Related Experiment Videos
Invasive meningococcal disease: patient and strain characteristics set new challenge for prevention and control
G Paret1, N Keller, A Barzilai
1Pediatric ICU, Chaim Sheba Medical Center, Tel Aviv University Sackler School of Medicine, Tel-Hashomer, Israel.
Abstract:
Differences in the course of invasive meningococcal disease, in prevalence, case-to-carrier ratio, geographical pattern, age distribution and antibiotic resistance have been related to major serogroups and their serotypes. The relationships between Neisseria meningitidis serogroups and clinical manifestation, outcome and patient characteristics are assessed. All hospitalized patients in six major hospitals in central Israel with a verified meningococcal disease during 1990-1994 were included (n = 66). Their personal and clinical data and the results of bacteriological and serological tests of their blood and cerebrospinal fluid (CSF) were recorded. Meningococci were isolated from both blood and CSF, from blood alone, and from CSF alone in 60.6%, 18.2%, and 21.2% of the cases, respectively. The highest proportion of isolations were from infants < 1 year (34.8%), followed by children aged 1 to 5 years (25.8%). Serogroup B prevailed in 62.1%, while groups C and W135 accounted for 28.8% and 9.1%, respectively. Serogroup B predominated in children < 1 year, while in patients aged 5-22 years, C strains were the major pathogen (P < 0.001). Serogroup B accounted for 93% of the cases of meningitis, 58% of meningococcemia and 42% of fulminant meningococcemia, while group C strains were the major cause of fulminant meningococcemia (50%). The overall case fatality rate was 7.6%: fulminant meningococcemia 8.3%, and meningococcemia 10%. It was concluded that N. meningitidis group C continues to account for almost a third of the cases of meningococcal disease and is the major cause of fulminant meningococcemia.
Insights
Invasive meningococcal disease (IMD) shows variations based on Neisseria meningitidis serogroups. Group C strains are a significant cause of severe IMD, particularly fulminant meningococcemia.
Area of Science:
- Microbiology
- Epidemiology
- Infectious Diseases
Background:
- Invasive meningococcal disease (IMD) course varies by Neisseria meningitidis serogroup.
- Serogroup-specific differences impact prevalence, clinical presentation, and outcomes.
Purpose of the Study:
- To assess relationships between N. meningitidis serogroups and clinical manifestations, patient characteristics, and outcomes.
- To analyze serogroup distribution in IMD cases in central Israel.
Main Methods:
- Retrospective study of 66 hospitalized IMD patients in central Israel (1990-1994).
- Data collected included clinical details, bacteriological, and serological test results from blood and cerebrospinal fluid (CSF).
Main Results:
- Serogroup B was predominant (62.1%), especially in infants (<1 year).
- Serogroup C (28.8%) was the major pathogen in patients aged 5-22 years and the leading cause of fulminant meningococcemia (50%).
- Serogroup B caused most meningitis cases (93%), while Group C caused 50% of fulminant cases.
Conclusions:
- N. meningitidis group C remains a significant cause of IMD, accounting for nearly a third of cases.
- Group C strains are disproportionately associated with severe, life-threatening presentations like fulminant meningococcemia.