[Prevention of surgical infections. Our experiences after 4 years of preventive vaccination with staphylococcal vaccines].
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The work presents the results of the study of the immune status in 32 patients with acute infectious destructions of the lungs; of these, 17 patients were immunized with staphylococcal vaccine, which made it possible to achieve a positive clinical effect in 16 patients, thus shortening their sick-leave. The injection of the preparation was shown to increase the number of E-rosette-forming cells, "active" E-rosette-forming cells, theophylline-resistant and theophylline-sensitive lymphocytes.
Therapeutic efficacy of lincomycin used alone and in combination with inactivated staphylococcal vaccine and the effect of these agents on synthesis of antibodies and their content in blood serum were investigated. Lincomycin was shown to inhibit septic processes in the host. After its administration the number of the pathogens in the blood and organs markedly decreased. At the same time, lincomycin lowered antibody synthesis in the lymphoid organs and the content of alpha-antitoxins in blood serum. The use of lincomycin in combination with inactivated staphylococcal vaccine promoted an increase in the number of the antibody forming cells in the spleen and lymph nodes and the content of the antibodies to the staphylococcal alpha-toxin in blood serum of the animals with staphylococcal sepsis.
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In mice immunized with staphylococcal vaccine the arresting of graft-versus-host reaction under the influence of small doses of staphylococcal vaccine, hyperimmune antistaphylococcal serum, cyclophosphamide, antilymphocytic serum has been demonstrated. Small doses of staphylococcal vaccine stimulated the production of antibodies to staphylococci and dermal extract in the animals, previously immunized with this vaccine, with the simultaneous suppression of cell-mediated immune reactions to both antigens. Immunosuppressing agents have been found to inhibit humoral and cell-mediated immune response to microbial antigen and dermal extract. No influence of vermox and levamisole on the outcome of the graft-versus-host reaction has been registered; the latter preparation has been found to intensify cell-mediated immune reactions to microbial and tissue antigens.
Experiments on the development of a vaccine against staphylococcal mastitis were carried out in ewes. The vaccine (Spanish patent no. 9200223) has the following components: (i) inactivated (formalinized) bacteria (Staphylococcus aureus and a coagulase-negative staphylococcal species. Staphylococcus simulans) and S. aureus toxoid in presence of an adjuvant (dextran sulfate, Mw 500,000); and (ii) S. aureus exopolysaccharide included within liposomes. High serum antibody titres were obtained against whole cells from Staphylococcus aureus, Staphylococcus simulans, Staphylococcus hyicus and Staphylococcus epidermidis strains. However, there was no response to cells from Staphylococcus warneri and Staphylococcus chromogenes strains. An immune response (serum IgG) against the inoculated exopolysaccharide was obtained when > or = 20 micrograms of exopolysaccharide were included in liposomes and when > or = 20 mg of exopolysaccharide were adjuvanted with dextran sulfate instead of liposomes. For experimental infection assays, ewes were vaccinated during pregnancy and challenged either with a low virulence S. simulans strain or with a highly virulent S. aureus strain. In these assays, the incidence of S. simulans subclinical mastitis and of S. aureus acute mastitis was significantly lower in vaccinated animals than in unvaccinated controls. Specifically, on challenge with S. simulans, two out of 14 glands became infected among the vaccinated animals and nine out of ten glands in the unvaccinated group (p < 0.001). On challenge with S. aureus, no protection was detected when component (ii) was omitted from the vaccine; nine out of ten animals developed mastitis (two mild, two moderate and five severe).(ABSTRACT TRUNCATED AT 250 WORDS)
The clinical effectiveness, reactogenicity and immunological activity of cell free staphylococcal vaccine in the immunotherapy of chronic pyoderma patients under the conditions of controlled trials were studied. Immunotherapy was carried out in combination with traditional methods of treatment. A group of 39 patient received cell free staphylococcal vaccine subcutaneously; the second control group (30 patients) received the commercial preparation of staphylococcal antiphagin and the third group (31 patients) was treated by traditional methods without vaccines. The study revealed that cell free staphylococcal vaccine had low reactogenicity and was well tolerated by patients; in contrast to the methods of treatment in the control groups, the vaccine stimulated an increased levels of specific antibodies and IgA in the blood of the patients. Immunotherapy with cell free staphylococcal vaccine led to clinical convalescence and remission in 1-3 years (the term of observation) in 71.8% of cases. In the two control groups such effect did not exceed 23%.
The work presents the results of the study of the immune status in 18 patients with chronic bronchitis at the stage of remission, subjected to prolonged prophylactic treatment with the inhalations of levamisole solution, and in 16 patients receiving the inhalations of staphylococcal vaccine. These results indicate that the inhalations of levamisole have proved to be more effective than the inhalations of staphylococcal vaccine. In patients treated with levamisole an essential decrease in the ratio of theophylline-resistant to theophylline-sensitive E-rosette-forming lymphocytes has been noted. The determination of the sensitivity of lymphocytes and neutrophils to incubation with levamisole by means of the rosette-formation test makes it possible to prognosticate, taking into account the initial level of spontaneous E-rosette formation of these cells, the effectiveness of the prophylactic treatment of patients with chronic bronchitis. The determination of the sensitivity of the cells to incubation with staphylococcal toxoid is ineffective for the prognostication of the result of the treatment of such patients with staphylococcal vaccine.
The data obtained in the controlled trial of the immunotherapy of chronic bronchitis (CB) patients with lyophilized acellular staphylococcal vaccine developed at the Mechnikov Research Institute for Vaccines and Sera (USSR Acad. Med. Sci.), Moscow, are presented. The patients were divided at random into two groups; of these, one group received the vaccine and the other, placebo (0.9% sodium chloride solution). The preparations were injected subcutaneously simultaneously with traditional treatment. The vaccine was well tolerated by the patients. In the blood of the patients receiving the vaccine, in contrast to those receiving placebo, a significant increase in the level of specific antibodies determined in the passive hemagglutination test and IgG was noted. When following the remote consequences of the disease for a year after the course of immunotherapy, a significant decrease in the occurrence of aggravations, an increase in the duration of remission and a decrease in the duration of sick leaves were registered. These data indicate that the immunotherapy of CB with lyophilized acellular staphylococcal vaccine is a promising method of preventing relapses.
Histological, histochemical and electronmicroscopic investigations were carried out on gum biopsies taken from cases with chronic marginal periodontal disease before and after the treatment with staphylococcic vaccine, thus, morphopathologically proving the findings of Gafar et al. (1985) and of Georgescu et al. (1973; 1974; 1975; 1979; 1995). Before treatment, gum lesions were severe, consisting in an abundance of polymorphic inflammatory infiltrates in the chorion along with oedema and disorganised connective fibres, atrophies and ulceration of the mucosa, purulent deposits at the surface with bacteria and fungi. After the treatment with the staphylococcic vaccine, an epithelial regeneration was seen together with the absence of the chronic inflammation. The intensely fibroparius granulated tissue was also noted, in all cases observing abundant connective fibres, accounting for good results after treatment, notably the firmness of the tooth fitting.
Changes in activity of beta-lysins in blood serum were studied in the time course on albino mice infected with staphylococci and treated with rifampicin, lincomycin and inactivated staphylococcal vaccine administered in combination or alone. It was shown that staphylococcal infection lowered activity of the serum beta-lysins in the animals and therapeutic use of inactivated staphylococcal vaccine stimulated beta-lysin activity. Therapeutic use of rifampicin or lincomycin under the same conditions lowered activity of beta-lysins. The inhibitory effect of rifampicin was less pronounced. Combined use of the antibiotics and the vaccine promoted an increase in activity of beta-lysins as compared to the use of the antibiotics alone.
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An experiment on guinea pigs immunized with staphylococcal vaccine prepared from water-soluble antigens revealed that the degree of developing sensitization and specific resistance was essentially determined by the method and schedule of the administration of the preparation. The intranasal administration of the vaccine induced a lesser degree of sensitization in comparison with its subcutaneous injection. The optimum response to the administration of the vaccine (a low sensitization level and a high degree of protection from infection) was observed in the animals immunized first intranasally and then by subcutaneous injection. The subcutaneous injection of the preparation in combination with its subsequent intranasal application induced a more pronounced degree of sensitization and a lesser degree of protection from infection.
An unequivocal regularity in local and systemic reactions to multiple (in 5 injections) administration of lyophilized staphylococcal vaccine prepared from water-soluble antigens has been established in patients and in healthy adults: the number and intensity of reaction decreased after each subsequent injection. A similar tendency has been observed in the vaccinees who were examined for their IgE levels. These data are indicative of the desensitizing action of the vaccine.
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In 18 patients with furunculosis and in 9 with chronic inflammation of upper respiratory tract, some cellular immunity parameters were tested. These were: phagocytosis index and bactericidal activity against leukocytes. Humoral immunity was also investigated by measurement of serum gammaglobulins. All test were performed before treatment and 30 days after application of the last dose of autologous vaccine. In 12 patients with furunculosis, improvement of the clinical status (disappearance of furunculosis) was appearing together with an increase of phagocytosis index and bactericidal activity of leukocytes without changes in gamma-globulin levels. No such changes were found in remaining patients in whom no clinical improvement was found. The authors suggest that cellular immunity factors studied in this investigation permit for evaluation of the immunity status in patients receiving autologous staphylococcal vaccine.
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