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Am. J. Respir. Crit. Care Med., Volume 159, Number 6, June 1999, 1862-1867

Combined Treatment with Surfactant and Specific Immunoglobulin Reduces Bacterial Proliferation in Experimental Neonatal Group B Streptococcal Pneumonia

EGBERT HERTING, XIAOZHUANG GAN, PETRA RAUPRICH, CONNIE JARSTRAND, and BENGT ROBERTSON

Department of Pediatrics, University of Göttingen, Göttingen, Germany; Division for Experimental Perinatal Pathology, Department of Woman and Child Health, Karolinska Institute, Stockholm; and Division of Clinical and Oral Bacteriology, Department of Immunology, Pathology, and Infectious Diseases, Karolinska Institute, Huddinge Hospital, Stockholm, Sweden

Neonates suffering from group B streptococcal (GBS) pneumonia often lack type-specific opsonizing antibodies. We studied the influence of combined intratracheal treatment with surfactant and a specific antibacterial polyclonal antibody (IgG fraction) on bacterial proliferation and lung function in an animal model of GBS pneumonia. Near-term newborn rabbits received an intratracheal injection of either the specific IgG antibody, nonspecific IgG, surfactant, a mixture of surfactant and the antibody, or 0.9% saline. At 30 min the rabbits were infected with a standard dose (108) of the encapsulated GBS strain 090 Ia. After 5 h of mechanical ventilation the mean estimated increase in bacterial number in lung homogenate (log10 colonies/g) was 0.76 in the antibody group, 0.92 in the nonspecific IgG group, 0.55 in the surfactant group, and 1.29 in the saline group. A mean decrease in bacterial number (-0.05) was observed in the group that received combined treatment with surfactant and antibody (p < 0.05 versus all other groups). Lung-thorax compliance was significantly higher in both groups of surfactant-treated animals compared with saline or IgG treatment. We conclude that in experimental neonatal GBS pneumonia combined treatment with surfactant and a specific immunoglobulin against GBS reduced bacterial proliferation more effectively than either treatment alone.




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