Marcia Rench

Baylor College of Medicine | BCM · Section of Infectious Diseases

Background: We sought to define the frequency of antibiotic resistance over time in a collection of invasive GBS isolates derived from infant early-onset disease (EOD), late-onset disease (LOD), and late-late onset disease (LLOD). Methods: A multicenter retrospective review of infants born from 1970 to 2021 with GBS isolated from blood, cerebros...

Invasive group B streptococcal disease in childhood is uncommon and occupies a unique clinical niche. We present 10 children, 1-17 years of age, with invasive group B streptococcal disease from 2010 to 2020. Seven had conditions predisposing to infection and 3 had no identifiable risk factors. With appropriate consideration of pathogenesis, source...

Background Acellular pertussis (aP) vaccines replaced whole cell pertussis (wP) vaccines for the U.S. childhood primary series in 1997. As women primed with aP vaccines enter childbearing age, protection of infants through Tdap (tetanus toxoid, reduced diphtheria toxoid and acellular pertussis) vaccination during pregnancy may be impacted. Methods...

This series of 28 infants with group B streptococcal (GBS) cellulitis-adenitis from a single institution over 24 years offers insights important to the early recognition, spectrum of findings, and optimal management of this rare manifestation of invasive GBS disease.

Identified in the 1970s as the leading cause of invasive bacterial disease in neonates and young infants, Group B Streptococcus (GBS) is now also recognized as a significant cause of morbidity and mortality among adults with underlying medical conditions and the elderly. Concomitant with the increasing incidence of GBS invasive disease in adults is...

Background Acellular pertussis (aP) vaccines replaced whole cell pertussis (wP) vaccines for the recommended childhood primary series in the United States in 1997. As women primed with aP vaccines in childhood enter reproductive age, it is unknown how maternal aP-priming will impact pertussis protection conferred to infants through Tdap (tetanus to...

Background Kinetics of Tdap-induced maternally-derived antibodies in infants are poorly understood. Pre-Tdap era data suggest that maternal pertussis antibodies in infants have a half-life of approximately 5–6 weeks. Methods 34 mother-infant pairs had blood collected before maternal Tdap vaccination, 4 weeks later, at delivery (maternal and cord),...

Background Since 1970 group B Streptococcus (GBS) has been a frequent cause of sepsis or meningitis in young infants. Capsular polysaccharide type V was first recognized in 1990 and has increased to the point where it now causes ~15% of GBS infections. GBS type V strains are almost entirely sequence type 1 (ST1) in adult infections. To understand t...

Background Maternal immunization with tetanus, diphtheria, acellular pertussis vaccine (Tdap) in the third trimester reduces infant pertussis, but data are lacking on how this strategy impacts pertussis antibody levels in large cohorts of preterm infants Methods We collected paired maternal delivery-cord sera from infants of women who received Tda...

(Abstracted from JAMA 2018;320(14):1464–1470) Pertussis incidence is highest in infants too young to have completed their primary immunization series (6 months or younger), who are also at the highest risk of developing life-threatening complications. In high-income countries, pertussis-related mortality occurs predominantly in infants 3 months or...

Importance Immunization with tetanus, diphtheria, and acellular pertussis (Tdap) vaccine is recommended in the United States during weeks 27 through 36 of pregnancy to prevent life-threatening infant pertussis. The optimal gestation for immunization to maximize concentrations of neonatal pertussis toxin antibodies is unknown. Objective To determin...

Background Infant protection against severe pertussis requires sufficient maternal pertussis antibodies until infant immunization begins. The kinetics of maternally-derived Tdap-induced antibodies in infants is poorly understood. Methods 34 healthy mother-infant pairs were followed prospectively from maternal Tdap immunization to infant age 6 week...

Group B streptococcal (GBS) rectovaginal colonization prevalence in women of Indian descent living in the United States was 24.7% comparable with US rates but higher than rates reported from India. The capsular polysaccharide types were distinct in that type V was most common and 33% of GBS strains were nontypeable.

Background: Little is known regarding maternal group B streptococcal (GBS) colonization prevalence and capsular (CPS) serotype distribution among pregnant women in India. The objective of this prospective cohort study was to determine GBS recto-vaginal colonization prevalence in pregnant women at Dr. Ram Manohar Lohia Hospital in Delhi, India. Me...

Immunization of nonpregnant adults could help prevent invasive group B Streptococcus (GBS) infections, but adult immune responses have not been investigated. We defined capsular polysaccharide (CPS) and pilus island (PI) surface antigen distribution and expression and immune responses to GBS infection in nonpregnant adults. Prospective surveillance...

Background: Group A rotaviruses (RVA) are a significant cause of pediatric gastroenteritis worldwide. The New Vaccine Surveillance Network (NVSN) has conducted active surveillance for RVA at pediatric hospitals and emergency departments at three to seven geographically diverse sites in the U.S. since 2006. Methods: Over six consecutive years, fr...

Here we report the genome of a novel rotavirus A (RVA) strain detected in a stool sample collected during routine surveillance by the Centers for Disease Control and Prevention's New Vaccine Surveillance Network. The strain, RVA/human-wt/USA/2012741499/2012/G24P[14], has a genomic constellation of G24-P[14]-I2-R2-C2-M2-A3-N2-T9-E2-H3. The VP2, VP3,...

Tetanus, diphtheria and acellular pertussis (Tdap) and influenza vaccination is recommended during each pregnancy but uptake is suboptimal. We evaluated knowledge and acceptance of vaccination recommendations among pregnant women. Prospective, convenience survey of pregnant women presenting for antenatal care at the Pavilion for Women, Texas Childr...

Tetanus, diphtheria and acellular pertussis (Tdap) vaccine is recommended during each pregnancy, but national uptake is poor. We assessed Tdap uptake in a tertiary referral hospital served by university-affiliated and private obstetrical offices. Review of women delivering at Texas Children's Hospital Pavilion for Women, Houston, Texas, during Apri...

Tetanus, diphtheria, and acellular pertussis (Tdap) is recommended during each pregnancy, but national uptake is suboptimal. We audited Tdap uptake in a metropolitan tertiary referral hospital served by university-affiliated and private obstetric offices. Audit of women delivering at Texas Children's Hospital Pavilion for Women, Houston, Texas, dur...

Perinatal screening for Trypanosoma cruzi in a cohort of 4000 predominantly Hispanic women in southern Texas revealed that Chagas disease occurs with sufficient frequency (0.25%) that targeted perinatal screening should be considered to identify infected mothers and infants at risk for congenital infection.

Among 248 infants with late-onset group B streptococcal (GBS) disease from 1993 through 2012, approximately two-thirds (63%) had a gestation of at least 35 weeks and 72% of these became ill within 6 weeks of life (median 27 days), suggesting that third trimester maternal GBS immunization could substantially reduce the late-onset GBS disease burden...

Background: Cellulitis-adenitis syndrome is an uncommon manifestation of late-onset group B streptococcal (GBS) infection. We aimed to characterize GBS cellulitis-adenitis in the 21st century. Methods: Retrospective review of GBS cultures in infants aged < 1 year, from January 2000 through December 2013 hospitalized at Texas Children’s Hospital,...

Background: Tetanus, diphtheria and acellular pertussis immunization of infant contacts (cocooning) is recommended by the Centers for Disease Control and Prevention to prevent infant pertussis. We determined whether implementing a cocooning program at Ben Taub General Hospital, Houston, reduced severe pertussis in young infants. Methods: Infants...

Adult vaccination coverage is low and current strategies are unlikely to achieve Healthy People 2020 targets. We determined the attitude of adult infant contacts toward recommended adult vaccines and their willingness to receive vaccines should they be available during hospital visits or prenatal or infant clinic appointments. Survey of predominant...

Background: Further reduction in the group B streptococcal (GBS) disease burden in neonates in the United States awaits an additional prevention strategy, such as maternal immunization. Methods: We performed a prospective, multicenter, case-control study of 33 mothers delivering neonates with early onset GBS infection (cases), and 99 age- and et...

Influenza and pertussis prevention in young infants requires immunizing pregnant women and all caregivers (cocooning). We evaluated the knowledge and attitude of postpartum women about these two recommendations. A survey of predominantly Hispanic, underinsured, medically underserved postpartum women in Houston, Texas was performed during June 2010...

Background: We assessed vaccine effectiveness (VE) for RotaTeq (RV5; 3 doses) and Rotarix (RV1; 2 doses) at reducing rotavirus acute gastroenteritis (AGE) inpatient and emergency department (ED) visits in US children. Methods: We enrolled children <5 years of age hospitalized or visiting the ED with AGE symptoms from November 2009-June 2010 and...

Background. Pertussis booster vaccine (Tdap) recommendations assume that pertussis-specific antibodies in women immunized preconception, during, or after previous pregnancies persist at sufficient levels to protect newborn infants. Methods. Pertussis-specific immunoglobulin G (IgG) was measured by IgG-specific enzyme-linked immunosorbent assay (ELI...

Vaccine or vaccine-reassortant rotavirus strains were detected in fecal specimens from 5 of 106 (4.7%) immunocompetent children who required treatment for rotavirus gastroenteritis at a large pediatric hospital in Texas in 2009–2010. Four strains were related to pentavalent rotavirus vaccine, whereas one was related to monovalent rotavirus vaccine....

Group B Streptococcus (GBS) is the leading cause of meningitis in young infants. We evaluated long-term outcomes among GBS meningitis survivors. We hypothesized that despite reduced mortality, GBS meningitis would remain a significant cause of morbidity among GBS survivors. Ninety term and near-term infants diagnosed with GBS meningitis from 1998 t...

The duration of functional activity of group B streptococcal (GBS) glycoconjugate vaccine-induced capsular polysaccharide-specific (CPS) IgG was evaluated among healthy adult responders. Opsonophagocytic activity declined significantly from a 4-week post-immunization peak, but substantial functional activity, exceeding 1 log(10) reduction in GBS cf...

Mothers often are the source of pertussis illness in young infants. The Centers for Disease Control and Prevention recommend tetanus and diphtheria toxoids and acellular pertussis (Tdap) vaccine for postpartum women before hospital discharge. In January 2008, this recommendation was implemented in a predominantly Hispanic, medically underserved pop...

In 2006, the Advisory Committee on Immunization Practices recommended tetanus, diphtheria, acellular pertussis (Tdap) vaccination of all caregivers of infants aged <1 year ("cocooning") to prevent pertussis-related complications and deaths. We implemented cocooning in a predominantly Hispanic, medically underserved, uninsured population at a Housto...

Fecal specimens from children presenting to Texas Children's Hospital with acute gastroenteritis were tested for the presence of rotavirus. Children were grouped according to vaccination status, and pentavalent rotavirus vaccine effectiveness was calculated. Pentavalent rotavirus vaccine effectiveness against severe rotavirus gastroenteritis was su...

Group B streptococcal (GBS) meningitis is diagnosed less frequently than in the 1970s and 1980s. There are few contemporary data regarding outcomes from GBS meningitis and factors that might predict an adverse outcome. A retrospective evaluation was conducted of term and near-term infants (≥36 weeks' gestation) with GBS meningitis hospitalized at T...

: Antigenemia is common among children with rotavirus disease. Because obtaining stool specimens is cumbersome, we evaluated whether detection of antigenemia in sera obtained during routine clinical practice could augment rotavirus surveillance to assess the effect of vaccination. : We determined the sensitivity, specificity, and positive and negat...

Immunization information systems (IISs) are accessible sources of immunization data. We validated immunization information from a local IIS against provider records and assessed the system's utility in evaluating vaccine effectiveness against rotavirus disease using a case-control study. Among the 91% of case and control patients with immunization...

Background: Pentavalent rotavirus vaccine (RV5) was 98% efficacious against severe rotavirus gastroenteritis in pre-licensure studies. Post-licensure assessments report similar effectiveness in the first year of life among US infants, but the effectiveness of RV5 in older children has not been well assessed. Objectives: * To assess the effectiv...

The goal was to assess the effectiveness of complete (3-dose) or partial (1- or 2-dose) immunization with pentavalent rotavirus vaccine (RV5) against rotavirus acute gastroenteritis (AGE) in US clinical practice. A case-control evaluation was conducted in February through June 2008 at an emergency department in Houston, Texas. Case patients with ro...

We provided CDC recommended postpartum tetanus, diphtheria, acellular pertussis (Tdap) immunization to medically underserved, uninsured women in Houston through a standing order protocol. From January 7-April 30, 2008, 1129 of 1570 (72%) postpartum women (93% Hispanic; 11% < or = 19 years) received Tdap before hospital discharge. Tdap uptake was 96...

Recently, it was discovered that sialic acid residues on group B streptococcal (GBS) capsular polysaccharides (CPS) are O-acetylated. Since GBS vaccine development has focused on de-O-acetylated CPS, it became germane to investigate the influence of de-O-acetylated GBS vaccine formulations on functional activity of sera against strains that bear th...

Background: In 2006, the ACIP recommended tetanus, diphtheria, acellular pertussis (Tdap) booster of family members and caregivers (cocooning) to prevent severe pertussis in infants < age 6 months. Immunizing postpartum women, the source of approximately 33% of pertussis cases in young infants, prior to hospital discharge is the cornerstone of this...

Alpha C protein, found in 76% of non-type III strains of group B Streptococcus (GBS), elicits antibodies protective against alpha C-expressing strains in experimental animals, making it an appealing carrier for a GBS conjugate vaccine. We determined whether natural exposure to alpha C elicits antibodies in women. Geometric mean concentrations of al...

Group B Streptococcus (GBS) β C protein elicits protective antibodies in experimental animals, making β C protein an attractive component of a human GBS glycoconjugate vaccine. We determined whether natural exposure to β C protein elicits antibodies in humans. Geometric mean concentrations (in micrograms per milliliter) of β C-specific immunoglobul...

A phase 1, dose-escalating trial was conducted in healthy adults to evaluate immunogenicity and reactogenicity of a type V group B streptococcal (GBS) capsular polysaccharide (CPS)-tetanus toxoid (TT) conjugate vaccine. Participants received one dose of unconjugated V CPS (37 microg), V-TT (2.4 microg CPS/1.1 microg TT), V-TT (9.6 microg CPS/4.3 mi...

Background: Protein conjugation enhances immunogenicity of GBS capsular polysaccharide (CPS) vaccines. β C proteins elicit antibodies protective against β C protein-expressing strains in experimental infections and are attractive proteins for a GBS conjugate vaccine. Our aim was to determine if natural exposure to β C protein of GBS elicits antibod...

The reasons for the higher pertussis incidence among Hispanic infants, compared with among infants of other ethnicities, are unknown. The geometric mean concentration of pertussis toxin—specific immunoglobulin G in serum samples from 220 Hispanic neonates was 8.45 EU/mL, as determined by enzyme-linked immunosorbent assay, and it was significantly l...

The burden from group B streptococcal (GBS) disease in elderly persons (age, >or=65 years) has increased. Rates of colonization and prevalence of antibodies against capsular polysaccharides (CPS) that might confer protection against invasive GBS disease in such persons are not defined. A cross-sectional survey was conducted in an outpatient setting...

One-third of the cases of invasive group B streptococcal (GBS) disease now occur in adults ⩾65 years old. Serotype V is most frequent among these invasive isolates. The safety and immunogenicity of type V GBS capsular polysaccharide (CPS)-tetanus toxoid (V-TT) conjugate vaccine (CV) were assessed in 32 healthy adults 65–85 years old who were random...

Passively acquired maternal antibodies protect infants from many pathogens. With increasing reports of infant pertussis, we evaluated pertussis antibodies in maternal-infant paired sera from 1999-2000. Antibodies to pertussis toxin (PT), filamentous hemagglutinin (FHA), and fimbrial proteins (FIM) were measured by validated IgG-specific enzyme-link...

Infections caused by group B streptococcal (GBS) type V are increasingly common. Capsular polysaccharide (CPS)-protein conjugate GBS vaccines are immunogenic in healthy adults, but type V vaccines have not previously been tested. Thirty-five healthy, nonpregnant women were randomized to receive an intramuscular dose of GBS type V CPS-tetanus toxoid...

Microsoft Word 10.0.2627; Introduction: GBS causes a substantial invasive disease burden in adults ≥65 yrs of age, with estimated mortality at 30%. Serotype V is the most frequent cause of these infections. Objectives: To assess the safety and immunogenicity of V-TT CV in healthy adults 65-85 yrs of age and the functional activity of V-TT-induced V...

Introduction: The incidence of invasive GBS disease in adults 65 yrs of age and older is increasing and associated mortality is high. Rates of GBS colonization and prevalence of antibodies to the capsular polysaccharide (CPS) that might protect the elderly against invasive GBS disease are unknown. Objectives: To define the rate of GBS colonization,...

To determine the safety and immunogenicity of group B streptococcal (GBS) type III CPS-TT conjugate vaccine in pregnant women. Prospective, randomized (2:1, vaccine:placebo), double-blind, placebo-controlled trial in women at 30-32 weeks' gestation and their infants. Immune responses were measured with IgG-specific ELISA assays; killing of III GBS...

To determine whether 2 monovalent group B streptococcus (GBS) serotype II or III capsular polysaccharide (CPS)-tetanus toxoid (TT) conjugate vaccines combined in a single intramuscular dose would elicit immune responses comparable to those of monovalent vaccines, 75 healthy adults were randomized to receive GBS II-TT (3.6 µg of CPS), GBS III-TT (12...

Phase 1 and 2 clinical trials of group B streptococcal (GBS) capsular polysaccharide (CPS)-protein conjugate vaccines in healthy adults have demonstrated their safety and improved immunogenicity compared with uncoupled CPSs. Two recent trials sought to determine (i) whether adsorption of conjugate vaccine to aluminum hydroxide would improve immunog...

Mucous membrane colonization with group B streptococci (GBS) frequently persists in infants after treatment of invasive infection and may be associated with recurrent disease. To determine the frequency with which GBS colonization persists at mucous membrane sites after treatment of invasive early or late onset infection and to determine the effica...

An estimated 15% of invasive group B streptococcal (GBS) disease is caused by type II capsular polysaccharide (II CPS). In developing a pentavalent vaccine for the prevention of GBS infections, individual GBS CPSs have been coupled to tetanus toxoid (TT) to prepare vaccines with enhanced immunogenicity. Type II GBS (GBS II) vaccine was created by d...

Recurrent invasive disease due to group B Streptococcus (GBS) in twin infants has not been reported. We report 2 cases of recurrent GBS afflicting both siblings of a set of dichorionic twin infants. The maternal and infant colonizing and invasive strains were identical by sero-typing and pulsed-field gel electrophoresis (PFGE). Despite attempts at...

From 1993 through 1996, surveillance for invasive disease due to group B Streptococcus (GBS) in neonates aged <7 days and in peripartum pregnant women was performed in a racially and ethnically diverse cohort in 4 cities in the United States. In a birth population of 157,184, 130 neonatal cases (0.8 per 1000) and 54 maternal cases (0.3 per 1000) we...

To define factors influencing vertical transmission of and neonatal colonization with group B streptococci (GBS) in neonates representing ethnically and economically diverse populations, and to determine the serotype distribution of isolates, especially new types IV-VIII. Prospective, cross-sectional study of neonates born to women evaluated for GB...

About 40% of invasive group B streptococcal (GBS) isolates are capsular polysaccharide (CPS) types Ia or Ib. Because infant and maternal GBS infections may be preventable by maternal vaccination, individual GBS CPS have been coupled to tetanus toxoid (TT) to prepare vaccines with enhanced immunogenicity. Immunogenicity in rabbits and protective cap...

To determine whether growth of Candida from an endotracheal aspirate identifies a population of very low birth weight (VLBW; < or = 1500 gm) neonates at increased risk of systemic candidiasis. Prospective evaluation with weekly cultures of endotracheal and rectal specimens to determine colonization status. One hundred sixteen VLBW neonates (mean bi...

Physical features do not reliably distinguish premature infants with bacterial infections from those with noninfectious conditions. We evaluated the association of depressed plasma fibronectin with sepsis among hospitalized very low birth weight infants (< 1500 gm). Reference values were determined by sequential plasma sampling from 60 healthy very...

Two infants with typical clinical presentations for invasive neonatal group B streptococcal disease caused by a new serotype, type V, are described. Organisms of this capsular type should be sought among isolates from sick neonates to evaluate their prevalence and associated patterns of disease.

Background. Nosocomial infection is a major risk for premature infants with very low birth weights. One reason for their susceptibility to infection may be antibody deficiency, since there is little transfer of maternal IgG to the fetus before 32 weeks' gestation. Methods. We conducted a multicenter, double-blind study of neonates weighing 500 to 1...

THERE is considerable mortality and morbidity in the United States from perinatal group B streptococcal disease.1 , 2 Approximately 3 neonates per 1000 live births, or an estimated 11,000 infants annually, have invasive group B streptococcal disease; two thirds of these infections are caused by the Type III capsular serotype.3 Pregnancy-related mor...

As a result of inadequate placental transport of maternal IgG, preterm neonates of less than 32 weeks' gestation, especially those with birth weights less than 1,500 g, are profoundly hypogammaglobulinemic at birth, a condition that worsens during the first several weeks of life. This hypogammaglobulinemia is believed to contribute to their high fr...

Serum samples from 10 infants surviving type III, group B streptococcal (GBS) meningitis were collected acutely and longitudinally for 6 months to determine patterns of antibody response to the capsular polysaccharide and their in vitro functional correlates. Five infants who failed to develop specific antibody at a mean of 3.8 weeks after diagnosi...

We conducted a retrospective review of neonates with systemic candidiasis at a Houston hospital during the 5-year period 1982 through 1986. Factors associated with these infections, their clinical features, criteria for their diagnosis and the dose, duration, toxicity and efficacy of amphotericin B therapy were analyzed

We studied the pharmacokinetics of single doses of intravenous immunoglobulin (IVIG) of 1000, 750 and 500 mg/kg administered to 21 neonates with birth weights from 750 to 1500 g. No adverse effects were detected. Mean pharmacokinetic values for the large, intermediate and small dose groups, respectively, were: elimination half-life, 19.6, 28.7 and...

D'apres les etudes immunologiques et pharmacocinetiques realisees chez 28 prematures, les taux de cytotoxicite cellulaire dependante des anticorps antivirus herpes simplex (cca-VHS) peuvent etre prevus d'apres la cinetique des IgG et le titre initial ccA des immunoglobulines injectees en intraveineuses (IGIV). Discussion de la valeur preventive et...

Group B streptococcus is a common cause of postpartum infection, but breast abscess in a lactating woman has not been reported. Seven days postpartum, a woman developed mastitis resulting from type Ib/c group B streptococcus. She was treated with oral antibiotics for 1 week, with apparent resolution. Breast-feeding was continued, but at reduced fre...

Immunization of pregnant women with a polysaccharide vaccine of group B streptococcus is a promising strategy for the prevention of perinatal infections caused by group B streptococci. To explore the feasibility of this strategy, we vaccinated 40 pregnant women at a mean gestation of 31 weeks with a single 50-microgram dose of the Type III capsular...

Plasma fibronectin levels and complete blood cell counts were assessed prospectively among 100 infants less than 3 months of age with the provisional diagnosis of "possible sepsis". Seven of the ten infants with culture-proved bacteremia, meningitis, or urinary tract infection had low plasma fibronectin levels as did 12 (13%) of 90 infants with sup...

To assess the disposition, tolerance, and toxicity of an intravenous preparation of immunoglobulin (IGIV) in very low birth weight (VLBW) neonates, we administered single doses of 500 or 750 mg/kg to 20 neonates with birth weights between 750 and 1500 g during the first week of life. The infusion of this product was well tolerated. Modest changes i...

An epidemic of late-onset sepsis due to type Ib/c group B Streptococcus (Ib/c-GBS) occurred in a neonatal intensive care unit (NICU). During a seven-week period, five very low birth weight infants (index cases [ICs]) more than four weeks of age became bacteremic. Bacteriologic surveillance of neonates revealed persistent colonization in three ICs a...

The long-term outcome and admission features predictive of outcome were determined for 61 patients with group B streptococcal meningitis treated between 1974 and 1979. Infection was rapidly fatal in 13 patients (21%). Among the 48 survivors, 38 (79%) 3 years of age or older were available for comprehensive evaluation. Excluding five who had died be...

The single-dose pharmacokinetics of imipenem (N-formimidoyl thienamycin), a beta-lactam antibiotic, used in combination with cilastatin, a renal dehydropeptidase I inhibitor, were evaluated in 10 neonates 1 to 8 days of age. The imipenem-cilastatin combination was given intravenously over a 15-min period at a dose of 15 or 25 mg/kg. Drug concentrat...

In healthy adults, IgG is the major Isotype and IgG2 the predominant subclass of antibody (Ab) elicited in response to III-GBS polysaccharide vaccine (PV). Although immunization to prevent neonatal GBS disease is a promising strategy, it must be shown that III-GBS PV is immunogenic during pregnancy and that the Ab is an isotype and a subclass which...

A commercially available latex agglutination reagent, Directigen (Hynson, Westcott & Dunning, Div. Becton Dickinson & Co., Baltimore, Md.), in which a murine monoclonal antibody to group B streptococcal (GBS) antigen is the active component, was evaluated by using body fluid specimens from 94 sick infants. Antigen was detected in one or more admiss...

A radioimmunoprecipitin test was developed to determine the immunoglobulin class distribution of naturally acquired and vaccine-induced antibody to the native capsular polysaccharide of type III group B streptococci (III-GBS). In sera from adults and pregnant women with naturally acquired antibody, the mean percentage of antigen bound by immunoglob...

Clinical and laboratory features at admission for GBS meningitis have not been assessed as possible predictors of mortality or major neurological sequelae. From 1974 through 1979, 61 patients were admitted with this diagnosis. Infection was rapidly fatal in 13 (21%) and 38 of 48 (79%) survivors were evaluated at a mean of 5.8 years later (range 3.3...

SEVERAL TECHNIQUES for the detection of bacterial antigens in body fluids have been shown to be helpful in providing a rapid, specific etiologic diagnosis prior to culture results in infants and children with meningitis and bacteremia. For the detection of group B streptococcal (GBS) antigen, these include countercurrent immunoelectrophoresis (CIE)...