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Meningococcal sepsis

Joan L Robinson
Invasive meningococcal disease (IMD) is serious, often resulting in fulminant sepsis or meningitis. IMD in Canada is primarily attributable to serogroups B and C. There are routine programs for serogroup C vaccine at 12 months of age, with some jurisdictions routinely providing additional earlier doses. Adolescents routinely receive a booster dose of serogroup C vaccine or of a quadrivalent (serogroups A, C, W and Y) vaccine. Serogroup B vaccines are not recommended for routine use pending further data on the efficacy and duration of protection from the available vaccine...
February 2018: Paediatrics & Child Health
Tamara Hoppenbrouwers, Navin P Boeddha, Ebru Ekinci, Marieke Emonts, Jan A Hazelzet, Gertjan J Driessen, Moniek P de Maat
OBJECTIVES: Children with meningococcal sepsis are highly at risk for fulminant disease, multiple organ failure, and death. Recently, neutrophil extracellular traps levels have been indicated as a marker for severity in different kinds of sepsis. Our aim was to study the role of neutrophil extracellular traposis in meninogococcal sepsis in children. DESIGN: We measured myeloperoxidase-DNA, a marker for neutrophil extracellular traps, in serum of meningococcal sepsis patients upon admission to PICU, at 24 hours, and at 1 month and studied the association with clinical outcome...
February 9, 2018: Pediatric Critical Care Medicine
P O'Lorcain, D E Bennett, S L Morgan, R J Cunney, S M Cotter, M T Cafferkey, D M O'Flanagan
OBJECTIVES: To assess how invasive meningococcal disease (IMD) records held by the Irish Meningitis & Sepsis Reference Laboratory (IMSRL) compare to records of IMD notifications reported on the national integrated electronic Computerised Infectious Disease Reporting (CIDR) system. STUDY DESIGN: We assessed the completeness, data quality and timeliness of IMD notifications and reference laboratory records for the period between 01 July 1999 and 30 June 2015 by identifying discrepant and/or missing data items in a matched case data set and by measuring the timeliness of case reporting...
January 22, 2018: Public Health
Johannes B Herrmann, Marcel Muenstermann, Lea Strobel, Alexandra Schubert-Unkmeir, Trent M Woodruff, Scott D Gray-Owen, Andreas Klos, Kay O Johswich
Sepsis caused by Neisseria meningitidis (meningococcus) is a rapidly progressing, life-threatening disease. Because its initial symptoms are rather unspecific, medical attention is often sought too late, i.e., when the systemic inflammatory response is already unleashed. This in turn limits the success of antibiotic treatment. The complement system is generally accepted as the most important innate immune determinant against invasive meningococcal disease since it protects the host through the bactericidal membrane attack complex...
January 23, 2018: MBio
Unni Gopinathan, Kathrine Røe Redalen, Anne-Marie Trøseid, Peter Kierulf, Petter Brandtzaeg, Anne Hansen Ree, Jens Petter Berg, Reidun Øvstebø
N. meningitidis induces extensive gene expression changes in human monocytes, suggesting that complex networks of signaling pathways are activated during meningococcal sepsis. These effects are modulated by the anti-inflammatory cytokine interleukin-10 (IL-10). To further study changes in signal transduction suggested by mRNA data, we used kinase substrate arrays to identify composite kinase activities induced by lysates from a primary human monocyte model system. Cell lysates were prepared from monocytes treated with the following experimental conditions: 106 N...
2018: PloS One
Gerben Marsman, Helen von Richthofen, Ingrid Bulder, Florea Lupu, Jan Hazelzet, Brenda M Luken, Sacha Zeerleder
Circulating histones have been implicated as major mediators of inflammatory disease because of their strong cytotoxic effects. Histones form the protein core of nucleosomes; however, it is unclear whether histones and nucleosomes are equally cytotoxic. Several plasma proteins that neutralize histones are present in plasma. Importantly, factor VII-activating protease (FSAP) is activated upon contact with histones and subsequently proteolyzes histones. We aimed to determine the effect of FSAP on the cytotoxicity of both histones and nucleosomes...
December 12, 2017: Blood Advances
Rodrigo Siqueira Batista, Andréia Patrícia Gomes, Jorge Luiz Dutra Gazineo, Paulo Sérgio Balbino Miguel, Luiz Alberto Santana, Lisa Oliveira, Mauro Geller
Meningococcal disease is the acute infection caused by Neisseria meningitidis, which has humans as the only natural host. The disease is widespread around the globe and is known for its epidemical potential and high rates of lethality and morbidity. The highest number of cases of the disease is registered in the semi-arid regions of sub-Saharan Africa. In Brazil, it is endemic with occasional outbreaks, epidemics and sporadic cases occurring throughout the year, especially in the winter. The major epidemics of the disease occurred in Brazil in the 70's caused by serogroups A and C...
November 2017: Asian Pacific Journal of Tropical Medicine
Elena Capel, Jean-Philippe Barnier, Aldert L Zomer, Christine Bole-Feysot, Thomas Nussbaumer, Anne Jamet, Hervé Lécuyer, Daniel Euphrasie, Zoé Virion, Eric Frapy, Philippe Pélissier, Olivier Join-Lambert, Thomas Rattei, Sandrine Bourdoulous, Xavier Nassif, Mathieu Coureuil
Neisseria meningitidis is the causative agent of cerebrospinal meningitis and that of a rapidly progressing fatal septic shock known as purpura fulminans. Meningococcemia is characterized by bacterial adhesion to human endothelial cells of the microvessels. Host specificity has hampered studies on the role of blood vessels colonization in N. meningitidis associated pathogenesis. In this work, using a humanized model of SCID mice allowing the study of bacterial adhesion to human cells in an in vivo context we demonstrate that meningococcal colonization of human blood vessels is a prerequisite to the establishment of sepsis and lethality...
November 17, 2017: Virulence
Kine Nordheim, Ingunn Holmefoss Hovland, Bjørn Erik Kristiansen, Per Ivar Kaaresen, Trond Flaegstad
AIM: We examined children hospitalised for invasive meningococcal disease, a leading cause of paediatric sepsis, in Troms County, North Norway, from 1973 to 2016, including the epidemic in the 1970s and 1980s. METHODS: This study was a retrospective review of children under the age of 15 years who were hospitalised for meningococcal disease at the University Hospital of North Norway and Harstad Hospital. We studied hospital and bacteriological records to determine the incidence rates and phenotypes involved...
October 28, 2017: Acta Paediatrica
Unni Gopinathan, Reidun Øvstebø, Berit Sletbakk Brusletto, Ole Kristoffer Olstad, Peter Kierulf, Petter Brandtzaeg, Jens Petter Berg
BACKGROUND: Biological interpretation of DNA microarray data may differ depending on underlying assumptions and statistical tests of bioinformatics tools used. We used Gene Set Enrichment Analysis (GSEA) and Ingenuity Pathway Analysis (IPA) to analyze previously generated DNA microarray data from human monocytes stimulated with N. meningitidis and IL-10 ("the model system"), and with meningococcal sepsis plasma before and after immunodepletion of IL-10 ("the patient plasma system"). The objectives were to compare if the two bioinformatics methods resulted in similar biological interpretation of the datasets, and to identify whether GSEA provided additional insight compared with IPA about the monocyte host response to meningococcal activation...
October 27, 2017: BMC Immunology
Ilir Tolaj, Hamdi Ramadani, Murat Mehmeti, Hatixhe Gashi, Arbana Kasumi, Visar Gashi, Haki Jashari
PURPOSE: Prompt recognition and aggressive early treatment are the only effective measures against invasive meningococcal disease (IMD). Anti-inflammatory adjunctive treatment remains controversial and difficult to assess in patients with IMD. The purpose of this study was to evaluate the effect of dexamethasone (DXM) as adjunctive treatment in different clinical forms of IMD, and attempt to answer if DXM should be routinely used in the treatment of IMD. METHODS: In this non-interventional clinical study (NIS), 39 patients with meningococcal septicaemia with or without of meningitis were included, and compared regarding the impact of dexamethasone (DXM), as an adjunctive treatment, on the outcome of IMD...
June 2017: Medical Archives
María Elena Arnáiz-García, Ana María Arnáiz-García, Francisco Gutierrez-Diez, Juan Francisco Nistal, Jose María González-Santos, Ivana Pulitani, Carlos Amado-Diago, Javier Arnáiz
We report a dramatic case of meningococcal sepsis manifesting as purpura fulminans in an elderly diabetic woman. Hemodynamic instability and severe bilateral cutaneous lesions involving her hands and feet developed rapidly. Specific antibiotic therapy and the administration of inotropic and vasopressor drugs were initiated. The severity and extension of the cutaneous lesions (attributed to purpura fulminans) worsened because of the need for vasoconstrictors for the treatment of septic shock. Bilateral transmetatarsal and metacarpal amputations were required to stabilize the patient...
September 2017: Puerto Rico Health Sciences Journal
Jack Garland, Rexson Tse
Cardiopulmonary resuscitation (CPR) can create a range of unusual lesions and injuries, which may complicate forensic evaluation. Although potentially sinister findings, neck injury and conjunctival petechiae may also be seen in patients who have undergone CPR. We report a case of an individual with subcutaneous bruising and hemorrhage in the deep structures of the neck and florid conjunctival petechiae at autopsy that can be explained by cardiopulmonary resuscitation and meningococcal sepsis.
December 2017: Forensic Science, Medicine, and Pathology
H F Wunderink, I N Vlasveld, M J Knol, A van der Ende, E H R van Essen, E J Kuijper
BACKGROUND: Meningococcal disease usually presents as meningitis and/or septicaemia, but can also present as pneumonia or arthritis. Since 2000, a worldwide increase in meningococcal disease is reported which is caused by a new virulent clone of serogroup W (MenW:cc11). This subtype is more likely to give an atypical clinical presentation and results in high mortality rates. CASE DESCRIPTION: A 68-year-old woman with polymyalgia rheumatica, managed with prednisone, developed an acute gastrointestinal syndrome of nausea, diarrhoea, vomiting, fever and chills...
2017: Nederlands Tijdschrift Voor Geneeskunde
Hayley Lavender, Katy Poncin, Christoph M Tang
Neisseria meningitidis is a major cause of bacterial meningitis and sepsis worldwide. Capsular polysaccharide vaccines are available against meningococcal serogroups A, C, W and Y. More recently two protein based vaccines, Bexsero® and Trumenba®, have been licenced against meningococcal serogroup B strains; both vaccines contain meningococcal factor H binding protein (fHbp). fHbp is a surface exposed lipoprotein which binds the negative complement regulator, complement factor H (CFH), thereby inhibiting the alternative pathway of complement activation...
July 24, 2017: Infection and Immunity
Giovanni Di Caprio, Novella Carannante, Mariano Bernardo, Susanna Cuccurullo, Carlo Pallotto, Carlo Tascini
Neisseria meningitidis is a causative agent of community-acquired sepsis and meningitis in humans. These diseases are associated with high mortality and morbidity if treatment is not started promptly. The empiric antibiotic treatment depends on patient factors and local epidemiology. In the past years, an increased number meningococcal strain with reduced susceptibility to penicillin has also been described. We analysed the susceptibility pattern of 11 N. meningitidis strains isolated between 2013 and 2016...
December 2017: Journal of Chemotherapy
Tsitsi D Mubaiwa, Evgeny A Semchenko, Lauren E Hartley-Tassell, Christopher J Day, Michael P Jennings, Kate L Seib
Glycomics is a rapidly growing field that focuses on the structure and function of carbohydrates (glycans) in biological systems. Glycan interactions play a major role in infectious disease, at all stages of colonisation and disease progression. Neisseria meningitidis, the cause of meningococcal sepsis and meningitis, and Neisseria gonorrhoeae, which causes the sexually transmitted infection gonorrhoea, are responsible for significant morbidity and mortality worldwide. Neisseria meningitidis displays a range of surface glycosylations including capsule polysaccharide, lipooligosaccharide and O-linked glycoproteins...
July 31, 2017: Pathogens and Disease
Maria João Simões, Célia Bettencourt, Rosita De Paola, Maria Giuliani, Mariagrazia Pizza, Monica Moschioni, Jorge Machado
OBJECTIVE: Although the incidence of meningococcal disease has been declining over the past decade in Portugal MenB meningococci is still an important cause of meningitis and sepsis. The aim of this study was to estimate the strain coverage of the 4CMenB vaccine in Portugal in order to support health policies for prevention and control of meningococcal disease. METHODS: Since 2002 the clinical and laboratory notification of meningococcal disease is mandatory in Portugal...
2017: PloS One
Carolyn M Buckwalter, Elissa G Currie, Raymond S W Tsang, Scott D Gray-Owen
Background.: The multicomponent meningococcal serogroup B vaccine (4CMenB) is an outer membrane vesicle and recombinant protein-based vaccine licensed to protect against serogroup B meningococcal disease. It remains unknown whether this vaccine will prevent carriage or transmission, key aspects in long-term vaccine success and disease eradication. Methods.: Using a "humanized" transgenic mouse model of nasal colonization, we took a systematic approach to estimate the potential for carriage prevention against antigenically diverse Neisseria meningitidis strains and to compare this protection to an invasive meningococcal disease challenge model...
May 15, 2017: Journal of Infectious Diseases
Enrique Chacon-Cruz, Jorge Arturo Alvelais-Palacios, Jaime Alfonso Rodriguez-Valencia, Erika Zoe Lopatynsky-Reyes, Maria Luisa Volker-Soberanes, Rosa Maria Rivas-Landeros
Neonatal conjunctivitis is usually associated with vagina's infection by Chlamydia sp., N. gonorrhoeae, and/or other bacteria during delivery. Meningococcal neonatal conjunctivitis is an extremely rare disease. We report a case of neonatal meningococcal sepsis/conjunctivitis and asymptomatic carriage of N. meningitidis from both parents (vagina and nasopharynx). As part of our active surveillance for meningococcal disease at the Tijuana General Hospital (TGH), Mexico, we identified a 3-day-old newborn with meningococcal conjunctivitis and sepsis...
2017: Case Reports in Infectious Diseases
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