Assessment of serum anti-Bordetella pertussis antibody titers among medical staff members.

This study comparatively evaluated the titers of the bacterial agglutination (BA) antibody for Bordetella pertussis, anti-pertussis toxin (PT) antibody, and anti-filamentous hemagglutinin (FHA) antibody in the serum of medical staff members. The geometric means of the anti-PT and anti-FHA antibody titers were 5.83 and 17.17 EU/mL, respectively. The positive rates of the BA antibodies against Tohama and Yamaguchi strains (> or = 40x), and anti-PT and anti-FHA antibodies (>10 EU/mL) were 81.3, 72.9, 43.8, and 68.8%, respectively. A high anti-PT antibody titer (>94 EU/mL) was found in 1 staff member, but this individual had no recent respiratory symptoms. The titers of the BA antibody against the Yamaguchi strain were weakly associated with the anti-PT antibody titers, but the BA antibody titer was not useful for predicting anti-PT antibody positivity. The seroprevalence of anti-pertussis antibody among medical staff was heterogeneous, suggesting that this group could be at high risk for pertussis. Judgments made using BA antibody or anti-PA antibody results differ, and thus careful evaluation of anti-pertussis antibody titers is necessary. Prompt and accurate diagnostic tools are crucial for infection control in the hospital setting.

Evaluation of inflammatory-response-induced thoracoscopic surgical stress.

OBJECTIVE: Due to the paucity of reports evaluating stress induced by thoracoscopic surgery with minithoracotomy, we assessed this stress based on the inflammatory response to surgery. METHODS: Differences in pre- and postoperative peripheral white blood cell (WBC) count, serum C-reactive protein (CRP), and serum interleukin-6 (IL-6) were evaluated, defined as dW, dCRP, and dIL-6. Thoracoscopic partial lung resection cases were divided into 2 groups by access route: Group A patients in which surgery was concluded via several small access ports. and Group B patients going surgery via small access ports plus minithoracotomy. We also compared dW in standard lobectomy with exploratory thoracotomy (thoracotomy without lobectomy) cases. RESULTS: No significant difference was seen in dW, dCRP, or dIL-6 between groups. dW in response to exploratory thoracotomy was lower than that in standard lobectomy (p = 0.06). CONCLUSIONS: Surgical stress induced by thoracoscopic partial lung resection does not increase significantly when minithoracotomy is added. Postoperative inflammatory response may, however, be influenced by the extent of surgical trauma.