The candida precipitin test in an immunosuppressed population.

Ninety-one immunosuppressed, high-risk patients suspected of having invasive candidiasis were tested during their septic episode for the presence of candida precipitin (CP) antibody using the counterimmunoelectrophoresis (CIE) method. In 12 patients, systemic candidiasis was confirmed but only 6 of these (50%) had candida precipitins. In 14 "questionable" cases who died without a definitive diagnosis, 8 (57%) had precipitin antibody. Of the 65 patients who did not have serious candida infection, 20 (31%) had candida precipitins. In this population we found the presence of candida precipitins to be neither sensitive (50%) nor specific (69%) for the diagnosis of invasive candidiasis.

Neutrophil chemotaxis during and after general anesthesia and operation.

The neutrophil granulocytes of 43 patients undergoing general anesthesia and operation were examined to determine if altered function occurs during these procedures. Neutrophil chemotaxis, random migration, and total and differential leukocyte counts were determined immediately before anesthesia; after 35 to 60 minutes of anesthesia but before operation; 60 minutes after initiation of operation; and 60 minutes after operation. Anesthetic agents included 1 to 3.5% enflurane, 0.5 to 2% halothane, or 0.5 to 1.1 mg/kg of morphine plus N2O-O2 (60:40). Neutrophil and total white blood cell counts were uninfluenced by any of the anesthetics; however, marked rises in both occurred during operation and persisted postoperatively after each of the anesthetic technics. Neutrophil chemotaxis was reduced an average of 36, 32, and 21%, respectively, by halothane, enflurane, and morphine before operation and 20, 10, and 5% intraoperatively. Preoperative reductions in chemotaxis were statistically significant after all anesthetics. However, only halothane produced a significant intraoperative reduction in chemotaxis. Postoperative neutrophil chemotaxis did not differ from control (preanesthesia) values after any of the anesthetics. Halothane and enflurane reduced leukocytic random migration before but not after operation. Morphine had no effect on random migration at any time. These data demonstrate that anesthesia impairs neutrophil function in man but that operation appears to reverse this depression.

Rapid specific identification of group D streptococci by counterimmunoelectrophoresis.

Clinical isolates of group D streptococci have been examined by counterimmunoelectrophoresis (CIE) to determine if this method might be of value in the rapid identification of the members of this group. Group D organisms identified by classical biochemical and serologic procedures were inoculated into Todd Hewitt broth and incubated at 37 degrees C. After 4 hours of incubation, free group D streptococcal antigen was detected in broth cultures from 70 of 70 group D enterococcal strains. Precipitin lines were readily visible immediately after electrophoresis in each case. In contrast, 10 nonenterococcal group D strains failed to produce detectable free group D antigen in the Todd Hewitt broth after 4, 24, or 48 hours incubation. Such antigen was detectable, however, after 48 hours incubation in Mueller Hinton broth containing 10 grams of glucose per liter. Representative strains of group A, C, G, and B streptococi, Streptococcus viridans and Streptococcus pneumoniae grown in Todd-Hewitt broth for 4 hours gave no precipitin lines when reacted against adsorbed monospecific group D antiserum. Group D antigen was also detected in broth cultures of direct swabs and in 18-hour blood culture broths. CIE appears to be a rapid and sensitive procedure for identification of the enterococcal strains of group D streptococci from clinical isolates.