Mildred W. Barnes

Changing Etiology of Bacterial Endocarditis in the Antibacterial Era: Experiences at Boston City Hospital 1933-1965

Abstract During 12 selected years from 1933 to 1965, 337 patients were documented as having bacterial endocarditis at Boston City Hospital, 43 of them with 2 organisms and 10 with 3 in their blood,...

COLD AGGLUTININS. III. OBSERVATIONS ON CERTAIN SEROLOGICAL AND PHYSICAL FEATURES OF COLD AGGLUTININS IN CASES OF PRIMARY ATYPICAL PNEUMONIA AND OF HEMOLYTIC ANEMIA

Some of the properties of cold agglutinins in certain human sera have been listed in a recent review (1). The knowledge concerning these properties is based on studies of the phenomenon by various methods in serum or plasma from isolated cases of a large variety of conditions. With respect to the cold agglutinins in cases of primary atypical pneumonia, limited studies of certain aspects were reported in 1918 (2) in one case of atypical bronchopneumonia, in 1938 (3) in a similar case, and recently (4) in a few cases which more closely resemble those of primary atypical pneumonia of unknown etiology with which we have been concerned in the previous papers of this series. In the course of serological studies of cases of atypical pneumonia beginning in the fall of 1942, a number of observations were made on certain features of the cold agglutinin reaction and on the methods used for demonstrating and titrating these agglutinins. Circumstances did not permit extensive and complete studies of all the aspects of this reaction which were contemplated. A number of the observations that were made are of sufficient interest, however, to warrant a presentation of the results at this time, even though some of them are only of a preliminary nature. The investigations which are reported in this paper deal with two broad categories: (1) some serological properties of the cold agglutinins, particularly their relation to the human group isoagglutinins and to cold agglutinins for erythrocytes of other animals, and (2) certain physical properties of the cold agglutinins. Data concerning certain features of the technique are presented in the paper which follows.

Duration of hospitalization for acute bacterial meningitis at Boston City Hospital during 12 selected years, 1935-1972.

An analysis is presented of the duration of hospitalization of the patients with acute bacterial (purulent) meningitis which occurred at Boston City Hospital during 12 selected years between 1935 and 1972. Considerable differences in the length of stay in the hospital were noted depending on the bacterial etiology, whether the infection was present on admission or acquired within the hospital, and, of course, whether the patient survived or died. Most of the deaths occurred within the first few days after admission or after the diagnosis was first established, but even among fatal cases, the survival time differed depending on the etiology and site of acquisition of the infection. During the years after effective antibiotics became available the hospital stay of patients who survived after admission for meningococcal, influenzal, or pneumococcal meningitis was shorter than before. The same has not been true for meningitis caused by other gram-positive cocci, gram-negative rods, or mixed infections, probably reflecting the relative ineffectiveness of antimicrobial therapy in such patients.