Sporadic Meningococcal Disease in Adults: Results of a 5-Year Population-Based Study

Stephens, David S.

doi:10.7326/0003-4819-123-12-199512150-00007

Cited by 113 publications

(64 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The meningococcal strains used in this study were obtained from several geographic locations over a period of years and span the genetic diversity of N. meningitidis. Invasive isolates collected as part of a prospective population-based surveillance for meningococcal disease in metropolitan Atlanta, Ga., from 1988 to the present (25,31), serogroup A meningococcal isolates representing each clonal group (I to VIII) (kindly provided by Mark Achtman), and isolates obtained from the collection of the Centers for Disease Control and Prevention, Atlanta, Ga., were examined in this study. Nasopharyngeal isolates were provided from a study of asymptomatic carriers in the metropolitan Atlanta area (Stephens et al, unpublished).…”

Section: Methodsmentioning

confidence: 99%

exl , an Exchangeable Genetic Island in Neisseria meningitidis

et al. 2001

View full text Add to dashboard Cite

The genetic structure and evolution of a novel exchangeable meningococcal genomic island was defined for the important human pathogen Neisseria meningitidis. In 125 meningococcal strains tested, one of three unrelated nucleotide sequences, designated exl (exchangeable locus), was found between a gene required for heme utilization, hemO, and col, encoding a putative Escherichia coli collagenase homologue. The 5 boundary of each exl cassette was the stop codon of hemO, whereas the 3 boundary was delineated by a 33-bp repeat containing neisserial uptake sequences located downstream of col. One of the three alternative exl cassettes contained the meningococcal hemoglobin receptor gene, hmbR (exl3). In other meningococcal strains, hmbR was absent from the genome and was replaced by either a nucleotide sequence containing a novel open reading frame, exl2, or a cassette containing exl3. The proteins encoded by exl2 and exl3 had no significant amino acid homology to HmbR but contained six motifs that are also present in the lipoprotein components of the lactoferrin (LbpB), transferrin (TbpB), and hemoglobin-haptoglobin (HpuA) uptake systems. To determine the evolutionary relationships among meningococci carrying hmbR, exl2, or exl3, isolates representing 92 electrophoretic types were examined. hmbR was found throughout the population structure of N. meningitidis (genetic distance, >0.425), whereas exl2 and exl3 were found in clonal groups at genetic distances of <0.2. The commensal neisserial species were identified as reservoirs for all of the exl cassettes found in meningococci. The structure of these cassettes and their correlation with clonal groups emphasize the extensive gene pool and frequent horizontal DNA transfer events that contribute to the evolution and virulence of N. meningitidis.

show abstract

Section: Methodsmentioning

confidence: 99%

exl , an Exchangeable Genetic Island in Neisseria meningitidis

et al. 2001

View full text Add to dashboard Cite

show abstract

“…Variation in the plasminogen-activator inhibitor 1 (PAI-1) gene has been associated with increased susceptibility to meningococcal septic shock, but not an overall risk of meningococcal disease (382). In studies in Atlanta, Ga., and Maryland, underlying medical conditions were uncommon among adolescents and young adults but frequent among persons over 24 years old (168,331). Predisposing conditions in those studies included human immunodeficiency virus infection, congestive heart failure, malignancy, diabetes mellitus, organ transplantation, and corticosteroid use.…”

Section: Risk Factors For Infectionmentioning

confidence: 99%

“…Black race and lower socioeconomic status have been associated with an increased risk, but whether race per se actually increases the risk is doubtful (163,184,299). Functional or anatomic asplenia; deficiencies or genetic polymorphisms in components of the innate immune system, such as terminal complement components, properdin, Toll-like receptor 4, and mannose-binding lectin; and human immunodeficiency virus infection have all been associated with an increased risk (94,103,119,175,203,271,306,327,331). Variation in the plasminogen-activator inhibitor 1 (PAI-1) gene has been associated with increased susceptibility to meningococcal septic shock, but not an overall risk of meningococcal disease (382).…”

Section: Risk Factors For Infectionmentioning

confidence: 99%

Prospects for Vaccine Prevention of Meningococcal Infection

2006

View full text Add to dashboard Cite

SUMMARY Neisseria meningitidis is the leading cause of bacterial meningitis in the United States and worldwide. A serogroup A/C/W-135/Y polysaccharide meningococcal vaccine has been licensed in the United States since 1981 but has not been used universally outside of the military. On 14 January 2005, a polysaccharide conjugate vaccine that covers meningococcal serogroups A, C, W-135, and Y was licensed in the United States for 11- to 55-year-olds and is now recommended for the routine immunization of adolescents and other high-risk groups. This review covers the changing epidemiology of meningococcal disease in the United States, issues related to vaccine prevention, and recommendations on the use of the new vaccine.

show abstract

“…An increased risk of IMD was observed for HIV-infected individuals in a prospective, active, population and laboratory based surveillance study over 5 years (1988-1993) in Atlanta (RR = 23.8; 95 % CI: 7.4-74.7) [99]. Antiretroviral therapy during this period was not yet widely used.…”

Section: Risk Of Imd In Persons With Hiv Infectionmentioning

confidence: 99%