Carriage of penicillin-resistant pneumococci in Malawian children.

In a prospective study of pneumococcal carriage in 200 Malawian children under 5 years of age, 47.5% were carriers. The carriage rate was highest in those aged 3-12 months and did not vary with family size, nor was it higher in those who had recently been admitted to hospital. Nasopharyngeal swabs were significantly more efficient than throat swabs in detecting carriers (p < 0.001) but nasopharyngeal swabs alone would have missed seven (8%) carriers. Pneumococcal isolates from 22% of carriers and from eight cases of meningitis and one of empyema showed intermediate resistance to penicillin (MIC 0.1-1.0 mg/l). All were sensitive to the 3rd-generation cephalosporin cefotaxime but one of the penicillin-resistant pneumococci and two of the clinical isolates had increased MICs of cefuroxime (0.5 mg/l).

Sensitization to sugar cane pollen in Okinawan allergic children.

Specific IgE antibodies to sugar cane pollen were investigated in seventy-four Okinawan children who suffered from allergic disorders. Only two (2.7%) with asthma of the 74 patients had specific IgE antibodies to sugar cane pollen as well as house dust and Dermatophagoides farinae. However, they have no histories of their symptoms being aggravated when sugar cane flowers bloom. From these results, the sensitization to sugar cane pollen exists in a small number of Okinawan allergic children, however, the low incidence of positivity could reflect lack of exposure to sensitizing doses of sugar cane pollen in these children.

Comparison of allergic diseases and specific IgE antibodies in different parts of Japan.

We investigated the differences of allergic diseases and specific IgE antibodies to inhaled or ingested allergens between two cities in a Japanese pediatric population. One of the two cities is Itoman, which is a subtropical city in Okinawa prefecture; the other is Gifu, which is a Temperate Zone city in Gifu prefecture. The prevalence of asthma or wheezy bronchitis was significantly higher in Itoman; however, the prevalence of atopic dermatitis was significantly higher in Gifu. Furthermore, the positive percentages of specific IgE antibodies to inhaled allergens such as house dust, and Dermatophagoides farinae were higher in Itoman. The positive percentages of specific IgE antibodies to ingested allergens such as egg white, cow milk, and soybean were higher in Gifu. These results suggest that the differences in prevalence of allergic diseases and allergens may depend on differences in the triggering environmental factors between different parts of Japan.

Comparison of the MAST chemiluminescent assay system with RAST and skin tests in allergic children.

The MAST chemiluminescent assay (CLA) system uses enzyme-linked antihuman IgE and a chemiluminogenic substance to determine specific IgE antibodies. The MAST CLA system therefore not only makes unnecessary the precautions required for handling isotopic materials but has the advantage of long-term reagent stability. The MAST CLA system assay protocol consists of three steps: overnight incubation of serum, a 4-hour incubation with enzyme-labeled antibody, and a 30-minute chemiluminescent reaction, which produces a visible image (immunograph) on high-speed instant Polaroid film. We evaluated this MAST CLA system in 47 allergic children and compared the results with those for RAST and skin tests. Good correlations were found between MAST and RAST for house dust, Dermatophagoides farinae, cat, Japanese cedar pollen, egg white, and soybeans, the correlation coefficients being greater than 0.60. When the diagnostic results for MAST and RAST were compared with those of skin test reactions for house dust, Dermatophagoides farinae, cat, Japanese cedar pollen, egg white, and soybeans, MAST had a sensitivity of 85% and a specificity of 82% as compared with 88% and 83% for RAST. Further, an average of 2.1 different allergens were detected in one serum sample. These results suggest that the MAST CLA system can be used to detect specific IgE antibodies and that it provides accurate results for allergic children.

Goldberg-Shprintzen syndrome: Hirschsprung disease, hypotonia, and ptosis in sibs.

We describe a brother and sister with Hirschsprung disease, hypotonia, and ptosis. Their condition resembles that in 2 sibs reported by Goldberg and Shprintzen. We conclude that the clinical characteristics in 8 reported cases with similar clinical manifestations represent a distinct autosomal recessive syndrome, Goldberg-Shprintzen syndrome.