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Countercurrent Immunoelectrophoresis in the Diagnosis of Haemophilus influenzae Type b Infection: Relationship of Detection of Capsular Antigen to Age, Antibody Response, and Therapy

Countercurrent Immunoelectrophoresis in the Diagnosis of Haemophilus influenzae Type b Infection:... Abstract • Sixty-one patients with Haemophilus influenzae type b infection were studied for the presence of capsular antigen by countercurrent immunoelectrophoresis. Antigen was present (≥10 ng/ml) in admission blood or cerebrospinal fluid samples of 92% of patients with meningitis and could be detected in blood for up to 17 days. Despite bacterial cultures reverting to negative, detectable antigen was present at two to three days in 75% of patients, and at four to five days in 54%. No difference in persistence of antigen was found in patients with meningitis who were receiving ampicillin or chloramphenicol. Antigenemia was less frequently detected in patients without meningitis who were studied at the time of hospital admission (7/22, P <.01). However, antigen was detected 24 hours after onset of therapy in one initially negative patient; in four other patients who lacked circulating antigen, bone or joint aspirates or nasopharyngeal secretions were antigen positive. Circulating antigen was less frequently detected in individuals 2 years of age or older and those with convalescent hemagglutinating titers greater than or equal to 1:4. We propose that older patients may develop early anticapsular antibody responses to their infection that interfere with detection of circulating antigen. (Am J Dis Child 131:1357-1362, 1977) References 1. O'Reilly RJ, Anderson P, Ingram DL, et al: Circulating polyribophosphate in Hemophilus influenzae, type b meningitis: Correlation with clinical course and antibody response . J Clin Invest 56:1012-1022, 1975.Crossref 2. Edwards EA, Muehl PM, Peckinpaugh RO: Diagnosis of bacterial meningitis by counterimmunoelectrophoresis . J Lab Clin Med 80:449-454, 1972. 3. Coonrod JD, Rytel MW: Determination of aetiology of bacterial meningitis by counterimmunoelectrophoresis . Lancet 1:1154-1157, 1972.Crossref 4. Ingram DL, Anderson P, Smith DH: Countercurrent immunoelectrophoresis in the diagnosis of systemic diseases caused by Hemophilus influenzae type b . J Pediatr 81:1156-1159, 1972.Crossref 5. Shackelford P, Campbell J, Feigin RD: Countercurrent immunoelectrophoresis in the evaluation of childhood infections . J Pediatr 85:478-481, 1974.Crossref 6. Feigin RD, Stechenberg BW, Chang MJ, et al: Prospective evaluation of treatment of Hemophilus influenzae meningitis . J Pediatr 88:542-548, 1976.Crossref 7. Smith EWP, Ingram DL: Counterimmunoelectrophoresis in Hemophilus influenzae type b epiglottitis and pericarditis . J Pediatr 86:571-573, 1975.Crossref 8. Granoff DM, Nankervis GA: Cellulitus due to Haemophilus influenzae type b: Antigenemia and antibody responses . Am J Dis Child 130:1211-1214, 1976. 9. Anderson P, Peter G, Johnston RB, et al: Immunization of humans with polyribophosphate, the capsular antigen of Hemophilus influenzae, type b . J Clin Invest 51:39-44, 1972.Crossref 10. Anderson P, Johnston RB, Smith DH: Human serum activities against Hemophilus influenzae, type b . J Clin Invest 51:31-38, 1972.Crossref 11. Anderson P, Johnston RB, Smith DH: Methodology in detection of human serum antibodies to Hemophilus Influenzae, type b , in Sell SHW, Karzon D (eds): Hemophilus Influenzae . Nashville, Tenn, Vanderbilt University Press, 1973, pp 87-94. 12. Coonrod DJ, Rytel MW: Detection of typespecific pneumococcal antigens by counterimmunoelectrophoresis: 1. Methodology and immunologic properties of pneumococcal antigens . J Lab Clin Med 81:770-777, 1973. 13. Greenwood BM, Whittel HC, Dominic-Rajkovic O: Countercurrent immunoelectrophoresis in the diagnosis of meningococcal infections . Lancet 2:519-521, 1971.Crossref 14. Hoffman TA, Edwards EA: Group-specific polysaccharide antigen and humoral antibody response in disease due to Neisseria meningitidis . J Infect Dis 126:636-644, 1972.Crossref 15. Edwards EA: Immunological investigations of meningococcal disease: II. Some charac teristics of group C antigen of Neisseria meningitidis in the sera of patients with fulminant meningococcemia . J Infect Dis 129:538-544, 1974.Crossref 16. Whittle HC, Greenwood BM, Davidson N, et al: Meningococcal antigen in diagnosis and treatment of group A meningococcal infections . Am J Med 58:823-828, 1975.Crossref 17. Diagnosis and prognosis in pyogenic meningitis , editorial. Lancet 1:1277-1278, 1976. 18. Feigin RD, Wong M, Shackelford PG, et al: Countercurrent immunoelectrophoresis of urine as well as of CSF and blood for diagnosis of bacterial meningitis . J Pediatr 89:773-775, 1976.Crossref 19. Wald ER, Levine MM: Frequency of detection of Hemophilus influenzae type b capsular polysaccharide in infants and children with pneumonia . Pediatrics 57:266-268, 1976. 20. Granoff D, Nankervis GA: Circulating capsular antigen in infant rats infected with Hemophilus influenzae type b . J Infect Dis 136:292-296, 1977.Crossref 21. Bradshaw MW, Parke JC, Schneerson R, et al: Bacterial antigens cross-reactive with the capsular polysaccharide of Haemophilus influenzae type b . Lancet 1:1095-1096, 1971.Crossref 22. Ribner B, Keusch GT: Staphylococcus aureus antigen in cerebrospinal fluid cross-reactive with Haemophilus influenzae type b antiserum . Ann Intern Med 83:370-371, 1975.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Diseases of Children American Medical Association

Countercurrent Immunoelectrophoresis in the Diagnosis of Haemophilus influenzae Type b Infection: Relationship of Detection of Capsular Antigen to Age, Antibody Response, and Therapy

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References (22)

Publisher
American Medical Association
Copyright
Copyright © 1977 American Medical Association. All Rights Reserved.
ISSN
0002-922X
DOI
10.1001/archpedi.1977.02120250039006
Publisher site
See Article on Publisher Site

Abstract

Abstract • Sixty-one patients with Haemophilus influenzae type b infection were studied for the presence of capsular antigen by countercurrent immunoelectrophoresis. Antigen was present (≥10 ng/ml) in admission blood or cerebrospinal fluid samples of 92% of patients with meningitis and could be detected in blood for up to 17 days. Despite bacterial cultures reverting to negative, detectable antigen was present at two to three days in 75% of patients, and at four to five days in 54%. No difference in persistence of antigen was found in patients with meningitis who were receiving ampicillin or chloramphenicol. Antigenemia was less frequently detected in patients without meningitis who were studied at the time of hospital admission (7/22, P <.01). However, antigen was detected 24 hours after onset of therapy in one initially negative patient; in four other patients who lacked circulating antigen, bone or joint aspirates or nasopharyngeal secretions were antigen positive. Circulating antigen was less frequently detected in individuals 2 years of age or older and those with convalescent hemagglutinating titers greater than or equal to 1:4. We propose that older patients may develop early anticapsular antibody responses to their infection that interfere with detection of circulating antigen. (Am J Dis Child 131:1357-1362, 1977) References 1. O'Reilly RJ, Anderson P, Ingram DL, et al: Circulating polyribophosphate in Hemophilus influenzae, type b meningitis: Correlation with clinical course and antibody response . J Clin Invest 56:1012-1022, 1975.Crossref 2. Edwards EA, Muehl PM, Peckinpaugh RO: Diagnosis of bacterial meningitis by counterimmunoelectrophoresis . J Lab Clin Med 80:449-454, 1972. 3. Coonrod JD, Rytel MW: Determination of aetiology of bacterial meningitis by counterimmunoelectrophoresis . Lancet 1:1154-1157, 1972.Crossref 4. Ingram DL, Anderson P, Smith DH: Countercurrent immunoelectrophoresis in the diagnosis of systemic diseases caused by Hemophilus influenzae type b . J Pediatr 81:1156-1159, 1972.Crossref 5. Shackelford P, Campbell J, Feigin RD: Countercurrent immunoelectrophoresis in the evaluation of childhood infections . J Pediatr 85:478-481, 1974.Crossref 6. Feigin RD, Stechenberg BW, Chang MJ, et al: Prospective evaluation of treatment of Hemophilus influenzae meningitis . J Pediatr 88:542-548, 1976.Crossref 7. Smith EWP, Ingram DL: Counterimmunoelectrophoresis in Hemophilus influenzae type b epiglottitis and pericarditis . J Pediatr 86:571-573, 1975.Crossref 8. Granoff DM, Nankervis GA: Cellulitus due to Haemophilus influenzae type b: Antigenemia and antibody responses . Am J Dis Child 130:1211-1214, 1976. 9. Anderson P, Peter G, Johnston RB, et al: Immunization of humans with polyribophosphate, the capsular antigen of Hemophilus influenzae, type b . J Clin Invest 51:39-44, 1972.Crossref 10. Anderson P, Johnston RB, Smith DH: Human serum activities against Hemophilus influenzae, type b . J Clin Invest 51:31-38, 1972.Crossref 11. Anderson P, Johnston RB, Smith DH: Methodology in detection of human serum antibodies to Hemophilus Influenzae, type b , in Sell SHW, Karzon D (eds): Hemophilus Influenzae . Nashville, Tenn, Vanderbilt University Press, 1973, pp 87-94. 12. Coonrod DJ, Rytel MW: Detection of typespecific pneumococcal antigens by counterimmunoelectrophoresis: 1. Methodology and immunologic properties of pneumococcal antigens . J Lab Clin Med 81:770-777, 1973. 13. Greenwood BM, Whittel HC, Dominic-Rajkovic O: Countercurrent immunoelectrophoresis in the diagnosis of meningococcal infections . Lancet 2:519-521, 1971.Crossref 14. Hoffman TA, Edwards EA: Group-specific polysaccharide antigen and humoral antibody response in disease due to Neisseria meningitidis . J Infect Dis 126:636-644, 1972.Crossref 15. Edwards EA: Immunological investigations of meningococcal disease: II. Some charac teristics of group C antigen of Neisseria meningitidis in the sera of patients with fulminant meningococcemia . J Infect Dis 129:538-544, 1974.Crossref 16. Whittle HC, Greenwood BM, Davidson N, et al: Meningococcal antigen in diagnosis and treatment of group A meningococcal infections . Am J Med 58:823-828, 1975.Crossref 17. Diagnosis and prognosis in pyogenic meningitis , editorial. Lancet 1:1277-1278, 1976. 18. Feigin RD, Wong M, Shackelford PG, et al: Countercurrent immunoelectrophoresis of urine as well as of CSF and blood for diagnosis of bacterial meningitis . J Pediatr 89:773-775, 1976.Crossref 19. Wald ER, Levine MM: Frequency of detection of Hemophilus influenzae type b capsular polysaccharide in infants and children with pneumonia . Pediatrics 57:266-268, 1976. 20. Granoff D, Nankervis GA: Circulating capsular antigen in infant rats infected with Hemophilus influenzae type b . J Infect Dis 136:292-296, 1977.Crossref 21. Bradshaw MW, Parke JC, Schneerson R, et al: Bacterial antigens cross-reactive with the capsular polysaccharide of Haemophilus influenzae type b . Lancet 1:1095-1096, 1971.Crossref 22. Ribner B, Keusch GT: Staphylococcus aureus antigen in cerebrospinal fluid cross-reactive with Haemophilus influenzae type b antiserum . Ann Intern Med 83:370-371, 1975.Crossref

Journal

American Journal of Diseases of ChildrenAmerican Medical Association

Published: Dec 1, 1977

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