[Methodology of the study of pre- and post-vaccination antibodies against serogroup C Meningococcus].
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Antibody Formation↗
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Results for “MENINGOCOCCUS INFECTIONS”
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[Meningococcus carriers among University Hospital personnel].
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Bacterial Vaccines↗
Epidemiology of acute necrotizing ulcerative gingivitis.
In the last 60 years, there have been approximately 50 studies of various suspected risk factors associated with acute necrotizing ulcerative gingivitis. Two thirds of these studies have been either surveys or case reports; nearly all the rest have been case-control studies. There have been only a few longitudinal and population-based studies, most of which were in high-risk populations. The findings of many studies pertain to gingivitis in general rather than in acute necrotizing ulcerative gingivitis in particular; the findings of other studies are based on small numbers or solely on case histories without the inclusion of control subjects. There are comparisons between the epidemiology of acute necrotizing ulcerative gingivitis as it occurs in military populations and the epidemiology of meningococcal meningitis (98-103). Both diseases have been reported in closed communities such as in young recruits away from home and in new surroundings. A temporal trend upward in disease frequency was described for both infections during World War II. Both infections appear to be characterized by low communicability, with no documented transmission by fomites or vectors. Furthermore, active disease in both cases is associated with markedly increased numbers of normally indigenous flora: B. intermedius in the case of acute necrotizing ulcerative gingivitis and Neisseria meningococcus in the case of epidemic meningococcal meningitis. Risk factors associated with both diseases include crowding, physical fatigue, increased stress, low socioeconomic status, and failure of host defense mechanisms. In general, there is potential for longitudinal studies of young people such as new military recruits and college students who are undergoing the transition from dependence to independence. It is intriguing that these young adults are suddenly at increased risk of this disease in late adolescence when they should be at peak fitness and, just as suddenly, at decreased risk after their early thirties. It appears that the dynamic tension between bacterial agents, environmental stressors, and host defense mechanisms is abruptly altered in certain young people, allowing the characteristic lesions to develop. Furthermore it appears that, in the United States at least, the disruption is limited primarily to white people relative to black people. It is possible that disease develops because young adults are brought together from diverse locations and perhaps exposed to a new microbial agent. However, acute necrotizing ulcerative gingivitis has not been demonstrated clearly to be transmissible, and if it is, the mode of transmission is not known.(ABSTRACT TRUNCATED AT 400 WORDS)
Female↗
[Purulent pericarditis in children: a 15 year-experience].
BACKGROUND: Purulent pericarditis is rare in developed countries, but its prognosis is regarded as serious. Early diagnosis and appropriate treatment should prevent complications. PATIENTS: Among the 119 pericarditis without congenital cardiopathy admitted in our pediatric cardiology unit between 1979 and 1994, 19 were purulent. The mean age of these 13 boys and six girls was 3 years (range: 3 months to 10 years). Symptoms always pointed to a chest disease whether pericarditis occurred first (n = 13) or it complicated evolution of a known infectious process (n = 6). Tamponnade was present in seven infants upon admission and required urgent pericardiocentesis or drainage. An extrapericardial infectious site was found in 11 cases: six pulmonary infections, three osteomyelitis, one cellulitis and one sinusitis. An organism was isolated in 17 cases, 14 times in the pericardial fluid, eight times on blood culture. The identified bacteria were: Staphylococcus aureus (n = 6), Haemophilus influenzae (n = 4), Streptococcus A (n = 3), Streptococcus pneumoniae (n = 3), Meningococcus (n = 1). Treatment consisted of intra-venous antibiotics associated 15 times to surgical drainage of the pericardium. One infant had no pericardiocentesis and no drainage because he presented late with constrictive pericarditis and needed pericardectomy. All infants healed but four developed contrictive pericarditis and required pericardectomy; none of these four patients had early drainage (two had no drainage at all). Pericardectomy, carried out between 2 and 6 months after the beginning of pericarditis with adiastolic signs and pericardial thickening, permitted healing in all cases and disappearance of all cardiac symptoms. CONCLUSIONS: Early diagnosis and treatment of purulent pericarditis, especially early pericardial drainage, are the best ways of avoiding constriction.
Child↗
The immunocompromised traveller.
Increasing numbers of immunocompromised people are travelling abroad to areas where the risks of some infections are increased. HIV positive people respond reasonably well to most vaccines when asymptomatic but response is less predictable when symptomatic disease is present. Generally, live vaccines should be avoided in all stages of HIV disease. Patients with anatomic or functional asplenia are at particular risk of severe sepsis due to encapsulated bacteria and from malaria. They should be immunised against the pneumococcus, meningococcus, and haemophilus and should avoid travel to areas where the probability of malaria transmission is high. Patients receiving cancer chemotherapy or transplant recipients on long-term immunosuppression should avoid live virus vaccines but may benefit from bacterial polysaccharide vaccines such as the pneumococcal vaccine. All patients with potentially impaired immunity should be assessed on an individual basis in terms of the risks and benefits involved in travel and available prophylactic measures. Immunisations useful in their native regions can be reviewed at the same time. Such travellers should carry a physician's letter and contact address in case of medical problems encountered abroad.
Aged↗
Phylogenetic and epidemiological analysis of Neisseria meningitidis using DNA probes.
The genetic relationships between various serotypes and serogroups of meningococcal strains were investigated by restriction fragment-length polymorphism (RFLP) analysis using a number of random DNA probes and a probe containing a truncated copy of the meningococcal insertion sequence IS1106. The data were used to estimate genetic distance between all pairs of strains and to construct phylogenetic trees for meningococcal strains. B15:P1.16R strains isolated from cases of systemic meningococcal disease in two health districts with a high incidence of disease were clonal in contrast to similar strains from cases occurring in other parts of the UK. Strains from these areas, which contain a similar genomic deletion, were found to be derived from two distinct lineages within the B15:P1.16R phylogenetic group. RFLP data demonstrated that present serological typing systems for the meningococcus do not necessarily reflect true genetic relationships.
Blotting, Southern↗
[Adhesiveness in Neisseria meningitidis. A virulence factor?].
The role of adhesivity as a factor of virulence in cases of N. meningitidis has not yet been established. Unlike other bacteria in which the presence of adhesivity reflects an enhanced virulence, a high capacity of adherence is associated with a low virulence and invasive capacity in cases of meningococcus. In order to gain more insight into the knowledge of this phenomenon we have studied the adhesivity of 109 strains of N. meningitidis to human pharyngeal epithelial cells. Twenty nine out of the 109 strains were isolated from blood or spinal fluid of patients with meningococcal infection (meningitis or septicemia), whereas the remaining 80 strains were obtained from pharyngeal smears of healthy carriers. The adhesivity was measured as the number of meningococci adhered to 50 epithelial cells according to Craven's scale. Strains of healthy carriers showed a greater adhesivity than that of patients (p less than 0.001). The relevance of the pharyngeal area in the evaluation of the adhesive capacity is in accordance with the hypothesis that meningococcal adhesivity decreases when the microorganism crosses the pharyngeal epithelium. The results would support the concept that the virulence of N. meningitidis is related to its adhesiveness.
Bacterial Adhesion↗
A civilian case of fatal meningococcemia due to Neisseria meningitidis, group Y.
The present report is that of a civilian episode of fatal, fulminant group Y meningococcemia in a previously healthy adolescent, who denied prior vaccination against group C meningococcus. The patient suffered abrupt onset of purpura, hypotension and cardiopulmonary arrest. A detailed clinical and pathologic report is included.
Adolescent↗
Use of nucleic acid probes for the detection of sexually transmitted infectious agents.
Deoxyribonucleic acid sequences specific for a pathogen of interest can be isolated from a variety of microorganisms. Such DNA probes can be exploited to detect infectious agents directly in infected patient material despite the presence of large numbers of other organisms and host DNA. This technology is dependent upon the recognition of a specific nucleotide sequence present in DNA extracted from a clinical sample by a radiolabeled or nonisotopically labeled DNA probe. We have isolated several DNA probes for the detection of pathogenic Neisseria which include a plasmid species unique to the gonococcus, as well as several cloned genes that detect both the gonococcus and the meningococcus. In addition, we characterized a unique plasmid of Chlamydia trachomatis that has proved to be quite useful as a DNA probe for the detection of this pathogen in cervical secretions and, by in situ hybridization, in Papanicolaou smears. Deoxyribonucleic acid hybridization as a diagnostic tool is still in its infancy. It holds a number of advantages over conventional methods of pathogen detection and serves as an alternative, as well as a complement, to available immunologic methods.
Bacterial Outer Membrane Proteins↗
[Present possibilities of anti-meningococcal vaccination].
In the form of answers to the most frequent questions the author reviews the present development of an antimeningococcal vaccine and describes the existing possibilities of vaccination. The article broaches the history of vaccine development, categories of antimeningococcal vaccines, their weaknesses and advantages. The author discusses the issue of a vaccine against meningococcus B, the difference between a polysaccharide and conjugated vaccine, the vaccination strategy in the Czech Republic and in the world and briefly describes the antimeningococcal immunity of our population.
Humans↗
The 2001 serological survey in the Czech Republic--invasive meningococcal disease.
In 2001, 730 sera from the population of 14 areas of the Czech Republic aged between 1 and 64 years were tested by a microplate assay for the presence of bactericidal antibodies against N. meningitidis A:4,21:P1. 10, N. meningitidis B:2a:P1.2,P1.5 and N. meningitidis C:2a:P1.2,P1.5. The Czech population showed high immunity against N. meningitidis A:4,21:P1.10, but low immunity against N. meningitidis B:2a:P1.2,P1.5 and N. meningitidis C:2a:P1.2,P1.5. The current epidemiological situation requires neither vaccination against meningococcus A nor inclusion of conjugated vaccine against meningococcus C into routine vaccination. Nevertheless, the invasive meningococcal disease surveillance programme needs to be continued since enabling rapid detection of possible changes in the epidemiological situation and subsequent vaccination intervention, if epidemiologically indicated. Conjugated vaccine against meningococcus C should replace polysaccharide vaccine A+C in all indications currently relevant in the Czech Republic.
Adolescent↗
[Functional hyposplenia after allogenic bone marrow transplantation: a case report].
Functional hyposplenia/asplenia is a severe longterm complication after allogeneic stemcell transplantation predominantly seen in patients who suffer from extensive chronic graft versus host disease (cGvHD). The risk of acquiring an overwhelming infection with encapsulated bacteria is ca. four fold increased in patients with functional hyposplenia/asplenia. Therefore follow up of patients who have received allogeneic blood stem cells (bone marrow or peripheral blood stem cells) should embrace screening for functional hyposplenia. When functional hyposplenia is diagnosed triple vaccination against streptococcus pneumonia, Haemophilus influenza type B and Meningococcus neisseria should be considered. Goldstandard in diagnosing functional hyposplenia is hepatosplenic scintigraphy. We present the case of 37 year old female in whom sonography was indicative of functional hyposplenia. The diagnosis was confirmed by scintigraphy. Sonography including color coded duplex sonography is a safe and cost saving procedure. Sensitivity, Specificity and predictive value of the following sonographic finding: a) decreasing splenic size and b) diminished or absent parenchymal blood flow are currently evaluated in a prospective study.
Adult↗
[Seroprevalence of bactericidal anti-meningococcal antibodies in Cantabria 10 months following a vaccination campaign].
BACKGROUND: The Self Governing Region of Cantabria within the state of Spain has a population of 541,885, of which 107,787 individuals are aged from 18 months to 19 years. A vaccination campaign against meningitis was conducted in this Region in February and March, 1997. It was directed at children from the age of 18 months up to 19 years old, and included all municipal areas, achieving a coverage of more than 95%. In the following 12 months the efficacy achieved by the vaccination was 95.68% for all age groups. To help decide on the need for re-vaccination, a study of the prevalence in serum of bactericide antibodies in the vaccinated population was carried out. METHODS: In December 1997 blood samples from 414 vaccinated children were analysed, obtained at random in opportunist sampling in First-Aid Centres and Public Hospitals within this Region, as well as from children in public kindergartens run by the General Board of Social Well-Being in Cantabria. The number of bactericide antibodies was analysed in the National Centre for Microbiology, and the level of "vaccination effect" was set at a dilution of 1/8. RESULTS: The following percentages of titres > or = 1/8 were obtained (the age groups of school pupils are shown in brackets): 0% (18-24 months old), 4% (1.5-4 years old), 7.1% (1.5 to 6 years old), 51.3% (6 to 12 years old). Due to the fact that the definition of the "vaccine effect" was artificially set at a dilution of 1/8, while other studies set it at a dilution of 1/4, in 287 serum samples with a result of < 1/8 the bactericide assay was repeated with a dilution of 1/4, with the result that 286 (99.6%) were negative. I.e., the final result does not vary if we set the cut-off point at 1/4 instead of 1/8. No significant differences were found due to whether or not the samples came from children in municipalities where there had been cases of meningitis C. CONCLUSIONS: Bactericide activity is very low in those children aged less than 4-6 years old, and is less than has been published, although it is greater above this age. This contrasts with the excellent clinical-epidemiological results, as there was no case amongst the least serologically "protected" population, in spite of the fact that meningococcus C remains in circulation in Cantabria, within the population that was not targeted by the campaign.
Adolescent↗
Neutralization of meningococcal endotoxin by antibody to core glycolipid.
Antibodies to Escherichia coli J5, a uridine 5'-diphosphate-galactose epimerase-less mutant of E. coli 0111, neutralized meningococcal endotoxemia from all three major capsular serogroups. We chose the dermal necrosis of the local Shwartzman phenomenon and the renal cortical necrosis of the general Shwartzman phenomenon as assays because these are the hallmarks of meningococcemia, and because meningococcal lipopolysaccharide (LPS) is a uniquely potent cause of dermal purpura and necrosis. Meningococcal antisera raised against LPS from MGC A, B, and C also provided good protection against endotoxemia from the homologous capsular groups, but it was inconsistent against the heterologous serogroups. The superiority of J5 antibodies (purified IgG as well as antiserum) is probably due to the fact that J5 LPS contains only the endotoxin core. Consequently, immunization with this mutant stimulates production of antibodies to core LPS without interference by the "0" antigenic determinants of the side chains. These observations indicate that the endotoxin core is the toxic moiety of meningococcal LPS, that the core LPS of meningococcus (MGC) is immunologically similar to enteric LPS, and that the antigenically variable "0" side chains of MGC LPS interfere with antibody production against the common core. They also suggest that antibodies prepared against this E. coli mutant could interrupt the devastating course of meningococcal endotoxemia in man, regardless of the capsular serogroup of the infecting strain.
Animals↗
[Meningococcal disease: epidemiological profile in the Municipality of Manaus, Amazonas, Brazil, 1998/2002].
This epidemiological study focused on meningococcal meningitis in the Municipality of Manaus, Brazil from 1998 and 2002, considering the following aspects: incidence and case-fatality, age, sex, clinical manifestations, evolution, diagnostic criteria, and predominant meningococcal strains. The mean incidence rate for meningococcal meningitis in Manaus during the study period was 7.8 cases per 100,000 inhabitants. The disease was more common in males. Infants (< 1 year age) were the most frequently affected age group. Mean case fatality was 14.0%. In 2002, serotype B meningococcus was the most prevalent (78.2%), while serotype C accounted for 7.2% of cases of meningococcal disease.
Adolescent↗
Improved methods of detection of meningococcal DNA from oropharyngeal swabs from cases and contacts of meningococcal disease.
In the UK the increasing use of pre-admission parenteral antibiotic therapy in meningococcal disease has lessened the value of routine cultures as a tool to confirm diagnosis, and laboratory confirmation of invasive meningococcal infection is achieved increasingly by non-culture, nucleic acid amplification methods. The purpose of this study was to evaluate a DNA extraction and meningococcal-specific DNA amplification methodology for detection of meningococci from oropharyngeal swabs. One hundred and six swabs from suspected or confirmed cases of meningococcal disease, and 94 swabs from contacts of meningococcal disease cases were examined. Of laboratory-confirmed cases, 38/65 (58.5%) yielded a positive oropharyngeal swab PCR result and 5/24 (20.8%) swabs from suspected but laboratory-unconfirmed cases were PCR positive. No significant differences in PCR positivity rates were found between the types of swab transport systems utilized, but transport time to the testing laboratory was found to affect PCR positivity (P < 0.05). Application of meningococcus-specific PCR to oropharyngeal swabs, in addition to routine culture of swabs, can provide valuable epidemiological information as well as case confirmation for contact management. PCR amplification of meningococcal PCR from oropharyngeal swabs will also increase the ascertainment in swabbing surveys carried out as part of meningococcal disease outbreak investigation and management.
DNA, Bacterial↗
Opsonisation and phagocytosis of group B meningococci by polymorphonuclear leucocytes: comparison of sulphonamide sensitive and resistant strains.
A large proportion of disease caused by sulphonamide resistant strains of group B type 15 meningococci affects patients 10-24 years. In contrast, disease caused by sulphonamide sensitive strains conforms to the usual pattern, and most infection occurs in early childhood. In an attempt to explain this phenomenon possible differences in susceptibility of resistant and sensitive strains to phagocytosis by polymorphonuclear leucocytes were investigated, using radioactively labelled bacteria. In initial experiments a group B resistant strain required higher concentrations of normal human serum and longer opsonisation times for phagocytosis than an ungroupable non-pathogenic meningococcus. Comparison of sulphonamide resistant and sensitive group B meningococci showed that with either heat inactivated serum or agammaglobulinaemic serum, phagocytosis did not occur with any of the strains, whereas if these two sera were used together, phagocytosis was restored to the level seen with normal human serum. Thus both antibody and complement are required for phagocytosis. Furthermore, opsonisation depended on an intact classical pathway of complement for each group B strain. In all the experiments there was no significant difference between the phagocytosis of sulphonamide sensitive and resistant group B strains neither with regard to the efficiency of opsonisation by normal human serum nor the exact requirements for antibody and complement.
Adolescent↗
Laboratory diagnosis of gonococcal infection by genetic transformation.
The transformation test for the detection of infection by Neisseria gonorrhoeae has been examined using pro gonococci as recipients and DNA preparations from 912 clinical isolates and from 240 direct swab specimens as donors. The reliability of the method was checked with DNA from clinical isolates; 82% of the N. meningitidis from throat swab specimens were capable of transforming the gonococcal recipients, but after identification of the meningococcus by the aminopeptidase profile, the transformation test was then 99.5% positive for the gonococcus with virtually no false-positives. The only other organism to give a positive reaction was N. lactamica, which occurred once in 912 specimens. When applied directly to swab specimens, the reliability of the test was reduced, but this may have been related to variability of the specimen itself. However, 7 of 15 specimens which were microscopically suspected to be gonococci but unculturable were positive; also, 9 out of 38 unculturable specimens that were not even suspected to be gonococci were positive. Hence the test was able to identify the presence of gonococci that were unculturable. The aminopeptidase activities were not sensitive enough to be detected in the direct swab specimens, and neither cys nor leu auxotrophs were suitable as recipients to give a differentiation between N. gonorrhoeae and N. meningitidis. Evidence was obtained which would support the proposition that the transfer of genetic material between N. gonorrhoeae and N. meningitidis may occur.
Aminopeptidases↗