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Meningococcal sepsis

Navin P Boeddha, Gertjan J Driessen, Marjon H Cnossen, Jan A Hazelzet, Marieke Emonts
OBJECTIVE: To study whether the circadian variation of plasminogen-activator-inhibitor-1 (PAI-1) levels, with high morning levels, is associated with poor outcome of children with meningococcal sepsis presenting in the morning hours. DESIGN: Retrospective analysis of prospectively collected clinical and laboratory data. SETTING: Single center study at Erasmus MC-Sophia Children's Hospital, Rotterdam, the Netherlands. SUBJECTS: 184 patients aged 3 weeks to 18 years with meningococcal sepsis...
2016: PloS One
Xiao Wang, Ding Zhang, Mikael Sjölinder, Yi Wan, Hong Sjölinder
CD46, a membrane cofactor expressed on all nucleated human cells, plays an essential role in suppressing autoimmune reactions and protecting host cells from complement-mediated attack. Human transgenic CD46 homozygous mice (CD46(+/+) ) are prone to lethal sepsis upon infection with Neisseria meningitidis (N. meningitidis). However, the underlying mechanisms are poorly understood. Here, we determined that CD46(+/+) mice produce large numbers of M1 type macrophages with enhanced surface expression of MHC II and production of pro-inflammatory mediators such as IL-6, TNF, IL-12, and IL-1β In the presence of M-CSF or GM-CSF, CD46 signaling enhances monocyte-macrophage differentiation...
October 28, 2016: European Journal of Immunology
Jack Garland, Rexson Tse, Allan D Cala
Sepsis remains a difficult diagnosis at autopsy. With respect to meningococcal sepsis, a timely and definite diagnosis is critical because it requires public health department notification and the administration of prophylactic antibiotics to potential close contacts. A previous case series, in which both blood and cerebrospinal fluid were unavailable, suggested vitreous humor polymerase chain reaction might be a useful test in diagnosing meningococcal sepsis. We describe a fatal case of meningococcal sepsis where Neisseria meningitidis was detected in both vitreous humor and blood polymerase chain reaction, in addition to positive blood cultures...
December 2016: American Journal of Forensic Medicine and Pathology
Cilian Ó Maoldomhnaigh, Richard J Drew, Patrick Gavin, Mary Cafferkey, Karina M Butler
BACKGROUND: In 1999, invasive meningococcal disease was hyperendemic in Ireland at 14.75/100 000 population, with 60% group B and 30% group C diseases. National sepsis guidelines and meningococcal C vaccines were introduced in 2000. Despite a spontaneous decline in group B infection, invasive meningococcal disease remains a leading cause of sepsis. This study characterises the epidemiology of invasive meningococcal disease in children in Ireland since the introduction of meningococcal C vaccine and reviews its clinical presentation, hospital course and outcome in anticipation of meningococcal B vaccine introduction...
August 26, 2016: Archives of Disease in Childhood
Matthias Vossen, Dieter Mitteregger, Christoph Steininger
Neisseria meningitidis remains the most important cause of bacterial meningitis worldwide, particularly in children and young adults. The second most common and a potentially severe end-organ manifestation of invasive meningococcal disease (excluding systemic sepsis) is meningococcal pneumonia. It occurs in between 5% and 15% of all patients with invasive meningococcal disease and is thus the second most common non-systemic end-organ manifestation. To establish the diagnosis requires a high level of clinical awareness - the incidence is therefore very likely underreported and underestimated...
August 17, 2016: Vaccine
Maria Ceci, Margherita Conrieri, Irene Raffaldi, Veronica Pagliardini, Antonio Francesco Urbino
We report a case of acute hemorrhagic edema of infancy (AHEI) occurred in an 11-month-old male infant after upper respiratory tract infection. The onset was dramatic with petechiae, ecchymosis, and annular, nummular, or targetoid purpuric plaques on the extremities, face, and ears. Acute hemorrhagic edema of infancy is a benign form of leukocytoclastic vasculitis that typically affects children between 4 and 24 months of age. The etiology remains still unknown. The potential triggers of AHEI include preceding bacterial or viral infections, immunizations, and drugs...
May 30, 2016: Pediatric Emergency Care
Rikhav P Gala, Martin D'Souza, Susu M Zughaier
Neisseria meningitidis is a leading cause of bacterial meningitis and sepsis and its capsular polysaccharides (CPS) are a major virulence factor in meningococcal infections and form the basis for serogroup designation and preventive vaccines. We have formulated a novel meningococcal nanoparticulate vaccine formulation that does not require chemical conjugation, but encapsulates meningococcal CPS polymers in a biodegradable material that slowly release antigens, thereby has antigen depot effect to enhance antigenicity...
June 14, 2016: Vaccine
A Audemard-Verger, E Descloux, D Ponard, A Deroux, B Fantin, C Fieschi, M John, A Bouldouyre, L Karkowsi, G Moulis, H Auvinet, F Valla, C Lechiche, B Davido, M Martinot, C Biron, F Lucht, N Asseray, A Froissart, R Buzelé, A Perlat, D Boutboul, V Fremeaux-Bacchi, S Isnard, B Bienvenu
Complement system is a part of innate immunity, its main function is to protect human from bacterial infection. As genetic disorders, complement deficiencies are often diagnosed in pediatric population. However, complement deficiencies can also be revealed in adults but have been poorly investigated. Herein, we describe a case series of infections revealing complement deficiency in adults to study clinical spectrum and management of complement deficiencies.A nationwide retrospective study was conducted in French university and general hospitals in departments of internal medicine, infectious diseases enrolling patients older than 15 years old who had presented at least one infection leading to a complement deficiency diagnosis...
May 2016: Medicine (Baltimore)
M Thimmesch, E Bodart, P Gavage, J-P Misson, J Frère
INTRODUCTION: Neisseria meningitidis is a Gram-negative bacteria that can be highly pathogenic in humans and responsible for life-threatening and acute diseases. In a few cases, it can lead to an atypical form of sepsis-acute, subacute, or chronic-which, even if progression is slower, may carry the same risks for patients as conventional acute forms. CASES: Case 1 presented with recurrent fever, polyarthralgia, and generalized macular rash. Case 2 had fever for the previous 10days with neck pain and macular rash...
June 2016: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
Fatemeh Yarian, Mojgan Bandehpour, Negar Seyed, Bahram Kazemi
BACKGROUND AND OBJECTIVE: Neisseria meningitidis is a leading cause of meningitis and sepsis worldwide. The factor H binding protein (fHBP) is a key virulence factor of Neisseria meningitidis that is able to selectively bind to human factor H, the key regulator of the alternative complement pathway, which it has important implications for meningococcal pathogenesis and vaccine design. The aims of present research were cloning, expression, purification of fHbp and confirmation of the interaction between serum factor H (fH) and produced factor H binding protein...
February 2016: Iranian Journal of Microbiology
F McGill, R S Heyderman, B D Michael, S Defres, N J Beeching, R Borrow, L Glennie, O Gaillemin, D Wyncoll, E Kaczmarski, S Nadel, G Thwaites, J Cohen, N W S Davies, A Miller, A Rhodes, R Read, T Solomon
No abstract text is available yet for this article.
June 2016: Journal of Infection
Raffaella Rossi, Monica Konar, Peter T Beernink
Neisseria meningitidis causes cases of bacterial meningitis and sepsis. Factor H binding protein (FHbp) is a component of two licensed meningococcal serogroup B vaccines. FHbp recruits the complement regulator factor H (FH) to the bacterial surface, which inhibits the complement alternative pathway and promotes immune evasion. Binding of human FH impairs the protective antibody responses to FHbp, and mutation of FHbp to decrease binding of FH can increase the protective responses. In a previous study, we identified two amino acid substitutions in FHbp variant group 2 that increased its thermal stability by 21°C and stabilized epitopes recognized by protective monoclonal antibodies (MAbs)...
June 2016: Infection and Immunity
Shimon Takada, Sho Fujiwara, Toshiya Inoue, Yuki Kataoka, Yoshiro Hadano, Kentaro Matsumoto, Kyoko Morino, Taro Shimizu
We mainly refer to the acute setting of meningococcemia. Meningococcemia is an infection caused by Neisseria meningitidis, which has 13 clinically significant serogroups that are distinguishable by the structure of their capsular polysaccharides. N. meningitidis, also called meningococcus, is a Gram-negative, aerobic, diplococcus bacterium. The various consequences of severe meningococcal sepsis include hypotension, disseminated intravascular coagulation (DIC), multiple organ failure, and osteonecrosis due to DIC...
2016: Internal Medicine
Irene Rivero-Calle, Lucia Vilanova-Trillo, Jacobo Pardo-Seco, Lidia Blanco Salvado, Laura Illade Quinteiro, Federico Martinon-Torres
BACKGROUND: Invasive meningococcal disease remains a rare infectious disease not only with high mortality but also with important morbidity. Until recently no universal vaccine existed against serogroup B, which explains most of the cases in settings like Europe. The objective of this study was to analyze the clinical course and sequelae of meningococcal disease in Spain. METHODS: Retrospective review of all children younger than 15 years admitted to any of the 36 hospitals in the MENDICOS Spanish network (www...
April 2016: Pediatric Infectious Disease Journal
Aimee Tan, Dorothea M C Hill, Odile B Harrison, Yogitha N Srikhanta, Michael P Jennings, Martin C J Maiden, Kate L Seib
Neisseria meningitidis is a human-specific bacterium that varies in invasive potential. All meningococci are carried in the nasopharynx, and most genotypes are very infrequently associated with invasive meningococcal disease; however, those belonging to the 'hyperinvasive lineages' are more frequently associated with sepsis or meningitis. Genome content is highly conserved between carriage and disease isolates, and differential gene expression has been proposed as a major determinant of the hyperinvasive phenotype...
February 12, 2016: Scientific Reports
F McGill, R S Heyderman, B D Michael, S Defres, N J Beeching, R Borrow, L Glennie, O Gaillemin, D Wyncoll, E Kaczmarski, S Nadel, G Thwaites, J Cohen, N W S Davies, A Miller, A Rhodes, R C Read, T Solomon
Bacterial meningitis and meningococcal sepsis are rare conditions with high case fatality rates. Early recognition and prompt treatment saves lives. In 1999 the British Infection Society produced a consensus statement for the management of immunocompetent adults with meningitis and meningococcal sepsis. Since 1999 there have been many changes. We therefore set out to produce revised guidelines which provide a standardised evidence-based approach to the management of acute community acquired meningitis and meningococcal sepsis in adults...
April 2016: Journal of Infection
D Morales, L Moreno, M Herranz, E Bernaola, I Martínez-Baz, J Castilla
INTRODUCTION: Systematic childhood vaccination against meningococcus C has had a considerable impact on meningococcal invasive disease (MID). The aim of this study is to perform an analysis on the epidemiology, the clinical features, and the factors associated with a worse prognosis of MID, in the era of a meningococcal C vaccine. MATERIAL AND METHODS: The study included confirmed cases of MID in children less than 15 years of age in Navarra, Spain, between 2008 and 2014...
January 18, 2016: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
Fariza Shams, Neil J Oldfield, Si Kei Lai, Sarfraz A Tunio, Karl G Wooldridge, David P J Turner
Neisseria meningitidis is a leading cause of fatal sepsis and meningitis worldwide. As for commensal species of human neisseriae, N. meningitidis inhabits the human nasopharynx and asymptomatic colonization is ubiquitous. Only rarely does the organism invade and survive in the bloodstream leading to disease. Moonlighting proteins perform two or more autonomous, often dissimilar, functions using a single polypeptide chain. They have been increasingly reported on the surface of both prokaryotic and eukaryotic organisms and shown to interact with a variety of host ligands...
April 2016: MicrobiologyOpen
Mustapha M Mustapha, Jane W Marsh, Mary G Krauland, Jorge O Fernandez, Ana Paula S de Lemos, Julie C Dunning Hotopp, Xin Wang, Leonard W Mayer, Jeffrey G Lawrence, N Luisa Hiller, Lee H Harrison
Neisseria meningitidis is a leading bacterial cause of sepsis and meningitis globally with dynamic strain distribution over time. Beginning with an epidemic among Hajj pilgrims in 2000, serogroup W (W) sequence type (ST) 11 emerged as a leading cause of epidemic meningitis in the African 'meningitis belt' and endemic cases in South America, Europe, Middle East and China. Previous genotyping studies were unable to reliably discriminate sporadic W ST-11 strains in circulation since 1970 from the Hajj outbreak strain (Hajj clone)...
October 2015: EBioMedicine
Monica Konar, Rolando Pajon, Peter T Beernink
Factor H binding protein (FHbp) is part of two vaccines recently licensed for prevention of sepsis and meningitis caused by serogroup B meningococci. FHbp is classified in three phylogenic variant groups that have limited antigenic cross-reactivity, and FHbp variants in one of the groups have low thermal stability. In the present study, we replaced two amino acid residues, R130 and D133, in a stable FHbp variant with their counterparts (L and G) from a less stable variant. The single and double mutants decreased thermal stability of the amino- (N-) terminal domain compared with the wild-type protein as measured by scanning calorimetry...
December 1, 2015: Proceedings of the National Academy of Sciences of the United States of America
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