[Simultaneous vaccination against influenza and invasive pneumococcal disease in chronic dialysis patients]. / Simultánní ockování proti chripce a invazivnímu pneumokokovému onemocnení pacientu v pravidelné dialyzacní lécbe.

STUDY OBJECTIVE: To evaluate the antibody response to simultaneous vaccination against influeza and pneumococcal disease in chronic dialysis patients. METHODS: Fifty-four chronic dialysis patients were vaccinated with subunit influenza vaccine Influvac. Thirty-five of these patients were vaccinated with both influenza vaccine and Pneumo 23 vaccine while 19 patients received influenza vaccine alone. Antibodies against influenza vaccine antigens were determined in paired sera by the hemagglutination inhibition test. The geometric mean titre (GMT) of antibodies, protection level (PR), seroconversion (SC) and conversion factor (CF) were calculated. The levels of antibodies against pneumococcal vaccine antigens were detected by the EIA and the geometric mean concentrations of antibodies were calculated from the results. RESULTS: Simultaneous vaccination did not induce adequate PR for antigens A H1N1 and A H3N2, SC and CF for A H3N2 and B. Influenza vaccination alone resulted in inadequate PR and SC for A H3N2, with CF being adequate for all of the antigens. The geometric mean titres of antibodies were higher in the patients vaccinated with influenza vaccine alone, the difference not being statistically significant. Good responsiveness to the pneumococcal vaccine was observed, with the geometric mean concentrations of antibodies increasing 4.8 times after vaccination but decreasing to 1/3 a year later. CONCLUSION: The antibody response to influenza vaccine was negatively influenced by immunodeficiency due to underlying diseases in dialysis patients. Although poorer results were achieved in patients vaccinated with influenza vaccine alone compared to those vaccinated with the two vaccines, the difference was not significant. An adjuvant influenza vaccine is expected to be more promising.

[Determination of antibodies to streptolysin O]. / Stanovení protilátky proti streptolyzinu O.

A new procedure for the assessment of the antibody against streptolysin O by a micromethod was tested by comparison with the photometric reference method. Agreement between the two methods was very good. The differences in titres did not exceed the titration error of the method. Based on the tested micromethod, a diagnostic set was produced in the Czech Republic which is to be used for common titration of antistreptolysin O in serum. The ITEST ASO was tested in relation to the photometric reference method and standardized neutralization micromethod of the National reference laboratory for streptococci and enterococci in Prague. From a group of 135 selected sera with different titres there was agreement between all tested methods. Selected kits used abroad for the titration of antistreptolysin O were tested in the National reference laboratory by using the authors own standardized materials and methods.

The group specific polysaccharide antibody in children with non-suppurative sequelae of group A streptococcal infection.

The kinetics of the group A specific polysaccharide antibody were studied in children with acute rheumatic fever who had no carditis, children with acute rheumatic fever who had carditis and developed rheumatic heard disease and in children with acute poststreptococcal glomerulonephritis. The children with rheumatic fever who had carditis and those who did not, were kept on continuous antistreptococcal prophylaxis. In the group of children who developed rheumatic heart disease the titer of the antibody at onset was significantly higher than those who had rheumatic fever but no carditis (P = 0.01). After a mean follow-up period of three years, a high titer was maintained in children who developed rheumatic heart disease only and was significantly higher than that found in children with rheumatic fever who had no carditis (P = 0.001) and in children with poststerptococcal nephritis (P = 0.001).

Human heart sarcolemmal sheath antibodies in children with non-suppurative sequelae of group A streptococcal infections: a follow up study.

The kinetics of the human heart sarcolemmal sheath antibody were studied in children with acute rheumatic fever who had no carditis, children with acute rheumatic fever who had carditis and developed rheumatic heart disease, and in children with acute poststreptococcal glomerulonephritis. The children with rheumatic fever and those who developed valvular heart disease were given continuous secondary antistreptococcal prophylaxis. The titre of antibody at onset was significantly higher than that of the controls in children with acute rheumatic fever and carditis and in children with acute poststreptococcal nephritis. The difference in the antibody titre between children with rheumatic fever who had no carditis and controls was not statistically significant. After a mean follow up of three years, however, a high titre was only maintained in children with rheumatic fever who developed valvular heart disease.

Electron microscopic localization of lipoteichoic acid on group A streptococci.

The location of lipoteichoic acid (LTA) on the surface of group A streptococci was studied by immunoelectron microscopic and ultrastructural cytochemical methods, i.e. by means of LTA antibodies labelled with ferritin, or concanavalin A labelled with ferritin or colloidal gold. All these methods proved the LTA to be located on the outer cell surface of most group A streptococcus strains. The differences in the intensity of labelling paralleled the hydrophobicity of the strains, being substantially higher in the strains exhibiting a high degree of hydrophobicity. Treatment of streptococci with pronase or trypsin led to a complete loss of surface-located LTA. On the other hand, pepsin treatment of streptococci under mild conditions resulted in an increased amount of surface-located LTA in some strains. On the isolated cell walls, LTA could be demonstrated only on the outer surface of the walls. These findings correlated well with the presumed role of group A streptococcus LTA in the adherence of streptococci to the epithelial cells which is accomplished with the aid of surface-located LTA molecules.

[Submicroscopic aspects of the adherence of group B streptococci to vaginal epithelial cells]. / Submikroskopické aspekty adherence streptokoku skupiny B k vaginálním epiteliálním bunkám.

The submicroscopic structure of surfaces in the streptococci of group B, type III (strain 13/63) and the ultrastructure of the interaction of this streptococcus strain with human vaginal cells were studied. The surface of the majority of B streptococci was smooth after using the conventional fixing techniques of electron microscopy; however, about 25% of streptococcal cells had an additional layer of filamentous protrusions on their surface. A marked layer of capsular material was visualized by means of the preincubation of this streptococcus strain with a type-specific antiserum. The incubation of B streptococci with vaginal cells without any addition of antibody allowed for the demonstration of the contact of a part of the cells of the bacterial population with the epithelial cells through filamentous protrusions. However, the majority of the smooth-surface cells was separated from vaginal cells by a gap wide up to 150 nm. It was demonstrated by additional incubation with type-specific antiserum that the above mentioned gap corresponded to the capsular substance of bacteria. Hence the capsule of streptococci in group B is the basic component of their surface responsible for adherence to vaginal cells. Adherence of B streptococci to vaginal epithelia was accompanied neither by bacterium ingestion nor by the destruction of epithelial cells.

Reactivity of antistreptococcus hyperimmune sera with human myocardial tissue.

Antimyocardial antibodies were determined in hyperimmune rabbit sera against group A streptococci. The detection method was indirect immunofluorescence in human myocardial tissue sections. Positively reacting sera were absorbed with group A streptococcus cell walls and cytoplasmic membranes, the objective being to locate the cross-reacting antigen in the streptococcus cell under the given experimental conditions. Cell walls gave the better absorption results. Whether or not the streptococci possessed the Fc-reacting factor was without influence on the absorption result.

Adherence of group A streptococci to epithelial cells in tissue culture.

Using the HEp-2 cell line system the factors and mechanisms of group A Streptococcus adherence had been studied. It was shown that high adherence was chiefly found in strains showing attributes of virulence (presence of M protein, growth in human blood, lethality for mice). The data supplied by experiments with pepsin and LTA suggest that there exist at least two mechanisms of adherence.