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Ideggyogyaszati Szemle May 2017Neisseria meningitidis, the meningococcus, is a Gram-negative diplococcal bacterium that is only found naturally in humans. The meningococcus is part of the normal... (Review)
Review
Neisseria meningitidis, the meningococcus, is a Gram-negative diplococcal bacterium that is only found naturally in humans. The meningococcus is part of the normal microbiota of the human nasopharynx and is commonly carried in healthy individuals. In some cases systemic invasion occurs, which can lead to meningitis and/or septicemia. Invasive disease caused by Neisseria meningitidis is potentially devastating, with a high case fatality rate and high rates of significant sequelae among survivors after septicaemia or meningitis. Between 2006-2015 every year between 34 and 70 were the numbers of the registered invasive disease because of Neisseria meningitis, the morbidity rate was 0.2-0.7⁰⁄₀₀₀₀. Half of the diseases (50.7%) were caused by B serotype N. meningitidis, 23.2% were C serotype. In this article the authors summarise what you must do and must not do as primary care physician when suddenly meeting a young patients suspected of having meningococcus infection.
Topics: Humans; Meningococcal Infections; Neisseria meningitidis; Primary Health Care
PubMed: 29870630
DOI: 10.18071/isz.70.0151 -
PloS One 2014Prior influenza infection is a risk factor for invasive meningococcal disease. Quantifying the fraction of meningococcal disease attributable to influenza could improve...
IMPORTANCE AND OBJECTIVE
Prior influenza infection is a risk factor for invasive meningococcal disease. Quantifying the fraction of meningococcal disease attributable to influenza could improve understanding of viral-bacterial interaction and indicate additional health benefits to influenza immunization.
DESIGN, SETTING AND PARTICIPANTS
A time series analysis of the association of influenza and meningococcal disease using hospitalizations in 9 states from 1989-2009 included in the State Inpatient Databases from the Agency for Healthcare Research and Quality and the proportion of positive influenza tests by subtype reported to the Centers for Disease Control. The model accounts for the autocorrelation of meningococcal disease and influenza between weeks, temporal trends, co-circulating respiratory syncytial virus, and seasonality. The influenza-subtype-attributable fraction was estimated using the model coefficients. We analyzed the synchrony of seasonal peaks in hospitalizations for influenza, respiratory syncytial virus, and meningococcal disease.
RESULTS AND CONCLUSIONS
In 19 of 20 seasons, influenza peaked≤2 weeks before meningococcal disease, and peaks were highly correlated in time (ρ = 0.95; P <.001). H3N2 and H1N1 peaks were highly synchronized with meningococcal disease while pandemic H1N1, B, and respiratory syncytial virus were not. Over 20 years, 12.8% (95% CI, 9.1-15.0) of meningococcal disease can be attributable to influenza in the preceding weeks with H3N2 accounting for 5.2% (95% CI, 3.0-6.5), H1N1 4.3% (95% CI, 2.6-5.6), B 3.0% (95% CI, 0.8-4.9) and pH1N1 0.2% (95% CI, 0-0.4). During the height of influenza season, weekly attributable fractions reach 59%. While vaccination against meningococcal disease is the most important prevention strategy, influenza vaccination could provide further protection, particularly in young children where the meningococcal disease vaccine is not recommended or protective against the most common serogroup.
Topics: Humans; Influenza, Human; Meningococcal Infections; United States
PubMed: 25265409
DOI: 10.1371/journal.pone.0107486 -
Vaccine Apr 2023Representative information on disease course and outcome of invasive meningococcal disease (IMD) is important because of the shift in meningococcal epidemiology that...
INTRODUCTION
Representative information on disease course and outcome of invasive meningococcal disease (IMD) is important because of the shift in meningococcal epidemiology that recently occurred in the Netherlands. With this study, we update earlier research on the burden of IMD in the Netherlands.
MATERIAL AND METHODS
We performed a retrospective study using Dutch surveillance data on IMD from July 2011 to May 2020. Clinical information was collected from hospital records. The effect of age, serogroup, and clinical manifestation on disease course and outcome was assessed in multivariable logistic regression analyses. Grouping of infecting isolates was performed by Ouchterlony gel diffusion or by PCR.
RESULTS
Clinical information was collected for 278 IMD cases of which the majority had IMD-B (55%), followed by IMD-W (27%), IMD-Y (13%), and IMD-C (5%). Most patients presented with meningitis (32%) or sepsis (30%). Hospitalisation for ≥ 10 days was most frequent among 24-64 year olds (67%). ICU admission was highest among 24-64 year olds (60%), and in case of sepsis (70%), or sepsis plus meningitis (61%). Sequelae at discharge was lower for patients with mild meningococcaemia compared to patients with sepsis plus meningitis (OR: 0.19, 95% CI: 0.07-0.51). The overall case fatality rate was 7%, and was highest for IMD-Y (14%) and IMD-W (13%) patients.
CONCLUSIONS
IMD remains a disease with high morbidity and mortality. Sepsis (with or without meningitis) is associated with a more severe disease course and outcome compared to other clinical manifestations. The high disease burden can be partly prevented by meningococcal vaccination.
Topics: Humans; Netherlands; Retrospective Studies; Incidence; Meningococcal Infections; Neisseria meningitidis; Sepsis; Serogroup; Meningococcal Vaccines; Meningitis, Meningococcal
PubMed: 36933982
DOI: 10.1016/j.vaccine.2023.03.017 -
Emerging Infectious Diseases Apr 2024In 2022, concurrent outbreaks of hepatitis A, invasive meningococcal disease (IMD), and mpox were identified in Florida, USA, primarily among men who have sex with men.... (Review)
Review
In 2022, concurrent outbreaks of hepatitis A, invasive meningococcal disease (IMD), and mpox were identified in Florida, USA, primarily among men who have sex with men. The hepatitis A outbreak (153 cases) was associated with hepatitis A virus genotype IA. The IMD outbreak (44 cases) was associated with Neisseria meningitidis serogroup C, sequence type 11, clonal complex 11. The mpox outbreak in Florida (2,845 cases) was part of a global epidemic. The hepatitis A and IMD outbreaks were concentrated in Central Florida and peaked during March--June, whereas mpox cases were more heavily concentrated in South Florida and had peak incidence in August. HIV infection was more common (52%) among mpox cases than among hepatitis A (21%) or IMD (34%) cases. Where feasible, vaccination against hepatitis A, meningococcal disease, and mpox should be encouraged among at-risk groups and offered along with program services that target those groups.
Topics: Male; Humans; Hepatitis A; Florida; HIV Infections; Homosexuality, Male; Mpox (monkeypox); Sexual and Gender Minorities; Disease Outbreaks; Meningococcal Infections
PubMed: 38526187
DOI: 10.3201/eid3004.231392 -
Journal of Preventive Medicine and... Dec 2018The invasive disease from Neisseria meningitidis is one of the leading causes of death for meningitis and sepsis at all ages. The highest incidence of cases occurs at...
The invasive disease from Neisseria meningitidis is one of the leading causes of death for meningitis and sepsis at all ages. The highest incidence of cases occurs at paediatric and adolescent age, but no age of life is considered protected from this infection and disease. Prevention against the five main serogroups is possible using the combined conjugated polysaccharide vaccine against the ACWY (anti-MenACWY) serogroups and the meningococcal B (anti-MenB) protein vaccines. Trumenba vaccine, approved by the EMA (European Medicine Agency) for use in individuals aged ≥ 10 years, protects against serogroup B invasive disease. This bivalent, recombinant vaccine is able, when given with a 0-6 month schedule, to induce a protective response in adolescents and young adults, comparable with a 3-doses schedule. For this reason, the Trumenba vaccine should be used routinely with the 2-dose schedule (0-6 months). The 3-doses use could be considered in particular situations, like an occurring epidemic or particular individual risk factors such as asplenia or complement deficit, but is not needed for underlying conditions like diabetes or heart diseases.
Topics: Adolescent; Humans; Meningococcal Infections; Meningococcal Vaccines; Neisseria meningitidis, Serogroup B; Young Adult
PubMed: 30656227
DOI: 10.15167/2421-4248/jpmh2018.59.4.1096 -
Epidemiology and Infection Oct 2001We examined the use of polymerase chain reaction (PCR) in investigating suspected cases of meningococcal infection in Birmingham. Data held by Birmingham Health...
We examined the use of polymerase chain reaction (PCR) in investigating suspected cases of meningococcal infection in Birmingham. Data held by Birmingham Health Authority were interrogated to determine cases of suspected or confirmed meningococcal infection for a 3-year period from April 1996. The microbiology departments of five local hospitals completed a standard proforma about the microbiological investigation of cases and included details of patient age, clinical presentation and method of confirmation of the clinical diagnosis. Of 273 cases, 123 had PCR performed on either cerebrospinal fluid and/or blood. Groups more likely to have a PCR done were those presenting with septicaemia alone, and those in the 5-14 year age group. In 33 cases. PCR was the only positive microbiological result. Over the study period there was increasing but variable use of PCR in the investigation of meningococcal infection and PCR increased the yield of confirmed cases.
Topics: Adolescent; Adult; Age Distribution; Child; Child, Preschool; England; Humans; Infant; Meningococcal Infections; Neisseria meningitidis; Polymerase Chain Reaction; Retrospective Studies; Sepsis
PubMed: 11693504
DOI: 10.1017/s0950268801005842 -
Journal of Thrombosis and Haemostasis :... Feb 2008In pediatric meningococcal sepsis, an imbalance between coagulation and fibrinolysis and proinflammatory action play major roles. We hypothesized that thrombin...
BACKGROUND AND OBJECTIVES
In pediatric meningococcal sepsis, an imbalance between coagulation and fibrinolysis and proinflammatory action play major roles. We hypothesized that thrombin activatable fibrinolysis inhibitor (TAFI) and/or TAFI activation markers are involved in the pathogenesis of meningococcal sepsis.
PATIENTS AND METHODS
Children with severe meningococcal sepsis (n = 112) previously included in Rotterdam-based trials participated in this study. Clinical and laboratory parameters and severity scores were assessed. TAFI and TAFI activation markers were determined: TAFI activation peptide (TAFI-AP) and (in)activated TAFI [TAFIa(i)]. The -438G/A, Ala147Thr, and Thr325Ile polymorphisms were genotyped.
RESULTS
TAFI levels were significantly decreased in patients with meningococcal disease at admission compared to the convalescence state. TAFI was decreased in patients with septic shock vs. those with no shock. TAFI-AP levels were increased in patients with disseminated intravascular coagulation (DIC) vs. patients without DIC. TAFI-AP and TAFIa(i) were significantly increased in non-survivors vs. survivors. TAFI-AP levels and the TAFI-AP/TAFI ratio were also strongly correlated to severity scores and laboratory parameters. The TAFI 325Ile/Ile genotype was overrepresented in patients with DIC.
CONCLUSIONS
Activation markers of TAFI were associated with the occurrence of DIC and mortality in meningococcal sepsis patients. A determination of TAFI, TAFI-AP, and TAFIa(i) is required to enable coherent interpretation of the role of TAFI in disease.
Topics: Adolescent; Carboxypeptidase B2; Child; Child, Preschool; Disseminated Intravascular Coagulation; Enzyme Activation; Female; Genetic Predisposition to Disease; Genotype; Humans; Infant; Male; Meningococcal Infections; Mutation, Missense; Neisseria meningitidis; Point Mutation; Serotyping; Severity of Illness Index; Shock, Septic; Survival Analysis; Treatment Outcome
PubMed: 18021301
DOI: 10.1111/j.1538-7836.2008.02841.x -
BMJ (Clinical Research Ed.) Mar 1989To determine the incidence of secondary meningococcal infection in close family and household contacts of index patients and to review the efficacy of chemoprophylaxis...
To determine the incidence of secondary meningococcal infection in close family and household contacts of index patients and to review the efficacy of chemoprophylaxis the records of 3256 cases occurring from 1984 through 1987 were examined. Seventeen secondary cases (0.5%) of infection were identified among these groups. The median interval between index and secondary cases was seven weeks. Fourteen secondary cases occurred more than one week after the disease was diagnosed in the index case. Three secondary cases had not received chemoprophylaxis and in another case the infecting strain had acquired resistance to rifampicin. Prophylaxis for the close contacts of 10 out of 11 of the remaining index patients failed to fulfil all the criteria of an optimal regimen. Even after optimal chemoprophylaxis the medical practitioner and the family should be aware of the increased and prolonged risk of secondary meningococcal infection among close contacts of patients with the disease.
Topics: Adult; Child; Child, Preschool; England; Family; Family Health; Female; Humans; Male; Meningococcal Infections; Nasopharynx; Neisseria meningitidis; Penicillin G; Penicillin Resistance; Retrospective Studies; Rifampin; Risk Factors; Time Factors; Wales
PubMed: 2495111
DOI: 10.1136/bmj.298.6673.555 -
Nature Reviews. Microbiology Jan 2012Neisseria gonorrhoeae and Neisseria meningitidis are Gram-negative bacterial pathogens that are exquisitely adapted for growth at human mucosal surfaces and for... (Review)
Review
Neisseria gonorrhoeae and Neisseria meningitidis are Gram-negative bacterial pathogens that are exquisitely adapted for growth at human mucosal surfaces and for efficient transmission between hosts. One factor that is essential to neisserial pathogenesis is the interaction between the bacteria and neutrophils, which are recruited in high numbers during infection. Although this vigorous host response could simply reflect effective immune recognition of the bacteria, there is mounting evidence that in fact these obligate human pathogens manipulate the innate immune response to promote infectious processes. This Review summarizes the mechanisms used by pathogenic neisseriae to resist and modulate the antimicrobial activities of neutrophils. It also details some of the major outstanding questions about the Neisseria-neutrophil relationship and proposes potential benefits of this relationship for the pathogen.
Topics: Animals; Gonorrhea; Humans; Meningococcal Infections; Microbial Interactions; Neisseria gonorrhoeae; Neisseria meningitidis; Neutrophils
PubMed: 22290508
DOI: 10.1038/nrmicro2713 -
Vaccine Dec 2008Bacterial meningitis and septicaemia is a global health problem often caused by Neisseria meningitidis. The complement system is the most important aspect of host... (Review)
Review
Bacterial meningitis and septicaemia is a global health problem often caused by Neisseria meningitidis. The complement system is the most important aspect of host defence against this pathogen, and the critical interaction between the two is influenced by genetic polymorphisms on both the bacterial and the host side; variations of the meningococcus may lead to increased survival in human sera, whereas humans with complement deficiencies are more susceptible to meningococcal infections. Here we discuss the mechanisms of meningococcal resistance against complement-mediated killing and the influence of both bacterial and host genetic factors.
Topics: Bacterial Capsules; Blood Bactericidal Activity; Complement System Proteins; Humans; Lipopolysaccharides; Meningococcal Infections; Neisseria meningitidis
PubMed: 19388162
DOI: 10.1016/j.vaccine.2008.11.059