A therapeutical outlook in "infectious" bronchial asthma.

Chronic bronchial asthma seems to be generated by abnormal functions of PMNs and eosinophils stimulated by local bacterial flora. Once stimulated, they release uncontrolled excessive amounts of ROI and various soluble mediators. These are the expression of disorders in the synthesis of SOD, catalase and other enzymes by PMNs and an excessive production of the so-called anti-inflammatory Th2 type cytokines, mainly IL-4 and IL-5 to the detriment of IFN gamma and other Th1 type cytokines. Treatment consisting of autovaccines obtained from local flora associated with immunomodulators instead of antibiotics or glucocorticoids proved to be beneficial for patients.

Bacteriological study of Neisseria strains isolated in Romania 1971-1992.

1496 Neisseria strains isolated from patients and carriers from 24 counties in Romania and Bucharest in 1971-1992 were studied. Serogroup A identified in 84.5% in 1987 shows a remarkable decrease in pre- and post-epidemic periods when serogroups B and C reach rates varying from 0 to 66.6% in 1975 for B and 38.8% in 1974 for C. Non-groupable strains were more frequently isolated in inter-epidemic periods, especially in carriers. Sensitivity to antibiotics of the meningococcal strains revealed a law rate of resistant strains, the most active antibiotics in decreasing order being: penicillin, chloramphenicol, tetracycline, ampicillin, rifampicin and erythromycin. Serogroup A was the most resistant to sulfamides as compared to the other serogroups, its resistance rate rising from 18.1% strains resistant to sulfathiazole in 1980-1985 to 60.7% in 1987 and to 83.3% in 1988.

Epidemiology of meningococcal meningitis in Romania 1971-1991.

The paper describes the endemic epidemic picture of meningococcal meningitis in Romania over 1971-1991 period. After the epidemic of 1970 with 1051 cases and a morbidity of 5.2 %000, the incidence of the disease suddenly decreased; thus in 1972-1984 the number of cases ranged from 191 to 534 per year, corresponding to a morbidity rate of 0.9 - 2.3 %000. Starting with the autumn of 1985 the incidence of meningococcal meningitis increased rapidly, reaching a maximum value in 1987 (2623 cases) and a morbidity rate of 11.4 %000. A spectacular decrease to 250-270 cases per year in 1990-1991 and a morbidity rate of 1.1 - 1.2 %000 were reported. Mortality followed closely the morbidity curve with a maximum in 1987 (0.4 %000). By contrast, lethality was higher in endemic periods with a maximum of 7.9% (1972), 8.9% (1975) and 6.3% (1990-1991), in the remaining years the lowest index being 1.4% (1980). The meningococcal meningitis epidemic of 1987 was due to group A Neisseria meningitidis identified in 84.5% of isolates from patients, the same serogroup decreasing in endemic periods to 0 (1991) or 5.5% (1974).

Characteristics of Neisseria meningitidis strains isolated in Romania between 1986 and 1989.

499 N. meningitidis strains were studied, 454 being isolated from CSF and blood and 45 from nasopharynx. Meningococcal serogroup A was prevalent in 1986-1988, having a decreasing tendency from 84.90% in 1987 to 45.0% in 1989. Serogroup C increased from 0.86% in 1986 to 15% in 1989. All strains, examined by diffusiometric method, were sensitive to ampicillin, cephalotin, chloramphenicol and rifampin. For tetracycline, resistance ranged from 2.28 to 6.0% in 1987-1989. The frequency of 52.0-72.14% resistant to sulphamides strains seems to be due to serogroup A prevalence. Six N. meningitidis strains, isolated in 1989, proved to be moderately resistant to penicillin with MIC greater than or equal to 0.1 mcg/ml. The results indicate the necessity of a continuous surveillance of meningococcal infection, both from the point of view of serogroup circulation and also of antibiotics sensitivity.