scholarly journals Doença Meningocócica Invasiva: Aplicação do Base Excess and Platelets Score numa Unidade de Cuidados Intensivos Pediátricos Portuguesa

2015 ◽  
Vol 28 (3) ◽  
pp. 342
Author(s):  
Luis Martins ◽  
Patrícia Mação ◽  
Carla Pinto ◽  
Teresa Dionísio ◽  
Andrea Dias ◽  
...  
Keyword(s):  
Organ Failure ◽  
Meningococcal Disease ◽  
Base Excess ◽  
Invasive Meningococcal Disease ◽  
Meningococcal Infection ◽  
Related Factors ◽  
Mortality And Morbidity ◽  
Multi Organ Failure ◽  
Risk Of Mortality ◽  
Excess Base

<strong>Introduction:</strong> Meningococcal infection has a high mortality and morbidity. Recently a new prognostic scoring system was developed for paediatric invasive meningococcal disease, based on platelet count and base excess – base excess and platelets score. The main objective of this study was to evaluate the accuracy of base excess and platelets score to predict mortality in children admitted to intensive care due to invasive meningococcal disease.<br /><strong>Material and Methods:</strong> Observational study, with retrospective data collection, during a 13.5 years period (01/2000 to 06/2013). Mortality by invasive meningococcal disease and related factors (organ dysfunction and multi-organ failure) were analysed. The base excess and platelets score was calculated retrospectively, to evaluate its accuracy in predicting mortality and compared with Paediatric Risk of Mortality and Paediatric Index of Mortality2.<br /><strong>Results:</strong> Were admitted 76 children with invasive meningococcal disease. The most frequent type of dysfunction was cardiovascular (92%), followed by hematologic (55%). Of the total, 47 patients (62%) had criteria for multi-organ failure. The global mortality was 16%. Neurologic and renal dysfunction showed the strongest association with mortality, adjusted odds ratio 315 (26 - 3 804) and 155 (20 - 1 299).<br />After application of receiver operating characteristic curves, Base Excess and Platelets score had an area under curve of 0.81, Paediatric Index of Mortality2 of 0.91 and Paediatric Risk of Mortality of 0.96.<br /><strong>Discussion: </strong>The Base Excess and Platelets score showed good accuracy, although not as high as Paediatric Risk of Mortality or<br />Paediatric Index of Mortality2.<br /><strong>Conclusions:</strong> The Base Excess and Platelets score may be useful tool in invasive meningococcal disease because is highly sensitive and specific and is objectively measurable and readily available at presentation.

scholarly journals Doença Invasiva Meningocócica em Cuidados Intensivos Pediátricos

2014 ◽  
Vol 27 (3) ◽  
pp. 291 ◽  
Author(s):  
Patrícia Mação ◽  
Gustavo Januário ◽  
Sofia Ferreira ◽  
Andrea Dias ◽  
Teresa Dionísio ◽  
...  
Keyword(s):  
Intensive Care ◽  
Organ Failure ◽  
Meningococcal Disease ◽  
Multiple Organ ◽  
Invasive Meningococcal Disease ◽  
Prognostic Scores ◽  
Meningococcal Infection ◽  
Meningococcal Infections ◽  
Mortality And Morbidity ◽  
Secondary Transport

<strong>Introduction:</strong> Meningococcal infection has a high mortality and morbidity in children. Aggressive initial shock approach, early referral, secondary transport and vaccination are potential factors with impact in reducing its mortality. Objectives were to characterize children admitted to intensive care due to invasive meningococcal disease, to evaluate their prognostic scores and mortality.<br /><strong>Material and Methods:</strong> Observational study, with retrospective data collection. Two periods were created according to the year of admission (A: 2000-2005 and B: 2006-2011). Prognostic parameters, organ failure and mortality rates were compared in these groups.<br /><strong>Results:</strong> 70 children were admitted with invasive meningococcal disease. When compared with other causes of admission, a decrease in the number of admissions due to invasive meningococcal disease was observed (period A: 3.4%; period B: 1.5%; p = 0.001). The presence of meningitis was 41% in period A and 29% in period B (p = 0.461). Rapidly progressive purpura occurred in 78% in period A and 50% in period B (p = 0.032). Children from period A had multi-organ failure (80%), disseminated intravascular coagulation (76%) and coma (22%) more frequently than children from period B (29%, 29%, 0%; p &lt; 0.05). Mortality was 26% in period A and 0% in period B (p = 0.006) and standardized mortality by PRISM was 1.3 and 0 in period A and B respectively.<br /><strong>Discussion:</strong> The decrease in the number of admissions due to invasive meningococcal disease can be explained by the introduction of anti-meningococcal C vaccine in 2006. Mortality decline can be possibly explained by an improvement in the initial patient stabilization and to secondary transport.<br /><strong>Conclusion:</strong> A decrease in the number of admissions due to invasive meningococcal disease and in mortality was observed.<br /><strong>Keywords:</strong> Child; Infant; Intensive Care Units, Pediatric; Meningococcal Infections; Multiple Organ Failure; Mortality; Portugal; Sepsis.

scholarly journals Evidence for Multi-Organ Infection During Experimental Meningococcal Sepsis due to ST-11 Isolates in Human Transferrin-Transgenic Mice

2020 ◽  
Vol 8 (10) ◽  
pp. 1456
Author(s):  
Michael Levy ◽  
Myriam Aouiti Trabelsi ◽  
Muhamed-Kheir Taha
Keyword(s):  
Transgenic Mice ◽  
Organ Failure ◽  
Meningococcal Disease ◽  
Dynamic Imaging ◽  
Factor H ◽  
Invasive Meningococcal Disease ◽  
Human Transferrin ◽  
Multi Organ Failure ◽  
Invasive Infections ◽  
Organ Infection

The description of invasive meningococcal disease that is provoked by Neisseria meningitidis (Nm) is frequently restricted to meningitis. However, a wide panel of clinical presentations can be encountered including severe forms with intense inflammatory reaction leading to multi-organ failure. Several human factors are involved in the development of invasive infections such as transferrin, factor H or CEACAM1. In this study, we used an experimental meningococcal infection in transgenic mice expressing the human transferrin to show multi-organ infection. Mice were infected by an intraperitoneal injection of bacterial suspension (1.5 × 107 colony-forming unit/mouse) of a bioluminescent serogroup C strain belonging to the clonal complex ST-11. Dynamic imaging and histological analysis were performed. The results showed invasion of tissues by Nm with bacteria observed, outside blood vessels, in the kidneys, the heart and the brain as well as skin involvement. These data further support the systemic aspect of invasive meningococcal disease with involvement of several organs including skin as in humans. Thus, our model can be used to study severe forms of meningococcal invasive infections with multi-organ failure.

Epidemiological Characteristics of Meningococcal Infection in Moscow

2020 ◽  
Vol 19 (2) ◽  
pp. 56-62
Author(s):  
M. I. Gritsay ◽  
M. A. Koroleva ◽  
N. N. Fomkina ◽  
I. S. Koroleva
Keyword(s):  
Young Adults ◽  
Mortality Rate ◽  
Incidence Rate ◽  
Meningococcal Disease ◽  
Invasive Meningococcal Disease ◽  
Meningococcal Infection ◽  
Epidemic Process ◽  
Epidemiological Features ◽  
Teenagers And Young Adults ◽  
Epidemiological Characteristics

Aims. The purpose of this study was to identify current epidemiological features of meningococcal infection in Moscow.Materials and methods. Cases of invasive meningococcal disease in Moscow from 2014 to 2018 and the biomaterial from patients with an invasive meningococcal disease were analyzed.Results. The features of the epidemic process of meningococcal disease in Moscow were revealed: increasing in the incidence rate involving teenagers and young adults into the epidemic process; meningococcal strains of serogroups W and A increased in the etiology of the invasive meningococcal disease; high mortality rate.Conclusions. It seems reasonable to recommend vaccination against meningococcal disease by including adolescents, young adults and persons over 65 years old.

scholarly journals Epidemiology of Invasive Meningococcal Disease with Decreased Susceptibility to Penicillin in Ontario, Canada, 2000 to 2006

2010 ◽  
Vol 54 (3) ◽  
pp. 1016-1021 ◽  
Author(s):  
Elizabeth M. Brown ◽  
David N. Fisman ◽  
Steven J. Drews ◽  
Sharon Dolman ◽  
Prasad Rawte ◽  
...  
Keyword(s):  
Meningococcal Disease ◽  
Regression Models ◽  
Temporal Trends ◽  
Fatal Outcome ◽  
Invasive Meningococcal Disease ◽  
Logistic Regression Models ◽  
The Public ◽  
Risk Of Mortality ◽  
Resistance To Penicillin ◽  
The Relationship

ABSTRACT Neisseria meningitidis has been relatively slow to acquire resistance to penicillin. We previously reported an increase in the incidence of invasive meningococcal disease (IMD) strains with decreased susceptibility to penicillin (DSP) in Ontario. Our objectives were to evaluate trends in IMD with DSP, to identify case-level predictors of IMD with DSP, and to evaluate the relationship among DSP, bacterial phenotype, and the likelihood of a fatal outcome. All IMD isolates received in Ontario between 2000 and 2006 were submitted to the Public Health Laboratories, Toronto, for confirmation of the species, serogroup determination, and susceptibility testing. Isolates were considered to be IMD strains with DSP if the penicillin MIC was ≥0.125 μg/ml. Temporal trends were evaluated using multivariable Poisson regression models. Correlates of diminished susceptibility and fatal outcome were evaluated with multivariable logistic regression models. The overall rate of IMD caused by strains with DSP in Ontario was approximately 1.20 cases per million population annually (95% confidence interval [95% CI], 0.99 to 1.46). Seventy-nine strains (21.7%) were IMD strains with DSP. There was no year-to-year trend in the incidence of IMD with DSP. IMD with DSP was strongly associated with strains of serogroups Y (odds ratio [OR], 6.3; 95% CI, 3.6 to 11.1) and W-135 (OR, 8.2; 95% CI, 4.0 to 16.7). Infection with serogroup B or C strains was associated with a marked increase in the risk of mortality (OR, 3.07; 95% CI, 1.39 to 6.75); however, no association between IMD with DSP and mortality was observed. In contrast to trends of the 1990s, the incidence of IMD with DSP was stable in Ontario between 2000 and 2006. In Ontario, the serogroup rather than the penicillin MIC is the microbiological parameter most predictive of mortality.

scholarly journals Epidemiological Characteristics of Meningococcal Infection in Moscow

2020 ◽  
Vol 19 (2) ◽  
pp. 56-62
Author(s):  
M. I. Gritsay ◽  
M. A. Koroleva ◽  
N. N. Fomkina ◽  
I. S. Koroleva
Keyword(s):  
Young Adults ◽  
Mortality Rate ◽  
Incidence Rate ◽  
Meningococcal Disease ◽  
Invasive Meningococcal Disease ◽  
Meningococcal Infection ◽  
Epidemic Process ◽  
Epidemiological Features ◽  
Teenagers And Young Adults ◽  
Epidemiological Characteristics

Aims. The purpose of this study was to identify current epidemiological features of meningococcal infection in Moscow.Materials and methods. Cases of invasive meningococcal disease in Moscow from 2014 to 2018 and the biomaterial from patients with an invasive meningococcal disease were analyzed.Results. The features of the epidemic process of meningococcal disease in Moscow were revealed: increasing in the incidence rate involving teenagers and young adults into the epidemic process; meningococcal strains of serogroups W and A increased in the etiology of the invasive meningococcal disease; high mortality rate.Conclusions. It seems reasonable to recommend vaccination against meningococcal disease by including adolescents, young adults and persons over 65 years old.

scholarly journals Invasive meningococcal disease

2013 ◽  
Vol 71 (9B) ◽  
pp. 653-658 ◽  
Author(s):  
Vanessa L. Strelow ◽  
Jose E. Vidal
Keyword(s):  
Meningococcal Disease ◽  
Case Fatality ◽  
Latex Agglutination ◽  
Invasive Meningococcal Disease ◽  
Computed Tomography Scan ◽  
Chain Reaction ◽  
Mortality And Morbidity ◽  
Polymerase Chain ◽  
Serotype B ◽  
Tomography Scan

Invasive meningococcal disease (IMD) is a major public health and continues to cause substantial mortality and morbidity. Serotype C is the most frequent in Brazil. The clinical spectrum of IMD is broad (meningitis, meningococcemia or both) and the clinical evolution may be unpredictable. Main features associated with mortality are: age higher than 50 years old, seizures, shock, and meningococcemia without meningitis. Blood cultures should be obtained immediately. Lumbar puncture can be performed without previous computed tomography scan (CT) in most cases. Clinical features can be useful to predic patients where an abnormal CT scan is likely. Cerebrospinal fluid (CSF) culture and Gram stain should always be required. Latex agglutination sensitivity is highly variable. Polymerase chain reaction is specially useful when other methods are negative or delayed. Usually ceftriaxone should not be delayed while awaiting CSF study or CT. Dexamethasone can be used in meningococcal meningitis. Early suspicion of IMD and antibiotic in primary care before hospitalization, rapid transportation to a hospital, and stabilization in an intensive-care unit has substantially reduced the case-fatality rate. Vaccines against serotypes A, C, W-135, and Y are available while vaccines against serotype B are expected.

Thirty-eight-negative-kinase-1 is a major mediator of trauma-induced intestinal injury and multi-organ failure

2018 ◽  
Vol 56 (08) ◽  
pp. e205-e206
Author(s):  
M Armacki ◽  
AK Trugenberger ◽  
A Ellwanger ◽  
T Eiseler ◽  
L Bettac ◽  
...  
Keyword(s):  
Organ Failure ◽  
Intestinal Injury ◽  
Multi Organ Failure ◽  
Major Mediator
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