Detection of pneumococcal capsular antigen in saliva of children with pneumonia

The concentration of pneumococcal capsular antigen (PCA) in saliva was examined in 44 Thai children aged between 2 months and 2 years admitted with community-acquired pneumonia and in 52 healthy controls. None of the children with pneumonia had a positive blood culture. PCA was detected by latex agglutination in the saliva of 12/44 (27%) children with pneumonia compared with 9/52 (17%) of the controls. More cases than controls had a PCA titre > or = 10 (9/44 (20%) vs 1/52 (2%), p < 0.01). Three of the five cases with a saliva PCA titre > or = 1000 were urine PCA antigen-positive. The salivary PCA titres were higher, but not significantly, in children with heavier pneumococcal carriage. Quantitative measurement of PCA in the saliva may be valuable in helping to make an aetiological diagnosis in children with pneumonia.

Fetal outcome in mothers with impaired glucose tolerance in pregnancy

A 75 g oral glucose tolerance test was carried out on 953 pregnant women who were identified on the basis of clinical risk factors. The tests were analysed by the WHO criteria: 826 were normal, 120 showed impaired glucose tolerance, and 7 identified diabetes. A number of obstetric and perinatal outcome measures were compared between the groups with normal and impaired glucose tolerance, and also with 135 women who had pre-existing Type 1 diabetes and delivered during the study period. There was no significant difference in the incidence of antenatal complications between mothers with normal and impaired glucose tolerance. There was a higher rate of induced labour (p < 0.05) and caesarean section (p < 0.01) in the impaired glucose tolerance group compared to the normal group, but no difference in fetal outcome or neonatal morbidity. All of these outcome measures were increased in the Type 1 diabetic pregnancies.