHODS: Archival samples of 215 nasopharyngeal (NP) and 113 meningitis isolates were tested for the killing efficacy of vancomycin. Specific DNA sequence changes in a transporter locus were identified for tolerant isolates. Similar tests were conducted prospectively on 517 NP isolates from healthy children. RESULTS: In archival isolates, tolerance to vancomycin was detected in 3.7% of NP and 10.6% of invasive isolates. Patients with meningitis caused by tolerant isolates had a worse estimated 30-day survival than did patients with meningitis caused by nontolerant isolates (49% vs. 86%; P = .048); 62.5% of tolerant archival NP isolates harbored a specific sequence change for pep27 and vex2 (P = .021). Prospective analysis of 517 carriage isolates indicated that 8.1% were tolerant to vancomycin and that 82.1% of tolerant isolates harbored the specified marker gene sequences (P = .001). CONCLUSIONS: Tolerance to vancomycin exists in the population of pneumococci. Tolerant isolates are associated with meningitis of increased mortality, and these isolates can be tracked by specific marker sequences in 2 genes.

Alleles↗
PubMed2004

Vaccination success rate and reaction profile with diluted and undiluted smallpox vaccine: a randomized controlled trial.

CONTEXT: Additional smallpox vaccine doses are needed to augment current US national stockpile. Aventis Pasteur smallpox vaccine (APSV), initially manufactured in the 1950s from the New York Board of Health vaccinia strain in a frozen preparation, appears as effective as lyophilized vaccine but the effectiveness of diluted doses of APSV is unclear. OBJECTIVE: To compare the vaccination success rate and the reaction profile of various APSV dilutions. DESIGN, SETTING, AND PARTICIPANTS: A double-blind, randomized controlled trial of 340 healthy vaccinia-naive adults aged 18 to 32 years from 3 academic medical centers who were vaccinated with 1 of 3 strengths of APSV dilutions (undiluted, 1:5, and 1:10) between October 9, 2002, and February 24, 2003. Volunteers were followed up every 3 to 5 days until the vaccination site healed for bandage changes, vaccine response assessment, and adverse event evaluation, followed by 1- and 2-month clinic evaluations and 6-month telephone interview. MAIN OUTCOME MEASURES: Successful vaccination, defined by presence of a vesicle or pustule at the inoculation site 6 to 11 days postvaccination, and local and systemic reactions to vaccination. RESULTS: A total of 340 volunteers were vaccinated (vaccine dose: undiluted, n = 113; 1:5 dilution, n = 114; and 1:10 dilution, n = 113). Following vaccination, 99.4% (95% confidence interval [CI], 97.9%-99.9%) of all volunteers had successful vaccinations. Success rates did not differ between the dilution groups (undiluted, 100.0%; 95% CI, 96.8%-100.0%; 1:5 dilution, 98.2%; 95% CI, 93.8%-99.8%; 1:10 dilution, 100.0% 95% CI, 96.8%-100.0%; P =.33). Overall, 99.7% of volunteers reported at least 1 local symptom at the vaccination site, and 61.8% had axillary lymphadenopathy, 15.0% developed satellite lesions, and 7.6% developed a rash away from the vaccination site. Fever developed in 21.5%. No differences were noted in local or systemic reactions between the 3 dilution groups (P>.05 for each comparison). A total of 25% of volunteers missed scheduled duties due to vaccine-related symptoms. CONCLUSIONS: Even at diluted doses, APSV is an effective smallpox vaccine, allowing for expansion of the current stockpile. However, reactogenicity was not reduced with dilution of the vaccine and, as with other smallpox vaccines, may impair daily activities.

Adult↗
PubMed2004

Reduction in high rates of antibiotic-nonsusceptible invasive pneumococcal disease in tennessee after introduction of the pneumococcal conjugate vaccine.

BACKGROUND: Invasive pneumococcal disease (IPD) is a burgeoning problem, with rates of antibiotic-nonsusceptible IPD, in particular, increasing during the past decade. One measure to combat IPD is vaccination with the recently introduced 7-valent pneumococcal conjugate vaccine (PCV). METHODS: To evaluate the effects of the introduction of PCV in 2000 on the epidemiology of antibiotic-nonsusceptible IPD, a database of IPD cases from January 1995 through December 2002 identified through active surveillance in 5 Tennessee counties was examined. For each case, clinical data were collected, and antibiotic susceptibility testing and serotyping were performed on available isolates. RESULTS: Among children younger than 2 years, IPD rates peaked at 235 cases per 100,000 in 1999 before decreasing, after PCV licensure, to 46 cases per 100,000 in 2002 (P<.001). The proportion of penicillin-nonsusceptible IPD isolates from this age group declined from 59.8% in 1999 to 30.4% in 2002 (P<.01). After 2001, similar decreases in IPD rates and in the proportion of antibiotic-nonsusceptible isolates recovered were seen among persons aged 2 years and older (P<.01). Rates of IPD due to PCV-associated serotypes declined after PCV introduction in all age groups (P<.001), whereas the rate of IPD due to nonvaccine serotypes increased among persons aged 2 years and older. CONCLUSIONS: In the 2 years since licensure, widespread PCV vaccination of children has resulted in dramatic declines in the proportion of antibiotic-nonsusceptible isolates in Tennessee. PCV vaccination of children also appears to be a highly effective method for reducing the burden of IPD in adults.

Anti-Bacterial Agents↗
PubMed2004

Immune responses and antibody decay after immunization of adolescents and adults with an acellular pertussis vaccine: the APERT Study.

As part of a prospective acellular pertussis (ACP) vaccine efficacy trial, 5 serum samples were obtained, over an 18-month period, from 101 ACP-vaccine recipients and 99 control subjects, to assess ACP antibody response and decay. Immunoglobulin (Ig) G and IgA antibodies to pertussis toxin (PT), filamentous hemagglutinin (FHA), pertactin (PRN), and fimbriae 2/3 (FIM) were measured by enzyme-linked immunosorbant assay, and titers of agglutinin were determined. Of the subjects, 16%-19% had preimmunization values of antibodies to PT that were above the assay's limit of quantitation (LOQ); in contrast, 36%-63% of the subjects had preimmunization values of antibodies to FHA, PRN, or FIM that were above the LOQ. Substantial increases in titers of IgG and IgA antibodies to the 3 ACP antigens (PT, FHA, and PRN) were observed. Over the 18-months, the percent decay in IgG and IgA antibodies ranged from 56% to 73% and from 57% to 70%, respectively; the IgG antibody response and decay suggests that geometric mean titers likely remain above the LOQ for 2-9 years and above the threshold of detection for 4-13 years. These findings support the use of ACP booster immunizations for adolescents and adults, to provide sustained levels of antibody.

Adolescent↗
PubMed2004

Prevalence of pertussis antibodies in maternal delivery, cord, and infant serum.

BACKGROUND: Passively acquired maternal antibodies protect infants from many pathogens. With increasing reports of infant pertussis, we evaluated pertussis antibodies in maternal-infant paired sera from 1999-2000. METHODS: Antibodies to pertussis toxin (PT), filamentous hemagglutinin (FHA), and fimbrial proteins (FIM) were measured by validated IgG-specific enzyme-linked immunosorbant assay (ELISA) in 64 maternal-umbilical cord serum pairs and in 61 of 64 infant sera. Geometric mean concentrations (GMCs) of pertussis antibodies and cord : maternal GMC ratios were calculated. RESULTS: Mean maternal age and gestation were 29.7 years (range, 19-42) and 39.3 weeks (range, 35.6-40.9), and 81% of mothers were white. GMCs of maternal antibodies at delivery (ELISA units/mL) were 2.4 for PT, 6.9 for FHA, and 13 for FIM. Cord GMCs were 169%, 178%, and 157% of maternal delivery values for PT, FHA, and FIM, respectively, demonstrating active placental transfer (P<.001). Pertussis-specific IgG values for each antigen decayed to below the threshold of detection by age 2 months. CONCLUSIONS: Despite efficient placental transfer, low maternal pertussis antibody levels and their rapid decay in infant sera leave infants with little humoral protection against pertussis. These data support the rationale for maternal or neonatal immunization, with acellular pertussis vaccines, to prevent life-threatening pertussis in early infancy.

Adhesins, Bacterial↗