PubMed · 7070472
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1982-06-03. Practical problems with insulin pumps.. https://doi.org/10.1056/nejm198206033062223
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OBJECTIVE: To evaluate the efficacy of a commercially available bacterin-toxoid vaccine for preventing Corynebacterium pseudotuberculosis-induced abscesses in sheep. DESIGN: Prospective randomized controlled trial. ANIMALS: 31 mixed-breed sheep seronegative for C pseudotuberculosis. PROCEDURE: Sheep were randomly assigned to vaccinate (n = 20) or nonvaccinate (11; control) groups. Sheep in the vaccinate group received 2 doses of serial A or serial B bacterin-toxoid vaccine at 4-week intervals. Serologic testing was conducted after vaccination to document an antibody response to vaccination. All sheep were challenge inoculated with virulent C pseudotuberculosis organisms 32 weeks after the second vaccination. Twenty weeks after challenge inoculation, all sheep were examined for external and internal abscesses secondary to C pseudotuberculosis infection. RESULTS: Vaccinated sheep developed an antibody response to both components of the vaccine, as measured by use of ELISA tests. After challenge inoculation, vaccinated sheep had significantly less external, internal, and total abscesses than control sheep. CLINICAL IMPLICATIONS: Vaccination of sheep with a commercially available bacterin-toxoid against C pseudotuberculosis could substantially decrease the prevalence and number of abscesses that form secondary to C pseudotuberculosis infection.
The paper reviews the literature relevant to the formation of spinal epidural abscess with or without concurrent meningeal infection following epidural catheterisation. The incidence of spinal epidural abscess lies probably in the area of 1:5000 catheterisations. Immunocompromised patients and patients with catheters in situ for more than 48 hrs. are particularly prone to develop epidural abscesses. S. aureus is isolated in 35-82% of the cases. The diagnosis based upon clinical findings, laboratory studies and MRI or CT plus myelography. The mortality is 5-10%. The treatment consists of removal of the catheter, microbiological studies, surgical decompression of the spinal cord, and prolonged antibiotic treatment. It is suggested that insertion of epidural catheters is performed under strict sterility, and that disposable syringes and unbroken vials are used for each injection, which should be administered through an epidural filter. The dressing should be changed daily simultaneously with review of the patient and the insertion site.