المؤلفون: Cristina Esteva, Mariona Fernández de Sevilla, Julio A. Vázquez, Carmen Muñoz-Almagro, Aleix Soler-Garcia, Antoni Noguera-Julian, Raquel Abad, Laia Alsina

المصدر: Journal of the Pediatric Infectious Diseases Society. 9:454-459

مصطلحات موضوعية: Male, Meningococcal Vaccines, Neisseria meningitidis, Serogroup B, medicine.disease_cause, 03 medical and health sciences, 0302 clinical medicine, Antigen, Risk Factors, 030225 pediatrics, medicine, Humans, 030212 general & internal medicine, Child, Immunodeficiency, biology, business.industry, Neisseria meningitidis, Infant, General Medicine, medicine.disease, Meningococcal Infections, Vaccination, Infectious Diseases, Spain, Child, Preschool, Pediatrics, Perinatology and Child Health, Immunology, biology.protein, Female, Bacterial antigen, Antibody, business, Recurrent bacterial meningitis, Meningitis

الوصف: Background Neisseria meningitidis serogroup B (MenB) is the most frequent cause of invasive meningococcal disease (IMD) in Spain. The multicomponent vaccine against MenB (4CMenB) was approved in Spain in January 2014. Methods We present 4 cases of children who developed MenB-associated IMD despite previous vaccination with 4CMenB. Extensive immunologic diagnostic work-up was performed in order to rule out any immunodeficiency. Also, molecular characterization of the MenB strain was conducted to determine whether bacterial antigens matched vaccine antigens. Results Among the 4 patients (2 girls), 2 had previous risk factors for IMD (recurrent bacterial meningitis of unknown origin and treatment with eculizumab). All patients developed meningitis, but only 2 developed septic shock; they were all cured without sequelae. No other primary or secondary immunodeficiencies were detected. MenB sequence type 213 was identified in 3 cases. With the exception of neisserial heparin-binding antigen peptide 465 present in 1 isolate, the rest of the isolated strains harbored vaccine antigen variants that did not match antigen variants included in the vaccine. Conclusions We present 4 children who developed MenB-associated IMD despite previous vaccination with 4CMenB. In 2 cases, the antibodies induced by 4CMenB likely were not effective against the isolated strains. A high level of suspicion for IMD seems advisable regardless of the patient’s vaccination history.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::c742e0b512c35d3ccaea7eef95202548Test
https://doi.org/10.1093/jpids/piz071Test

المؤلفون: Sofia Minguell, Julio A. Vázquez, Helena Pañella, A. Martínez, Angela Domínguez, Pere Godoy, Neus Cardeñosa, Neus Camps, Josep Álvarez

المصدر: Infection. 31:392-397

مصطلحات موضوعية: Adult, Male, Microbiology (medical), Pediatrics, medicine.medical_specialty, Time Factors, Adolescent, Meningococcal Vaccines, Meningitis, Meningococcal, medicine.disease_cause, Meningococcal disease, Polysaccharide Vaccine, Mass Vaccination, Risk Assessment, Age Distribution, Epidemiology, Case fatality rate, Prevalence, medicine, Humans, Serologic Tests, Registries, Sex Distribution, Child, Immunization Programs, business.industry, Neisseria meningitidis, Incidence (epidemiology), Polysaccharides, Bacterial, Infant, General Medicine, Middle Aged, medicine.disease, Meningococcal Infections, Survival Rate, Vaccination, Infectious Diseases, El Niño, Spain, Child, Preschool, Immunology, Female, business, Follow-Up Studies

الوصف: Background: The aim of this study was to investigate the clinical and epidemiological characteristics of meningococcal disease in Catalonia (Spain) after vaccination with the polysaccharide vaccine. Patients and Methods: Cases were collected by the Statutory Diseases Reporting System. Results: 176 cases were reported, an overall incidence of 2.9/100,000 persons/year. 60% of cases occurred during winter and spring. The case fatality rate was 6.3%. The highest age incidence was in children under 2 years of age (48/100,000 persons/year). Comparison of the cases detected by the Statutory Diseases Reporting System with those obtained by the Microbiological Reporting System shows that meningococcal disease surveillance in Catalonia was relatively complete (95.7%), with a positive predictive value of 66.3%. 115 cases (65%) were culture-confirmed with a rate of 1.9/100,000 persons/year. 86 (75%) cases were due to Neisseria meningitidis serogroup B and 21 to serogroup C (18%). Conclusion: Although infections due to serogroup C have decreased after mass vaccination with the polysaccharide vaccine, it is likely that the number of infections will decrease further with the conjugate meningococcal group C vaccine.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::c5760df86cc48f03ac8a0153401d8ce6Test
https://doi.org/10.1007/s15010-003-3121-6Test

المؤلفون: Carlos Rodrigo, Julio A. Vázquez, Jaume Canela, Francesc Marco, Juan Antonio Sáez-Nieto, Juliá González, Pere Domingo, Fernando A. Moraga-Llop, Julio Casal, M. Foz, Pedro Fernández-Viladrich, Joan A. Caylà, Nicolau Barquet

المصدر: JAMA. 278(6)

مصطلحات موضوعية: Adult, Male, Pediatrics, medicine.medical_specialty, Multivariate analysis, Adolescent, Population, Context (language use), Logistic regression, Meningococcal disease, Hemorrhagic Disorders, Severity of Illness Index, Hospitals, Urban, Central Nervous System Diseases, Outcome Assessment, Health Care, Medicine, Humans, Hospital Mortality, Prospective Studies, education, Child, Focal neurologic signs, Aged, education.field_of_study, Models, Statistical, business.industry, Infant, General Medicine, Odds ratio, Middle Aged, medicine.disease, Prognosis, Confidence interval, Anti-Bacterial Agents, Meningococcal Infections, Logistic Models, ROC Curve, Spain, Child, Preschool, Multivariate Analysis, Female, business, Algorithms

الوصف: CONTEXT Meningococcal disease is associated with significant morbidity and mortality. Development of a prognostic model based on clinical findings may be useful for identification and management of patients with meningococcal infection. OBJECTIVES To construct and validate a bedside model and scoring system for prognosis in meningococcal disease. DESIGN Prospective, population-based study. SETTING Twenty-four hospitals in the metropolitan area of Barcelona, Spain. PATIENTS A total of 907 patients with microbiologically proven meningococcal disease. Patients diagnosed with meningococcal disease from 1987 through 1990 were used to develop the prognostic model, and those diagnosed in 1991 and 1992 were used to validate it. OUTCOME MEASURES Clinical independent prognostic factors for mortality in meningococcal disease. The association between outcome and independent prognostic factors was determined by logistic regression analysis. A scoring system was constructed and tested using receiver operating characteristic curves. RESULTS Among 624 patients in the derivation set, 287 (46%) were male, the mean age was 12.4 years, and 34 patients (5.4%) died. Among 283 patients in the validation set, 124 (43.8%) were male, the mean age was 12.7 years, and 17 patients (6.0%) died. In multivariate analysis, independent predictors of death were hemorrhagic diathesis (odds ratio [OR], 101; 95% confidence interval [CI], 30-333), focal neurologic signs (OR, 25; 95% CI, 7-83), and age 60 years or older (OR, 10; 95% CI, 3-34), whereas receipt of adequate antibiotic therapy prior to admission was associated with reduced likelihood of death (OR, 0.09; 95% CI, 0.02-0.4). Hemorrhagic diathesis was scored with 2 points, presence of focal neurologic signs with 1 point, age of 60 years or older with 1 point, and preadmission antibiotic therapy was scored as -1. The clinical scores of -1, 0, 1, 2, and 3 or more points were associated with a probability of death of 0%, 2.3%, 27.3%, 73.3%, and 100%, respectively. CONCLUSIONS Hemorrhagic diathesis, focal neurologic signs, and age of 60 years or older were independent predictors of death in meningococcal disease, whereas receipt of adequate antibiotic therapy was associated with a more favorable prognosis. The scoring system presented is simple, is based on findings readily available at the bedside, and may be useful to help guide aggressive therapy.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::9bf1e30301d24f5cc994ca0c9ea837ffTest
https://pubmed.ncbi.nlm.nih.gov/9388080Test

المؤلفون: Julio A. Vázquez, J. Romero, Álvaro Pascual, C.M. del Castillo

المصدر: Clinical Microbiology and Infection. (9):964-965

مصطلحات موضوعية: Microbiology (medical), Bacteremia, Meningococcal Vaccines, Neisseria meningitidis, medicine.disease_cause, Neisseria meningitidis serogroup X, Microbiology, medicine, Humans, Typing, Serotyping, Child, Vaccines, Conjugate, biology, business.industry, Penicillin G, General Medicine, biology.organism_classification, medicine.disease, bacterial infections and mycoses, Virology, Anti-Bacterial Agents, Meningococcal Infections, Infectious Diseases, Spain, Multilocus sequence typing, Female, Neisseriaceae, business

الوصف: We describe an atypical presentation of bacteremia caused by N. meningitidis serogroup X. By multilocus sequence typing the isolate was characterized to the sequence type 2139, which is not related with the clonal complex recently isolated in Africa. Since 1984, only six cases of serogroup X N. meningitidis infections have been diagnosed in Spain. Nevertheless, after the application of the conjugated vaccine, attention should be paid to the emergence of infections caused by unusual serogroups of N. meningitidis.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::9adb72c41b7991ed980a3b2b9d58534fTest