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Microorganisms Dec 2023Children and adolescents living with HIV (CALHIV) are at high risk of meningococcal infections and may present lower immune responses to vaccines. The objectives of this...
BACKGROUND
Children and adolescents living with HIV (CALHIV) are at high risk of meningococcal infections and may present lower immune responses to vaccines. The objectives of this study were to assess the immunogenicity of the quadrivalent Men ACWY-TT vaccine (Nimenrix) in CALHIV after a two-dose schedule and to describe possible HIV-related factors that may affect the immunogenic response.
METHODS
A multicenter prospective study was designed, including CALHIV followed in five hospitals in Madrid, between 2019 and 2021. Two doses of the Men ACWY-TT vaccine were administered. Serum bactericidal antibody (SBA) assays using rabbit complement (rSBA) against serogroups C, W, and Y were used to determine seroprotection and vaccine response (the proportion achieving a putative protective titer of ≥eight or a ≥four-fold rise in titer from baseline). Serum was collected at baseline, and at 3 and 12 months after vaccination.
RESULTS
There were 29 CALHIV included, 76% of whom were perinatally infected. All were receiving TAR and presented a good immunovirological and clinical status overall. At baseline, 45% of CALHIV had seroprotective titers to at least one serogroup, with individual seroprotection rates of 24%, 28%, and 32% against C, W, and Y, respectively. After a two-dose schedule, vaccine response was 83% for each serogroup, eliciting a vaccine response to all serogroups in 69% of them. One year after vaccination, 75% of CALHIV maintained seroprotective titers against the C serogroup, and 96% against W and Y. None of the HIV-related characteristics analyzed could predict vaccine response or antibody duration.
CONCLUSIONS
CALHIV who received effective TAR and presented a good immuno-virological situation achieved an appropriate vaccine response after two doses of the Men ACWY-TT vaccine, and antibody-mediated protection against serogroups C, W, and Y was maintained in more than 70% of the patients one year after vaccination.
PubMed: 38257857
DOI: 10.3390/microorganisms12010030 -
The Journal of Infection Feb 2024This analysis investigated longitudinal changes in meningococcal carriage in adolescents in South Australia over 4 years. (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
This analysis investigated longitudinal changes in meningococcal carriage in adolescents in South Australia over 4 years.
METHODS
Data from the "B Part of It" study, which included a state-wide cluster randomized controlled trial in secondary-school students (n = 34,489 in 2017 and 2018) and serial cross-sectional studies in school leavers aged 17-25 years (n = 4028 in 2019-2020). Individuals had oropharyngeal swabs collected annually. This study included two unique cohorts: (1) individuals enrolled in 2019, with three consecutive annual swabs taken in 2017, 2018 and 2019; and (2) individuals enrolled in 2020, with swabs taken in 2017, 2018, and 2020. Disease-associated N. meningitidis genogroups were identified using PCR and whole genome sequencing. Univariate analysis identified risk factors for recurrent carriage (≥2).
RESULTS
Among school leavers, 50 (1.7%, total n = 2980) had carriage detected at successive visits. In participants with meningococcal carriage at successive visits, 38/50 (76.0%) had the same genogroup detected by porA PCR. Of those, 19 had the same MLST type and demonstrated minimal variation, indicating they most likely had sustained carriage of the same isolate (range 226 to 490 days, mean duration 352 [SD 51] days). In the 2019 school leaver cohort, 6.7% acquired carriage in their first year out of school compared to 3.3% in their final school year. Compared to single carriage detection, recurrent carriage was potentially more likely in older adolescents (16 compared to ≤15 years; OR = 1.97 (95%CI 1.0, 3.86); p = 0.048).
CONCLUSION
Whilst carriage is typically transient, some adolescents/young adults may have persistent carriage and are likely to be an important group in the transmission of meningococci.
Topics: Humans; Adolescent; Young Adult; Meningococcal Infections; South Australia; Longitudinal Studies; Cross-Sectional Studies; Multilocus Sequence Typing; Carrier State; Prevalence; Neisseria meningitidis
PubMed: 38242365
DOI: 10.1016/j.jinf.2024.01.002 -
JAMA Network Open Jan 2024Few studies have examined the incidence of long-term disabilities due to bacterial meningitis in childhood with extended follow-up time and a nationwide cohort.
IMPORTANCE
Few studies have examined the incidence of long-term disabilities due to bacterial meningitis in childhood with extended follow-up time and a nationwide cohort.
OBJECTIVE
To describe the long-term risks of disabilities following a childhood diagnosis of bacterial meningitis in Sweden.
DESIGN, SETTING, AND PARTICIPANTS
This nationwide retrospective registry-based cohort study included individuals diagnosed with bacterial meningitis (younger than 18 years) and general population controls matched (1:9) by age, sex, and place of residence. Data were retrieved from the Swedish National Patient Register from January 1, 1987, to December 31, 2021. Data were analyzed from July 13, 2022, to November 30, 2023.
EXPOSURE
A diagnosis of bacterial meningitis in childhood recorded in the National Patient Register between 1987 and 2021.
MAIN OUTCOMES AND MEASURES
Cumulative incidence of 7 disabilities (cognitive disabilities, seizures, hearing loss, motor function disorders, visual disturbances, behavioral and emotional disorders, and intracranial structural injuries) after bacterial meningitis in childhood.
RESULTS
The cohort included 3623 individuals diagnosed with bacterial meningitis during childhood and 32 607 controls from the general population (median age at diagnosis, 1.5 [IQR, 0.4-6.2] years; 44.2% female and 55.8% male, median follow-up time, 23.7 [IQR, 12.2-30.4] years). Individuals diagnosed with bacterial meningitis had higher cumulative incidence of all 7 disabilities, and 1052 (29.0%) had at least 1 disability. The highest absolute risk of disabilities was found for behavioral and emotional disorders, hearing loss, and visual disturbances. The estimated adjusted hazard ratios (HRs) showed a significant increased relative risk for cases compared with controls for all 7 disabilities, with the largest adjusted HRs for intracranial structural injuries (26.04 [95% CI, 15.50-43.74]), hearing loss (7.90 [95% CI, 6.68-9.33]), and motor function disorders (4.65 [95% CI, 3.72-5.80]). The adjusted HRs for cognitive disabilities, seizures, hearing loss, and motor function disorders were significantly higher for Streptococcus pneumoniae infection (eg, 7.89 [95% CI, 5.18-12.02] for seizure) compared with Haemophilus influenzae infection (2.46 [95% CI, 1.63-3.70]) or Neisseria meningitidis infection (1.38 [95% CI, 0.65-2.93]). The adjusted HRs for cognitive disabilities, seizures, behavioral and emotional disorders, and intracranial structural injuries were significantly higher for children diagnosed with bacterial meningitis at an age below the median.
CONCLUSIONS AND RELEVANCE
The findings of this cohort study of individuals diagnosed with bacterial meningitis during childhood suggest that exposed individuals may have had an increased risk for long-term disabilities (particularly when diagnosed with pneumococcal meningitis or when diagnosed at a young age), highlighting the need to detect disabilities among surviving children.
Topics: Child; Humans; Male; Female; Infant; Child, Preschool; Sweden; Cohort Studies; Retrospective Studies; Meningitis, Haemophilus; Meningitis, Meningococcal; Meningitis, Bacterial; Meningitis, Pneumococcal; Hearing Loss; Deafness; Seizures
PubMed: 38241045
DOI: 10.1001/jamanetworkopen.2023.52402 -
Frontiers in Microbiology 2023In Italy the introduction of meningococcal C conjugate vaccine in 2005 has led to a significant reduction of invasive meningococcal disease (IMD) caused by of serogroup...
BACKGROUND
In Italy the introduction of meningococcal C conjugate vaccine in 2005 has led to a significant reduction of invasive meningococcal disease (IMD) caused by of serogroup C (MenC). However, this serogroup is still responsible of sporadic cases, clusters and local outbreaks. The study aims to investigate the genotype and antimicrobial susceptibility profile of MenC isolates collected in Italy from 2000 to 2020.
METHODS
Bacterial isolates and biological samples (blood or cerebrospinal fluid) from invasive meningococcal cases are collected and characterized at the National Reference Laboratory for IMD of Istituto Superiore di Sanità. Antimicrobial susceptibility was determined by MIC Test Strip Method and interpreted according to the EUCAST breakpoints guideline. Genotypic characteristics, including multi locus sequence typing (MLST), finetype, and antimicrobial resistance target genes were performed and analyzed using the PubMLST database. Genomic comparison of core genome MLST (cgMLST) of MenC genomes was also carried out.
RESULTS
From 2000 to 2020, a total of 665 MenC isolates were investigated for antimicrobial susceptibility and 301 for genotyping. Over two decades, almost all MenC isolates resulted susceptible to antimicrobials with few isolates resulting resistant to ciprofloxacin ( = 2), penicillin G ( = 13), and rifampicin ( = 9), respectively. Molecular typing of MenC obtained from isolates or clinical specimens identified mostly the genotype C:P1.5-1,10-8:F3-6:ST-11(cc11). However, phylogenetic analysis, performed on genomes from MenC isolates, identified two sub lineages, 11.1 and 11.2, among cc11, of which the sub lineage 11.2 was the predominant.
CONCLUSION
Wider application of the genomic analysis and monitoring of antimicrobial susceptibility represent key aspects of IMD surveillance and to monitor the continued evolution of these hyperinvasive strains.
PubMed: 38235426
DOI: 10.3389/fmicb.2023.1272123 -
Epidemiology and Infection Jan 2024Little information exists concerning the spatial relationship between invasive meningococcal disease (IMD) cases and carriage. The aim of this study was to examine...
Little information exists concerning the spatial relationship between invasive meningococcal disease (IMD) cases and carriage. The aim of this study was to examine whether there is a relationship between IMD and asymptomatic oropharyngeal carriage of meningococci by spatial analysis to identify the distribution and patterns of cases and carriage in South Australia (SA). Carriage data geocoded to participants' residential addresses and meningococcal case notifications using Postal Area (POA) centroids were used to analyse spatial distribution by disease- and non-disease-associated genogroups, as well as overall from 2017 to 2020. The majority of IMD cases were genogroup B with the overall highest incidence of cases reported in infants, young children, and adolescents. We found no clear spatial association between carriage and IMD cases. However, analyses using carriage and case genogroups showed differences in the spatial distribution between metropolitan and regional areas. Regional areas had a higher rate of IMD cases and carriage prevalence. While no clear relationship between cases and carriage was evident in the spatial analysis, the higher rates of both carriage and disease in regional areas highlight the need to maintain high vaccine coverage outside of the well-resourced metropolitan area.
Topics: Child; Infant; Adolescent; Humans; Child, Preschool; Carrier State; Meningococcal Infections; Neisseria meningitidis; Oropharynx; Meningococcal Vaccines; Spatial Analysis
PubMed: 38234190
DOI: 10.1017/S0950268824000116 -
Human Vaccines & Immunotherapeutics Dec 2024Vaccination active, promising alternative immunological strategy to treat of CUD. Various models of cocaine vaccines have been evaluated in animals and humans with...
Vaccination active, promising alternative immunological strategy to treat of CUD. Various models of cocaine vaccines have been evaluated in animals and humans with relative success. In this sense, it is necessary to improve or optimize the cocaine vaccines already evaluated. Our laboratory previously reported the efficacy of the tetanus toxoid-conjugated morphine vaccine (M-TT). The M-TT vaccine can generate high titers of antibodies and reduce heroin-induced behavioral effects in rodents. So, it would be plausible to assume that if we modify the M-TT vaccine by changing the hapten and maintaining the rest of the structural elements of the vaccine, we will maintain the properties of the M-TT vaccine (high antibody titers). The objective of this study was to determine whether the antibodies generated by a tetanus toxoid-conjugated cocaine vaccine (COC-TT) can recognize and capture cocaine and decrease the cocaine-induced reinforcing effects. Male Wistar rats were immunized with the COC-TT. A solid-phase antibody-capture ELISA was used to monitor antibody titer responses after each booster dose in vaccinated animals. The study used cocaine self-administration and place-preference testing to evaluate the cocaine-reinforcing effects. The COC-TT vaccine could generate high levels of anti-cocaine antibodies. The antibodies reduced the cocaine self-administration and cocaine place preference. In addition, they decreased the cocaine-induced Fos protein expression. These findings suggest that the COC-TT vaccine generates a robust immunogenic response capable of reducing the reinforcing effects of cocaine, which supports its possible future use in clinical trials in patients with CUD.
Topics: Humans; Male; Rats; Animals; Rats, Wistar; Tetanus Toxoid; Antibodies; Enzyme-Linked Immunosorbent Assay; Cocaine; Antibodies, Bacterial; Vaccines, Conjugate; Meningococcal Vaccines
PubMed: 38228468
DOI: 10.1080/21645515.2023.2299068 -
Vaccine: X Jan 2024In 2019, ACWY meningococcal vaccination for people born between 2001 and 2007 was recommended. In Murcia, during the first 9 months, the coverage was 52.89%. This study...
In 2019, ACWY meningococcal vaccination for people born between 2001 and 2007 was recommended. In Murcia, during the first 9 months, the coverage was 52.89%. This study is aimed to evaluate the effects of e-mail reminders on vaccination coverage. A longitudinal, prospective trial was performed on non-vaccinated individuals with e-mail addresses. An e-mail reminder was sent to people assigned to the intervention group (born in any month, except January and July), and 4 weeks later, the same was sent to the control group. Vaccination coverage was assessed before and 4 weeks after each intervention. After the first intervention, 5.15% of the participants in the intervention group were vaccinated (1.57% in the control group). The increased likelihood of being vaccinated if a person had been sent an e-mail was 1.033 (95% confidence interval, 1.019-1.047; p = 0.001). This study highlighted the impact of e-mail as an appropriate method of communication for vaccination programmes.
PubMed: 38205135
DOI: 10.1016/j.jvacx.2023.100426 -
Human Vaccines & Immunotherapeutics Dec 2024Invasive meningococcal disease (IMD) is an acute life-threatening infection caused by the gram-negative bacterium, . Globally, there are approximately half a million...
Invasive meningococcal disease (IMD) is an acute life-threatening infection caused by the gram-negative bacterium, . Globally, there are approximately half a million cases of IMD each year, with incidence varying across geographical regions. Vaccination has proven to be successful against IMD, as part of controlling outbreaks, and when incorporated into national immunization programs. The South-Eastern Europe Meningococcal Advocacy Group (including representatives from Croatia, the Czech Republic, Greece, Hungary, Poland, Romania, Serbia, Slovenia and Ukraine) was formed in order to discuss the potential challenges of IMD faced in the region. The incidence of IMD across Europe has been relatively low over the past decade; of the countries that came together for the South-Eastern Meningococcal Advocacy Group, the notification rates were lower than the European average for some country. The age distribution of IMD cases was highest in infants and children, and most countries also had a further peak in adolescents and young adults. Across the nine included countries between 2010 and 2020, the largest contributors to IMD were serogroups B and C; however, each individual country had distinct patterns for serogroup distribution. Along with the variations in epidemiology of IMD between the included countries, vaccination policies also differ.
Topics: Child; Infant; Adolescent; Young Adult; Humans; Meningococcal Infections; Neisseria meningitidis; Europe; Czech Republic; Vaccination; Serogroup; Meningococcal Vaccines
PubMed: 38173392
DOI: 10.1080/21645515.2023.2301186 -
The Lancet Regional Health. Western... Feb 2024Oropharyngeal carriage of is frequent during adolescence, representing a major source of invasive meningococcal disease. This study examined the impact of a serogroup B...
BACKGROUND
Oropharyngeal carriage of is frequent during adolescence, representing a major source of invasive meningococcal disease. This study examined the impact of a serogroup B vaccination (, GSK 4CMenB) programme on adolescent carriage using genomic data.
METHODS
A total 34,489 oropharyngeal samples were collected as part of a state-wide cluster randomised-controlled trial in South Australia during 2017 and 2018 (NCT03089086). Samples were screened for the presence of DNA by PCR prior to culture. Whole genome sequencing was performed on all 1772 culture isolates and their genomes were analysed.
FINDINGS
Unencapsulated meningococci were predominant at baseline (36.3% of isolates), followed by MenB (31.0%), and MenY (20.5%). Most MenB were ST-6058 from hyperinvasive cc41/44, or ST-32 and ST-2870 from cc32. For MenY, ST-23 and ST-1655 from cc23 were prevalent. Meningococcal carriage was mostly unchanged due to the vaccination programme; however, a significant reduction in ST-53 capsule-null meningococci prevalence was observed in 2018 compared to 2017 (OR = 0.52; 95% CI: 0.30-0.87, p = 0.0106). This effect was larger in the vaccinated compared to the control group (OR = 0.37; 95% CI: 0.12-0.98, p = 0.0368).
INTERPRETATION
While deployment of the 4CMenB vaccination did not alter the carriage of hyperinvasive MenB in the vaccinated population, it altered the carriage of other sequence types following the vaccination program. Our findings suggest 4CMenB vaccination is unlikely to reduce transmission of hyperinvasive strains and therefore ongoing targeted vaccination is likely a more effective public health intervention.
FUNDING
This work was funded by GlaxoSmithKline Biologicals SA.
PubMed: 38169944
DOI: 10.1016/j.lanwpc.2023.100966 -
Open Forum Infectious Diseases Dec 2023College students are at increased risk for invasive meningococcal disease, but which students are most at risk is unclear.
BACKGROUND
College students are at increased risk for invasive meningococcal disease, but which students are most at risk is unclear.
METHODS
US meningococcal disease cases in persons aged 18-24 years during 2014-2017 were included. Patients were classified as undergraduate students or other persons. Incidence in different student and non-student populations was compared.
RESULTS
During 2014-2017, 229 meningococcal disease cases were reported in persons aged 18-24 years; 120 were in undergraduate students. Serogroup B accounted for 74% of cases in students. Serogroup B disease incidence was 4-fold higher in undergraduate students, 11.8-fold higher among first-year undergraduate students, and 8.6-fold higher among residence hall residents versus non-undergraduates. During outbreaks, students affiliated with Greek life had a 9.8-fold higher risk of disease compared to other students. A significantly higher party school ranking was observed for schools with sporadic or outbreak cases when compared to schools with no cases.
CONCLUSIONS
The findings of increased disease risk among first-year students and those living on campus or affiliated with Greek life can inform shared clinical decision-making for serogroup B vaccines to prevent this rare but serious disease. These data also can inform school serogroup B vaccination policies and outbreak response measures.
PubMed: 38149105
DOI: 10.1093/ofid/ofad607