Franz J. Fehrenbach

The incidence of legionella pneumonia: A 1-year prospective study in a large community hospital

In a 1-year prospective study, 28 of 476 pneumonia patients (5.9%) were diagnosed as having legionella pneumonia. Legionella pneumonia was diagnosed in 12 (5%) of 240 community-acquired pneumonias and in 16 (6.8%) of 236 nosocomial pneumonias. Four methods of establishing diagnosis were used: serum antibody detection, direct proof of legionellae by immunofluorescence, culture, and legionella antigen detection in urine. The latter method proved to be clearly advantageous to all other methods in establishing the diagnosis. Twelve of the 28 patients (42.8%) died; all of them had severe underlying diseases. The fatality rate in patients treated with erythromycin was 18.8% (3/16 cases) and 75% (9/12 cases) in patients treated with antibiotics other than erythromycin. In 57.1% (16/28 patients) legionella pneumonia was acquired nosocomially. The results of our study underscore the need to use a broad spectrum of legionella diagnostic methods routinely and to administer antibiotics effective against legionellae in cases of pneumonia of unknown cause.

Purification and characterization of CAMP-factor from Streptococcus agalactiae by hydrophobic interaction chromatography and chromatofocusing

CAMP-factor from Streptococcus agalactiae (group B streptococcus) was purified 60-fold from the culture supernatant to electrophoretic homogeneity in 57% yield. The purification procedure involved ammonium sulphate precipitation, ultrafiltration, hydrophobic interaction chromatography on Octyl-Sepharose and chromatofocusing on polybuffer exchanger PBE 94. The purified CAMP-factor consists of a single polypeptide chain with an apparent molecular weight of 25 kD and an isoelectric point of 8.9. The properties of the CAMP-factor demonstrated by charge-shift electrophoresis were consistent with those of an amphiphilic polypeptide.

Relapsing fever and its serological discrimination from lyme borreliosis

SummaryPatients withBorrelia-caused relapsing fever produce cross-reacting antibodies toBorrelia burgdorferi, the anti-genetically related causative agent of Lyme borreliosis. The antibody response of the serum of a patient (acute and convalescent) with relapsing fever was analysed by the immunoblot technique usingBorrelia hermsii andB. burgdorferi as antigens. The diagnosis was established by microscopic detection of spirochetes in the patients blood. The patients serum showed significantly elevated titers of IgG and IgM in aB. burgdorferi indirect immuno-fluorescence assay. Immunoblot analysis indicated the presence of cross-reacting antibodies directed toB. burgdorferi antigens with apparent molecular weights of 60, 41, 40, 36, 30 and 20 kDa.ZusammenfassungPatienten mit borrelieninduziertem Rückfallfieber produzieren kreuzreagierende Antikörper gegen den nah verwandten Erreger der Lyme-Borreliose,Borrelia burgdorferi. Wir beschreiben die Antikörperantwort einer Patientin mit klinisch diagnostiziertem Rückfallfieber gegenBorrelia hermsii, einem Erreger des zeckenübertragenen Rückfallfiebers in den USA, undB. burgdorferi. Die Diagnose eines Rückfallfiebers konnte durch den mikroskopischen Nachweis von Spirochäten im Blut der Patientin gesichert werden. Die Patientin zeigte signifikant erhöhte IgG- und IgM-Titer imB. burgdorferi-IFT. Die Immunoblot-untersuchungen zeigen, daß kreuzreagierende Antikörper gegenB. burgdorferi-Antigene mit einem apparenten Molekulargewicht von etwa 60, 41, 40, 36, 30, und 20 kDa gerichtet sind.