Which contacts of patients with meningococcal disease carry the pathogenic strain of Neisseria meningitidis? A population based study

Kristiansen, Bjørn-Erik; Tveten, Yngvar; Jenkins, Andrew

doi:10.1136/bmj.317.7159.621

Cited by 41 publications

(18 citation statements)

References 17 publications

(19 reference statements)

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“…Contact with hospitals and other institutional settings did not occur more frequently in cases. Experience with other organisms would suggest that transmission in the community is most likely to occur in household settings [14,15]. Although the number of individuals in case households was higher than in controls this difference was not statistically significant and there was no difference in overcrowding as measured by the number of individuals per bedroom in the two groups.…”

Section: Settingscontrasting

confidence: 48%

Fusidic acid resistance in community isolates of methicillin susceptible Staphylococcus aureus and the use of topical fusidic acid: a retrospective case–control study

Mason¹,

Howard²

2004

International Journal of Antimicrobial Agents

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Resistance to fusidic acid among community methicillin susceptible Staphylococcus aureus (MSSA) isolates in the United Kingdom and prescriptions for fusidic acid have both doubled over the past 6 years. A retrospective case-control study was undertaken to test the hypothesis that the use of topical fusidic acid is associated with the isolation of resistant organisms. A statistically significant association was found between fusidic acid resistance in MSSA isolates and exposure to topical fusidic acid (odds ratio: 2.77, 95% CI 1.01-7.93, P = 0.027). This study demonstrates for the first time an association between the use of topical fusidic acid and resistance at the individual patient level and supports the hypothesis that the observed increase in resistance is causally associated with the increased use of topical fusidic acid.

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Section: Settingscontrasting

confidence: 48%

Fusidic acid resistance in community isolates of methicillin susceptible Staphylococcus aureus and the use of topical fusidic acid: a retrospective case–control study

Mason¹,

Howard²

2004

International Journal of Antimicrobial Agents

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“…While observational studies have shown that chemoprophylaxis of household contacts of persons with IMD to eradicate nasopharyngeal carriage of Neisseria meningitidis reduces the risk of subsequent cases in those contacts [7,8], this has not been shown for contacts in other settings, although there are numerous reports on the occurrence of secondary cases in pre-school [2][3][4][5][9][10][11][12][13][14][15][16][17], school [2-5, 11, 17-30], and university or college settings [2,[31][32][33][34][35]. Asymptomatic transmission of the index strain has also been shown in these settings, although to a lesser extent than in household settings [10,16,36,37]. A survey of 12 European countries performed in 2006 revealed variation in policy regarding chemoprophylaxis for contacts between countries as well as within countries over time [38].…”

Section: Introductionmentioning

confidence: 99%

What is the evidence for giving chemoprophylaxis to children or students attending the same preschool, school or college as a case of meningococcal disease?

Hellenbrand

Hanquet²,

Heuberger

et al. 2011

Epidemiol. Infect.

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SUMMARYWe performed a systematic literature review to assess the effectiveness of chemoprophylaxis for contacts of sporadic cases of invasive meningococcal disease (IMD) in educational settings. No studies directly compared IMD risk in contacts with/without chemoprophylaxis. However, compared to the background incidence, an elevated IMD risk was identified in settings without a general recommendation for chemoprophylaxis in pre-schools [pooled risk difference (RD) 58 . 2/10 5 , 95 % confidence interval (CI) 27 . 3-89 . 0] and primary schools (pooled RD 4 . 9/10 5 , 95% CI 2 . 9-6 . 9) in the y30 days after contact with a sporadic IMD case, but not in other educational settings. Thus, limited but consistent evidence suggests the risk of IMD in pre-school contacts of sporadic IMD cases is significantly increased above the background risk, but lower than in household contacts (pooled RD for household contacts with no chemoprophylaxis vs. background incidence : 480 . 1/10 5 , 95 % CI 321 . 5-639 . 9). We recommend chemoprophylaxis for pre-school contacts depending on an assessment of duration and closeness of contact.

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“…Humans are the only natural host for meningococci, and healthy carriers are of primary importance in disease transmission (11). During epidemics, contacts of infected individuals tend to carry the epidemic strains (18), and the carriage rate is much higher in close contacts such as family members (10) or among individuals within institutions (24). Nasopharyngeal carriage in closed or semiclosed institutions such as universities may rise to Ͼ50% (4), which results in high meningococcal transmission rates (32).…”

mentioning

confidence: 99%

Development of Immunity to Serogroup B Meningococci during Carriage of Neisseria meningitidis in a Cohort of University Students

et al. 2004

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Understanding the basis of protective immunity is a key requirement for the development of an effective vaccine against infection with Neisseria meningitidis of serogroup B. We have conducted a longitudinal study into the dynamics of meningococcal acquisition and carriage in first-year university students. The detection of carriage of serogroup B meningococci correlated with an increase in detection of serum bactericidal activity (SBA) against both colonizing and heterologous serogroup B strains. Once induced, SBA remained high throughout the study. Although students showed increases in antibodies reactive with capsular polysaccharide and lipopolysaccharide (LPS), these antibody responses were transitory, and their decline was not accompanied by a corresponding decline in SBA. In contrast, there was a significant correlation between the presence of antibodies to the PorA outer membrane protein and SBA against both homologous and heterologous strains. SBA induced by a PorA-negative mutant confirmed the contribution of PorA to heterologous activity. Increases in SBA against a range of serogroup B strains were also observed in students in whom no meningococcal carriage was detected. This heterologous protection could not be associated with the presence of antibodies reacting with capsule, LPS, PorA, PorB, Rmp, Opa, Opc, or pilin, demonstrating that other, as yet unidentified, antigens contribute to the development of immunity to serogroup B meningococci. Identification of such antigens with the ability to induce an effective cross-reactive bactericidal response to a range of strains would be a major step in the production of a universally effective vaccine against infections caused by serogroup B meningococci.

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Which contacts of patients with meningococcal disease carry the pathogenic strain of Neisseria meningitidis? A population based study

Cited by 41 publications

References 17 publications

Fusidic acid resistance in community isolates of methicillin susceptible Staphylococcus aureus and the use of topical fusidic acid: a retrospective case–control study

Fusidic acid resistance in community isolates of methicillin susceptible Staphylococcus aureus and the use of topical fusidic acid: a retrospective case–control study

What is the evidence for giving chemoprophylaxis to children or students attending the same preschool, school or college as a case of meningococcal disease?

Development of Immunity to Serogroup B Meningococci during Carriage of Neisseria meningitidis in a Cohort of University Students

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