Early-onset group B streptococcus (GBS) disease in the infant is acquired by vertical transmission from the mother colonized with GBS. Thirty-four women colonized with GBS were treated with intravenous ampicillin sodium during labor. None of their infants were colonized with GBS at birth or within 48 hours. Twenty-four women colonized with GBS received no antibiotic therapy; 14 (58%) of their infants were colonized with GBS at birth or by 48 hours. This difference was highly significant. Mechanisms by which this may have occurred were temporary suppression of GBS vaginal and rectal colonization, high concentration of ampicillin in the amniotic fluid, and transplacental transport of the antibiotic to the infant. In areas where GBS disease is prevalent, we recommend screening pregnant women (34 to 36 weeks' gestation) and treating those colonized with GBS (with no history of penicillin hypersensitivity) with intravenous ampicillin during labor.
This article focuses on the experiences of eight states that have implemented comparable worth statutes: Connecticut, Iowa, Minnesota, Montana, New York, Oregon, Washington, and Wisconsin. Montana did not find any gender-related disparities between its job classes, but each of the other seven states uncovered disparities and remedied them by expending amounts ranging from 1% to 4% of total payroll. Public employee unions are comparable worth/pay equity's most influential political supporters, but union support usually diminishes in the wake of pay equity adjustments. Implementation has produced unanticipated consequences: in Iowa, for example, pay adjustments generally did not benefit more senior employees but rather, in many cases, raised individual employees' salaries above those of their supervisors. Each state analyzed job classes systematically, but several states modified the consultant-provided systems due to a belief that widely-used methods undervalued female predominant job classes. As comparable worth/pay equity implementation has both technical and political dimensions, important value choices must be made throughout the process.
The relative roles of serum factors required for opsonization of type XIV Streptococcus pneumoniae were investigated by means of luminol-enhanced chemiluminescence (CL), bactericidal, and immunofluorescence assays employing adult sera containing high (>1,000 ng of antibody nitrogen per ml) or low (<200 ng of antibody nitrogen per ml) antibody concentrations as determined by radioimmunoassay. Specific antibody concentration correlated directly with both total and heat-labile CL activity (P < 0.005) and with the bactericidal index (P < 0.05) at a serum concentration of 10%. The importance of specific antibody as an opsonin was confirmed by the abolition of CL activity and immunoglobulin immunofluorescence observed after absorption of heated sera with type XIV pneumococcal cells and by the dose response in CL and bactericidal activity observed with the addition of immunoglobulin G to hypogammaglobulinemic serum. A role for the classical complement pathway in opsonization was indicated by significantly greater CL integrals for high-antibody sera than for low-antibody sera depleted of factor D and by the bactericidal activity noted for untreated, but not magnesium ethylene glycol-bis(3-aminoethyl ether)-N,N-tetraacetic acidchelated low-antibody sera. The alternative pathway contributed more than half of the CL activity of both highand low-antibody sera. However, after magnesium ethylene glycol-bis(P-aminoethyl ether)-N,N-tetraacetic acid chelation, only sera with high antibody concentrations or agammaglobulinemic serum reconstituted with immunoglobulin G with high specific antibody levels supported significant bactericidal activity. Therefore, type-specific antibody and complement promote opsonization of type XIV S. pneumoniae, and this may occur via either complement pathway. These results suggest that CL is a suitable tool to delineate serum factors and their contribution to opsonization, but results must be related to other functional assays.
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