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Respiratory viruses and mycoplasma as cofactors for epidemic group A meningococcal meningitis
P S Moore1, J Hierholzer, W DeWitt
1Division of Bacterial Diseases, Centers for Disease Control, Atlanta, GA 30333.
Abstract:
To investigate the role of coincident respiratory viral and mycoplasmal agents in the pathogenesis of meningococcal meningitis, we performed a matched case-control study of 62 patients with group A meningococcal meningitis during an epidemic in Chad. Case patients were more likely than controls to have nasal colonization or infection with respiratory viruses and Mycoplasma species (matched odds ratio, 23; 95% confidence interval, 3.1 to 170). Respiratory pathogens were found more commonly in older patients with meningitis (odds ratios were 2.9 for children under age 5 years and 46.5 in those over age 15 years), consistent with the increasing risk of meningitis with age during epidemics. In controls, the presence of respiratory pathogens increased the risk of upper-respiratory-tract symptoms but did not significantly increase meningococcal carriage.
Insights
Co-infection with respiratory viruses and Mycoplasma species significantly increases the risk of developing meningococcal meningitis, particularly in older individuals. This finding highlights the role of these pathogens in meningitis pathogenesis.
Area of Science:
- Epidemiology
- Infectious Diseases
- Microbiology
Background:
- Meningococcal meningitis remains a significant public health concern, especially during epidemics.
- The role of co-infections with common respiratory pathogens in the pathogenesis of meningococcal meningitis is not fully understood.
Purpose of the Study:
- To investigate the association between respiratory viral and mycoplasmal agents and the development of meningococcal meningitis.
- To determine if age influences the risk of meningitis in the presence of these co-infections.
Main Methods:
- A matched case-control study was conducted with 62 patients diagnosed with group A meningococcal meningitis during an epidemic in Chad.
- Nasal colonization and infection with respiratory viruses and Mycoplasma species were assessed in cases and controls.
Main Results:
- Patients with meningococcal meningitis were significantly more likely to have nasal colonization or infection with respiratory viruses and Mycoplasma species (OR, 23; 95% CI, 3.1 to 170).
- The prevalence of respiratory pathogens increased with age, with higher odds ratios observed in older individuals (OR, 46.5 for those over 15 years).
- In controls, respiratory pathogens increased the risk of upper-respiratory-tract symptoms but did not significantly increase meningococcal carriage.
Conclusions:
- Co-infection with respiratory viruses and Mycoplasma species is strongly associated with the pathogenesis of meningococcal meningitis.
- Age is a critical factor, with older individuals exhibiting a substantially higher risk of meningitis when coinfected with these pathogens.