1022 EFFECT OF BLOOD TRANSFUSIONS ON GROUP B STREPTOCOCCAL ANTIBODY LEVELS

Abstract

The morbidity and mortality rate from group B streptococcal infection continues to be exceedingly high even with the use of potent antibiotics and optimal support measures. In previous studies we suggested that transfusion of fresh, whole blood containing opsonic antibody might alter mortality in this fulminant neonatal disease (Lancet I: 636, 1978). In the present studies we have examined type specific streptococcal antibody levels and opsonic activity in 38 infants who received transfusions of fresh, whole blood. Thirty-three infants received donor blood containing higher levels of opsonic activity than in their own pre-transfusion specimen. Twenty of these infants had increased opsonic activity in their post-transfusion specimen. Among the 20 with increased levels, 18 received partial or complete exchanges amounting to 50% or more of their blood volume (mean 65 ± 7.2 SE%). The mean transfusion volume in the patients whose opsonic level did not increase was only 33 ± 7.5 SE%. Five patients received blood with lower opsonic activity than their own and all had decreased levels in post-transfusion specimens. The mortality rate in the 21 patients studied who had group B disease and received transfusion of fresh whole blood (14%) was exceedingly low. Thus, transfusion may significantly affect the outcome of group B disease.