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Meningococcal chest infections in a general hospital
B I Davies1, L Spanjaard, J Dankert
1Department of Medical Microbiology, De Wever Ziekenhuis, Heerlen, The Netherlands.
Abstract:
In the course of one calendar year (1989-1990), 46 specimens of respiratory secretions (from 44 patients) cultured in the microbiology department of a large district general hospital in The Netherlands were found to yield Neisseria meningitidis. Twenty-eight of the 46 samples yielded pure cultures of meningococci and 18 yielded other recognised respiratory pathogens as well. Only one patient had pneumonia, whereas 19 had acute respiratory infections and 18 acute purulent exacerbations of chronic bronchitis. The remaining patients, who had a variety of symptoms, all had purulent sputum. Only 8 of the 44 patients were under 40 years of age; 21 were aged more than 60 years. Serological grouping and subtyping showed a predominance of group B strains (in 24 of 44 patients) and 13 strains were non-groupable. The importance of recognising or overlooking meningococci in cultures of respiratory secretions is discussed.
Insights
Neisseria meningitidis was identified in respiratory secretions from 44 patients over one year. This finding highlights the importance of recognizing meningococci in respiratory cultures, especially in older adults with purulent sputum.
Area of Science:
- Clinical Microbiology
- Infectious Diseases
- Respiratory Medicine
Background:
- Neisseria meningitidis is primarily known as a cause of meningitis and sepsis.
- Its role as a respiratory pathogen, particularly in non-epidemic settings, is less understood.
- The presence of meningococci in respiratory secretions can be overlooked or misidentified.
Purpose of the Study:
- To determine the frequency of Neisseria meningitidis isolation from respiratory secretions.
- To characterize the clinical presentations and patient demographics associated with meningococcal respiratory isolates.
- To discuss the clinical significance of identifying meningococci in respiratory cultures.
Main Methods:
- Retrospective analysis of respiratory secretion cultures from a district general hospital over a one-year period (1989-1990).
- Identification and characterization of Neisseria meningitidis isolates.
- Review of patient clinical data, including symptoms, diagnoses, and age.
Main Results:
- Neisseria meningitidis was isolated from 46 respiratory specimens (44 patients).
- Predominant isolates were serogroup B (24/44 patients).
- Affected patients were predominantly older adults (>60 years) presenting with acute respiratory infections, purulent exacerbations of chronic bronchitis, or purulent sputum.
Conclusions:
- Neisseria meningitidis can be found in respiratory secretions, particularly in older individuals with purulent respiratory conditions.
- The study emphasizes the need for microbiology laboratories to recognize meningococci in respiratory cultures.
- Failure to identify meningococci may lead to missed diagnoses and impact patient management.