ABSTRACT
Between 1984 and 1987, the number of reported cases of congenital syphilis in New Jersey tripled. Findings indicate an increase in early syphilis among females of childbearing age living in areas of high syphilis morbidity, reflecting, possibly, lifestyle changes within populations already at risk for the disease. Future studies and interventions are needed.
Subject(s)
Syphilis, Congenital/epidemiology , Adult , Female , Humans , Incidence , Infant, Newborn , Life Style , Maternal Behavior , New Jersey , Pregnancy , Risk Factors , Single Parent , Urban PopulationABSTRACT
A semiquantitative nasopharyngeal culture was found to be sensitive and specific in predicting middle ear pathogens in children with acute bacterial otitis media. In nasopharyngeal specimens with growth of at least 1,000 colonies, the tympanocentesis isolate was present and was either the predominant isolate or accounted for 50% of growth in 16 of 16 children. Data suggest that virulence of nasopharyngeal organisms plays a role in the pathogenesis of acute otitis media. Qualitative differences were found in the nasopharyngeal flora of children with bacterial otitis media as compared with children with clinical otitis media and sterile tympanocentesis cultures, children with uncomplicated upper respiratory illness, and healthy children. Abundant growth of Haemophilus influenzae (greater than or equal to 50% total colony count) was associated with children with bacterial otitis media, and abundant Branhamella catarrhalis was associated with the others (P less than or equal to 0.01). Abundant growth of Streptococcus pneumoniae occurred frequently and regardless of clinical category. Antibiotic treatment of children with otitis media resulted in rapid quantitative and qualitative changes in nasopharyngeal flora.
Subject(s)
Nasopharynx/microbiology , Otitis Media/microbiology , Acute Disease , Adolescent , Anti-Bacterial Agents/administration & dosage , Child , Child, Preschool , Ear, Middle/microbiology , Haemophilus influenzae/isolation & purification , Humans , Infant , Neisseriaceae/isolation & purification , Otitis Media/drug therapy , Respiratory Tract Infections/microbiology , Streptococcus pneumoniae/isolation & purification , Time Factors , Virulence , Virus Diseases/microbiologyABSTRACT
Biotype and serotype were determined for 473 isolates of Haemophilus influenzae from 399 children. Patients with invasive disease usually had serotypable (86%) and biotype 1 (80%) isolates. Respiratory isolates from well children and children whose illness was not caused by H. influenzae were rarely serotypable (1%) or biotype 1 (8%). Respiratory isolates from children whose illness was possibly or probably related to H. influenzae and isolates from children with cystic fibrosis were more frequently biotype 1, serotypable, or both (P less than 0.01 for all comparisons). Ten (67%) of 15 children with acute otitis media due to H. influenzae had tympanocentesis isolates which were biotype 1; only one isolate was serotypable. Isolates from inflamed conjunctivae had biotypes and serotypes similar to respiratory isolates from well children. Ampicillin resistance was less frequent among biotype 1 isolates (9%) compared with other biotypes (19%) (P less than 0.01). The data suggest that H. influenzae is biochemically heterogeneous and that noncapsular factors, frequently predictable by biotype, contribute to virulence.
