Exploratory analysis of immunization records highlights decreased SARS-CoV-2 rates in individuals with recent non-COVID-19 vaccinations

Multiple clinical studies are ongoing to assess whether existing vaccines may afford protection against SARS-CoV-2 infection through trained immunity. In this exploratory study, we analyze immunization records from 137,037 individuals who received SARS-CoV-2 PCR tests. We find that polio, Hemophilus influenzae type-B (HIB), measles-mumps-rubella (MMR), varicella, pneumococcal conjugate (PCV13), geriatric flu, and hepatitis A / hepatitis B (HepA-HepB) vaccines administered in the past 1, 2, and 5 years are associated with decreased SARS-CoV-2 infection rates, even after adjusting for geographic SARS-CoV-2 incidence and testing rates, demographics, comorbidities, and number of other vaccinations. Furthermore, age, race/ethnicity, and blood group stratified analyses reveal significantly lower SARS-CoV-2 rate among black individuals who have taken the PCV13 vaccine, with relative risk of 0.45 at the 5 year time horizon (n: 653, 95% CI: (0.32, 0.64), p-value: 6.9e-05). These findings suggest that additional pre-clinical and clinical studies are warranted to assess the protective effects of existing non-COVID-19 vaccines and explore underlying immunologic mechanisms. We note that the findings in this study are preliminary and are subject to change as more data becomes available and as further analysis is conducted.

Etiology and outcome of culture proven bacterial meningitis in children 6 to 24 months of age.

Introduction: Pediatric bacterial meningitis is a life-threatening illness that results from bacterial infection of the meninges and leaves some survivors with significant sequelae. More than 2/3 cases of meningitis occur in the 1st 2 years of life, owing to decreased immunity and high vascularity of the brain.This study was conducted to determine the frequency of hemophilus influenzae type b, streptococcus pneumonia and neisseria meningitidis and outcome in culture proven meningitis in children 6 months to 24 months. Study Design: Case series. Setting: Paeds Unit 1, Bahawal Victoria Hospital, Bahawalpur and Paeds Unit of District Headquarter (DHQ) Teaching Hospital, Dera Ghazi Khan. Period: 1st April 2017 to 30th September 2018. Material and Methods: A total of 220 children (110 from each center) of either sex with culture proven meningitis, aged 6 months to 24 months, were included in the study. Demographics, duration of fever, history of seizures, weight of child, vaccination status and bacteria isolated from CSF and outcome were analyzed. The outcome in the form of mortality was noted during the first 10 days of hospital stay. Results: Amongst a total of 220 children, 123 (55.9%) were male. There were 130 (59.1%) children who were less than or equal to 1 year of age. There were 154 (70.0%) children who were having a weight of 7 to 10 kg. Vaccination status was, 111 (50.5%) were fully vaccinated, 59 (26.8%) partially vaccinated and 50 (22.7%) not vaccinated. Duration of fever was, 141 (64.1%) had fever for more than 5 days. There were 139 (63.2%) children who had a history of seizures. Streptococcus pneumonia was the commonest bacteria found in 110 (50%) children followed by neisseria meningitides 53 (24.1%), H. Influenza 37 (16.8%). Overall mortality was noted in 34 (15.5%) children. Conclusion: In children with bacterial meningitis, mortality was high and most common bacteria were found to be s.pneumoniae followed by neisseria meningitidis and h.influenzae. Awareness about the empiric and directed antimicrobial therapy will help to lower the burden of morbidity and mortality related to bacterial meningitis.

Evolution of Different Bacterial Mningoencephalitis: Series of Case Presentations and Literature Review

Bacterial meningitis is one of the most important medical emergencies, a life-threatening condition that leads to death in all the cases in untreated patients. In infants and young children, especially under 5 years old, the most encountered and severe forms are caused by Streptococcus pneumoniae, Neisseria meningitidis and Hemophilus influenzae type b. The risk of neurological impairment after an acute episode of bacterial meningitis is relatively high. Worldwide, prevention through vaccination decreased dramatically incidence and mortality related to these disease. In Romania vaccination for Neisseria meningitides is optional available for just 6 months, vaccination for Streptococcus pneumoniae by one year, and for Haemophylus influenzae type B is available over 10 years. We present evolution of a series of three cases with different bacterial meningoencephalitis with severe evolution and prolonged hospitalization. All these cases were reported in unvaccinated children for germs that cause meningitis.

Latex Agglutination Test for Early Detection of Causative Organism in Acute Bacterial Meningitis

Introduction: Acute bacterial meningitis is one of the leading causes of mortality and morbidity in children. Identification of the causative organism is crucial to its management and outcome. The objective of this study was to see the usefulness of latex agglutination test in the early diagnosis of acute bacterial meningitis. Materials and Methods: A hospital based prospective cross-sectional study was conducted at Kanti Children’s Hospital during December 2004 to August 2005. Cerebrospinal fluid from 150 consecutive clinically suspected cases of acute bacterial meningitis between the age group of 2 months to 14 years were analyzed. Bacterial culture and latex agglutination test was done on cerebrospinal fluid obtained from all 150 suspected cases of acute bacterial meningitis. Latex agglutination test was done using the BD DirectigenTM Meningitis Combo test kit (Becton, Dickinson and company, USA) for Streptococcus pneumoniae, group B Streptococcus, Escherichia coli, Neisseria meningitidis group A,C and Y/ W135, and Hemophilus influenzae type b. Data was analysed by using SPSS Version 11.5. Results: Of the 150 Cerebrospinal fluid samples analysed bacterial culture identified only 4 meningitis cases giving an isolation rate of 1.3% whereas latex agglutination test identified 29 cases giving an isolation rate of 19.3% from 150 samples. Streptococcus pneumoniae, Hemophilus influenzae type b and Group B Streptococcus were the most common causative organism. Conclusion: Latex agglutination test has a better yield, higher sensitivity, provides microbiological diagnosis earlier than the traditional cerebrospinal fluid culture and is easy to perform. DOI: http://dx.doi.org/10.3126/jnps.v33i1.7047 J Nepal Paediatr Soc. 2013;33(1):34-38