Neonatal protection and preterm birth reduction following maternal group B streptococcus vaccination in a mouse model.

PURPOSE: Evaluate effects of maternal immunization in a mouse model of Group B Streptococcus (GBS) vaginal colonization using clinical isolates. MATERIALS AND METHODS: Female pregnant mice were immunized with heat-killed GBS 21 days before pregnancy and were inoculated intravaginally with GBS cultures (5 × 107 CFU twice a day for three days) from the 16th day of pregnancy. Gestation period and mice survival were monitored. Maternal anti-GBS IgG levels have been determined by ELISA analysis in vaccinated, unvaccinated mothers and newborns. RESULTS: Maternal immunization before pregnancy provided protection to newborns for three of the four GBS strains used. Evaluation of the immunogenicity showed that this vaccination induced higher levels of IgG in vaccinated compared to unvaccinated dams and the presence of antibodies in the offspring at embryonic and postnatal age, and a Th1 response and high levels of IgG2a subclass antibody and IFN-γ were detected. A significant reduction of preterm births was observed in vaccinated mothers (p< 0.05). CONCLUSIONS: Our finding suggest that vaccinated mothers could protect their progeny from GBS infection and preterm birth through passive immunization. The proposed mouse model may represent a noninvasive and effective tool to investigate pathogenetic mechanisms of GBS ascending infection and for vaccine protection studies.

Can dedicated ambulances improve the efficiency of the neonatal emergency transport service?

OBJECTIVE: To assess whether dedicated ambulances would improve the efficiency of the neonatal emergency transport service (NETS). METHODS: The efficiency of NETS was investigated in the Lazio region, Italy, by comparing data collected during the first 6 months of 1997 (from 1 January to 30 June), with those collected during the same months of 2000, using NETS availability and time investment as indicators. The data yielded by the study were reported as number and percentage, and were analyzed by SPSS 10.1 software; chi2 analysis with Pearson's correction was used to assess the statistical significance of the differences between the two groups; p < 0.05 was considered statistically significant. RESULTS: Our investigation showed a reduced availability of the service in 2000, compared to 1997 (90.4% vs. 95%; p < 0.03). We also noted that in 2000 all dedicated ambulances remained off duty for 26 days, owing to engine failure. The response time and the total transfer time where much longer in 2000 than in 1997 (response time > 30 min in 8% vs. 3%, p < 0.008; total transfer time > 120 min in 37% vs. 30%, p < 0.04). CONCLUSIONS: The reduced efficiency in 2000 was mainly due to the lack of ambulances used to replace the dedicated ambulances. However, the type of ambulance that may provide the best replacement for NETS remains an unsolved question.