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PubMed1989

[Short-term treatment of meningococcal infections].

Based upon our previous experience on the treatment of meningococcal infections with satisfactory evolution when the fourth day of therapy was finalized and taking into account published experiences with four or less days of therapy, we realized a study on the efficacy of a four days therapy when venial meningococcal infections but of seven days when the serious ones. The results obtained were like the former ones we published concerning to death rate but having inferior number of complications. The results of our study suggest that meningococcal infections may be successfully treated according to seriousness, with a four or seven-day course of intravenous penicillin G (300,000 UI/kg/day) distributed in six "aliquots" each four hours. The possibility of a four-days therapy, not taking into account seriousness, is considered for every meningococcal infections.

Adolescent↗
PubMedDate not supplied

[Characterization of the foci of meningococcal infection in closed groups of males].

A total of 257 foci of meningococcal infection in groups of servicemen were selectively examined in 1982-2002. From these groups 353 patients with generalized forms of the disease underwent hospitalization. Most of the foci had a single infection, the proportion of foci with 10-40 patients was 82.6%. The meningococcal infection rate among humans in the foci was 25-37%, group A meningococci playing the leading role. In the structure of meningococcal infection generalized forms of infection constituted 16%, localized forms constituted 25% and inapparent forms (carriers)--59%. The formation of the morbidity structure was influenced by the type of the focus (with a single or multiple infection) and the character of morbidity for many years (during epidemic or at the period between epidemics). No absolute dependence of the level of meningococcal carrier state in the groups of servicemen on the appearance of the generalized forms of meningococcal infection was noted. Thus, both during epidemic and at the period between epidemics the population of meningococci, heterogeneous in its serological structure and differing in its clinical and epidemiological importance, constantly circulated with the leading role played by group A meningococci.

Carrier State↗
PubMed2000

Preventing meningococcal infection in college students.

The incidence of invasive meningococcal disease in adolescents and young adults of high school and college age has recently increased in the United States. Recent studies indicate that certain groups of college students are at increased risk. This has led to the recent Advisory Committee Immunization Practices recommendation that college freshman dormitory residents be provided information about meningococcal infection and the benefits of vaccination. Future studies will need to focus on the potential vaccine prevention of the increased risk of meningococcal infection in persons of high school age, particularly as new conjugate meningococcal vaccines become available.

Adolescent↗
PubMed1983

[The role of the population gene pool in meningococcal infection morbidity].

The character of the distribution of HLA antigens in patients with meningococcal infection among Russians and Touvinians was revealed. The markers of susceptibility to meningococcal infection were detected in each national group. These markers were HLA-Bw22 in Touvinians. The gene of susceptibility to meningococcal infection occurred among Touvinians 2.3 times more frequently. This was probably the cause of a higher morbidity rate in meningococcal infection among Touvinians than among Russians.

Child↗
PubMed2006

Multicenter surveillance of invasive meningococcal infections in children.

OBJECTIVES: Meningococcal disease continues to result in substantial morbidity and mortality in children, but there is limited recent surveillance information regarding serogroup distribution and outcome in children in the United States. The objective of this study was to collect demographic, clinical, laboratory, and outcome information for infants and children who had Neisseria meningitidis infections of various serogroups and were cared for in 10 pediatric hospitals. METHODS: Investigators at each of the participating hospitals identified children with meningococcal infections and collected demographic and clinical information using a standard data form. Meningococcal isolates were sent to a central laboratory for serogrouping by slide agglutination and penicillin susceptibility. RESULTS: From January 1, 2001, through March 15, 2005, 159 episodes of systemic meningococcal infections were detected. The greatest numbers of children were younger than 12 months (n = 41) or were 12 to 24 months of age (n = 22). Meningitis was the most common clinical manifestation of disease accounting for 112 (70%) cases; 43 (27%) children had bacteremia only. Children who were younger than 5 years (17 of 102) were significantly less likely to require mechanical ventilation than children who were 5 to 10 years of age (12 of 24) or children who were older than 10 years (13 of 33). Overall, 55 (44%) isolates were serogroup B, 32 (26%) were serogroup C, and 27 (22%) were serogroup Y. All but 1 isolate (intermediate) were susceptible to penicillin. The overall mortality rate was 8% (13 of 159) but was greater for children who were > or = 11 years of age (7 [21.2%] of 33) than for children who were younger than 11 years (6 [4.8%] of 126). Unilateral or bilateral hearing loss occurred in 14 (12.5%) of 112 children with meningitis. CONCLUSIONS: The morbidity and the mortality of meningococcal infections are substantial. With the recent licensure of meningococcal conjugate vaccines, our baseline trends in meningococcal disease can be compared with those seen after widespread vaccination to assess the success of routine immunization.

Adolescent↗
PubMed1998

siaD PCR ELISA for confirmation and identification of serogroup Y and W135 meningococcal infections.

Non-culture diagnosis and serogroup determination of meningococcal infection is important in contact management where vaccination may be possible. A serogroup B and C PCR ELISA assay for the non-culture diagnosis and serogroup determination has proved invaluable for enhanced epidemiological surveillance and contact management. A polymerase chain reaction assay, based on a restriction fragment length polymorphism in the meningococcal serogroup Y and W135 sialyltransferase (siaD) gene, was developed to enhance the range of non-culture diagnosis of meningococcal infection from clinical samples. The PCR assay was adapted to an ELISA format incorporating hybridisation with serogroup-specific Y and W135 oligonucleotide probes. The serogroup-specific W135 and Y PCR ELISA is a useful addition to currently available serogroup B and C assay for non-culture diagnosis of meningococcal infection and outbreak investigation.

Enzyme-Linked Immunosorbent Assay↗
PubMed2000

Meningococcal infections and meningitis: what is new?

Meningococcal infection is one of the very few severe bacterial infections, in this era, that still can kill a relatively healthy child within minutes. Fortunately, it is a relatively rare disease. Rural practitioners may see one affected child once every 2-3 years, but once seen they will never forget it. The present article gives some examples of case scenarios along with a brief overview of the problem, with emphasis on early diagnosis, prevention and possible future developments.

Child, Preschool↗
PubMed1997

A new classification for pericarditis associated with meningococcal infection.

UNLABELLED: Acute meningococcal pericarditis is a rare clinical disorder. Our review of the literature disclosed that current classifications are confusing since they fail to differentiate between two distinct criteria: time and causality. We suggest a new classification of the various states of meningococcal pericarditis on the basis of the pathophysiological process: disseminated meningococcal disease with pericarditis (purulent, culture-positive, associated with meningococcal bacteraemia); isolated meningococcal pericarditis (purulent, culture-positive but without signs of meningeal or other clinical systemic involvement); and reactive meningococcal pericarditis (immunological, late-onset, culture-negative, resembling post-viral pericarditis). It is essential that clinicians recognize the various states of the disease, since they differ in natural history, treatment and prognosis. CONCLUSION: From personal experience and a literature review it emerges that meningococcal pericarditis should be classified as: (1) Pericarditis as local manifestation of disseminated meningococcal disease; (2) isolated meningococcal pericarditis; (3) reactive (immunopathic) meningococcal pericarditis.

Adolescent↗
PubMed1989

[The epidemiological characteristics of meningococcal infection in the USSR].

The epidemiological analysis of morbidity in meningococcal infection in the USSR in the period of 1969-1987 showed that the second rise of the morbidity level occurred in 1984 and was followed by its decrease in most of the regions of the USSR. This study also revealed that the characteristic feature of the second rise of morbidity in meningococcal infection was a considerable involvement of young children (aged up to 3 years), as well as the increased etiological role of group B meningococci in cases of meningococcal infection and the circulation of these microorganisms among the population. Besides, the preservation of the etiological importance of group A meningococci in many regions of the USSR, especially among adults, was noted. In this connection, the use of Soviet group A meningococcal polysaccharide vaccine on epidemiological indications was considered to be epidemiologically substantiated.

Age Factors↗
PubMed1985

[Characteristics of the meningococcal carrier state in organized collectives and its role in the development of generalized forms of meningococcal infection].

Complex (epidemiological and bacteriological) investigations of the level and structure of meningococcal carriership among the members of organized collective bodies differing in the epidemiological situation with respect to meningococcal infection have been carried out. The absence of differences between the total level of meningococcal carriership and the morbidity rate with respect to the generalized forms of meningococcal infection has been shown. The presence of cases of meningococcal meningitis in the groups under study has been found to depend on the intensity of the circulation of certain meningococcal serogroups. The possibility of the ecological reservation of the causative agents of meningococcal infection as polyagglutinable forms has been suggested.

Carrier State↗
PubMed1991

Amputation for gangrene of the limbs following severe meningococcal infection.

Five cases of severe meningococcal infection in children and young adults with gangrene leading to major amputation are described. They are associated with necrosis of the skin and soft tissue, intravascular coagulation and shock. The surgical options, prosthetic implications and the consequent rehabilitation outcome are discussed.

Adolescent↗
PubMed1978

Mortality in meningococcal infections.

Among 124 patients with meningococcal infections between 1966-1976, 108 had meningitis with a fatality rate of 7.4%, and 16 septicaemia with 18.8% fatality. High risk patients (more than 3 prognostically unfavourable characteristics) increased from 3.5% 1966-1970 to 15.6% 1971-1976, and the total mortality from 3.6 to 10.4%. The most unfavourable prognostic factor was low blood pressure at admission. High risk patients were more common among those who had meningococci with complete or partial sulfonamide resistance (25.7%) than among those having sensitive meningococci (11.9%). When the meningococci were at least partially sulfonamide-resistant, initial therapy with the combination of benzylpenicillin, sulfaisodimidine and chloramphenicol seemed to be more successful than benzylpenicillin alone in patients above 10 years. Ampicillin was used only in children, and these all survived.

Adolescent↗
PubMedDate not supplied

[Spectrum of antibodies to iron-regulated proteins in the blood sera of patients with meningococcal infection].

55 paired sera from 25 patients with meningococcal infection (meningitis, meningococcemia) were studied with the use of immunoblotting. In these sera antibodies to 15 iron-regulated proteins (IRP) were detected. In the process of the development of meningococcal infection an increase in the content of specific antibodies to IRP with molecular weights of 35 kDa (38%), 43 kDa (52%) and 47 kDa (38%) was found to occur. The induction of antibodies did not depend on the group of the infecting strain, as well as on the patient's age.

Adult↗
PubMed1982

[Late sequelae of meningococcal infections in adults].

Long-term sequels of meningococcal infection were examined in 120 patients aged 16 to 73 years within periods of one month to 6 years after the disease. It was found that the meningococcal infection not infrequently left consequences, such as hypertensive (18%) and epileptiform (2%) syndromes, pyramid insufficiency (11%), impairments of the cranial nerves (8%), intellect derangement (12.5%), psychoorganic syndrome (3.3%). Regular dispensary observation and treatment of such patients in the residual period is a socially important task.

Adolescent↗
PubMed1988

[The phenomenon of HLA antigen modification in meningococcal infection].

212 patients with the generalized forms of meningococcal infection have been examined. The intensity and quality of lymphocytotoxic reaction in the acute phase and the convalescence period of the disease have been analyzed and the blank calculation has been made at different clinical forms of meningococcal infection. The formation of modified tissue antigens at the acute stage of the disease in the presence of intoxication is shown and the probable role of the intensity of bacteremia in this formation is discussed.

Acute Disease↗
PubMed1999

Invasive meningococcal infection in Western Australia.

OBJECTIVES: To review signs and symptoms in children diagnosed with meningococcal infection; to assess age, sex and race distribution of meningococcal infection; and to assess associations of the presenting features with morbidity and mortality. DESIGN: Retrospective case notes review for a 5-year period. SUBJECTS: 105 patients aged between 19 days and 13 years. MAIN DATA REVIEWED: Temperature, blood pressure, heart rate, respiratory rate, type of rash, age, sex, race and outcome. RESULTS: Of the 105 patients, 67.6% were Caucasian, 27.6% Aboriginal and 4.8% of other origin. There were 14.3% patients under 3 months of age (2.9% neonates), 48.6% between 3 months and 2 years, 21% between 2 and 4 years and 16.2% older than 4 years. The male:female ratio was 1.4. Features at presentation in decreasing order of frequency were: fever (89.5%), tachypnoea (73.3%), rash (59% [maculopapular 17.1%, petechial 27.6% and purpuric 14.3%]), vomiting (52.4%), irritability (44.8%), tachycardia (37.5%), lethargy (36.2%), neck stiffness (32.4%) and non-specific immediately preceding illness (15.2%). Purpura and a reduced systolic blood pressure were significantly associated with an increased risk of mortality, purpura and reduced diastolic blood pressure with an increased risk of morbidity. Initial misdiagnosis occurred in 17.1% of cases, with the majority of those misdiagnosed (83.3%) aged less than 2 years. Predominant serotyping was Group B followed by Group C. Major findings were a marked male preponderance in patients under 3 months of age. The incidence of meningococcal infection in the Aboriginal population was approximately six times that in the non-Aboriginal population. The yearly incidence of meningococcal disease during the study period ranged from 5.2 to 10.5 per 100,000. Long-term morbidity occurred in 8.6% of cases and mortality was 8.6%. Higher morbidity and mortality figures were found in those with septicaemia alone. Children referred from peripheral hospitals had a higher mortality but a comparable morbidity.

Age Distribution↗
PubMed1986

Variation in the expression of pili and outer membrane protein by Neisseria meningitidis during the course of meningococcal infection.

The occurrence of antigenic shift during meningococcal infection has been investigated by comparison of paired isolates obtained from the blood, cerebrospinal fluid or nasopharynx of patients. Isolates from any individual produced identical DNA 'fingerprints' and showed stability in expression of both class 2 outer membrane protein and an antigen common to pathogenic Neisseria, confirming their origin as a single strain. One of the four strains examined produced variants which differed in the molecular mass of their class 5 outer membrane proteins. Three of the strains produced pili containing the epitope recognized by monoclonal antibody SM1 and two of these gave rise to variants which expressed pili of differing subunit molecular masses. The two variants of the remaining strain produced pilins lacking the common epitope detected by antibody SM1 but radioimmune precipitation with polyclonal anti-pilus antiserum revealed that variation in the molecular mass of the pilin expressed also occurred with this second class of pili. Antigenic variation in expression of both class 5 outer membrane proteins and pili therefore appears to be a common occurrence during meningococcal infection.

Antigens, Bacterial↗