Meningococcal infection in modern conditions: clinical, microbiological and preventive aspects

Cover Page

Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

The problem of meningococcal infection remains relevant due to the high epidemiological and social significance throughout the world, the unpredictability of the course, a wide range of clinical manifestations (from asymptomatic carriage to extremely severe generalized forms) with a high risk of life-threatening conditions and deaths, and a significant incidence of disability after past illness (loss of limbs, deafness, mental inferiority, and more). The changing serogroup landscape of meningococcal infection with an increase in the incidence of diseases caused by Neisseria meningitidis serogroup W, Y and others is noteworthy. The article presents an analytical review of literature and reflects current clinical, epidemiological, diagnostic and preventive trends in the Russian Federation and abroad. The review focuses on the epidemiological features of meningococcal infection, depending on the serogroup affiliation of meningococcus, the variety of clinical manifestations of the generalized form of meningococcal infection, including atypical manifestations, age-related features, depending on the serogroup of the pathogen. New diagnostic approaches and the possibilities of specific prophylaxis are highlighted. Attention is focused on the importance of monitoring the clinical and epidemiological characteristics of meningococcal infection depending on the genetic characteristics of the pathogen, and the need for further in-depth studies of this problem.

Full Text

Restricted Access

About the authors

Кsenija V. Markova

North-Pediatric Research and Clinical Center for Infectious Diseases

Author for correspondence.
Email: ksenija-sidorova@mail.ru

Postgraduate Student, Department of Neuroinfections and Organic Pathology of the Nervous System

Russian Federation, Saint Petersburg

Natalia V. Skripchenko

North-Pediatric Research and Clinical Center for Infectious Diseases; Saint Petersburg State Pediatric Medical University

Email: snv@niidi.ru

MD, PhD, Dr Med Sci, Honored Scientist of the Russian Federation, Professor, Deputy Director for Research

Russian Federation, Saint Petersburg

Yuriy V. Lobzin

North-Pediatric Research and Clinical Center for Infectious Diseases

Email: niidi@niidi.ru

MD, PhD, Dr Med Sci, acad. Russian Academy of Sciences

Russian Federation, Saint Petersburg

Vadim E. Karev

North-Pediatric Research and Clinical Center for Infectious Diseases

Email: vadimkarev@yandex.ru

MD, PhD, Dr Med Sci, Head of the Department of Tissue and Pathomorphological Methods

Russian Federation, Saint Petersburg

Alla A. Vilnits

North-Pediatric Research and Clinical Center for Infectious Diseases; Saint Petersburg State Pediatric Medical University

Email: vilnitz@mail.ru

MD, Ph.D., Art. Scientific Member of the Department of Neuroinfections and Organic Pathology of the Nervous System

Russian Federation, Saint Petersburg

Eugeniy Yu. Gorelik

North-Pediatric Research and Clinical Center for Infectious Diseases

Email: e.gorelik@mail.ru

MD, Ph.D, Acting Head of the Department of Neuroinfections and Organic Pathology of the Nervous System

Russian Federation, Saint Petersburg

Elvira A. Martens

North-Pediatric Research and Clinical Center for Infectious Diseases

Email: eamartens@yandex.ru

Head of the Laboratory of Medical Microbiology

Russian Federation, Saint Petersburg

Sergey V. Sidorenko

North-Pediatric Research and Clinical Center for Infectious Diseases

Email: sidorserg@gmail.com

Head of the Department of Molecular Microbiology and Epidemiology

Russian Federation, Saint Petersburg

References

  1. Абрамцева М.В., Тарасов А.П., Немировская Т.И. Менингококковая инфекция. Современные представления о возбудителе, эпидемиологии, патогенезе и диагностике. Сообщение 1 // Биопрепараты. Профилактика, диагностика, лечение. – 2014. – № 3. – С. 4–10. [Abramtseva MV, Tarasov AP, Nemirovskaya TI. Meningococcal infection: Modern insight into epidemiology, pathogenesis, diagnosis and causative agent. Biopreparaty. 2014;(3):4-10. (In Russ.)]
  2. Глазкова С.Э., Носова Е.С., Бакаева Т.Н., и др. Молекулярно-генетический мониторинг Neisseria meningitidis на территории республики Беларусь (2006–2010 гг.) // Здравоохранение (Минск). – 2011. – № 11. – С. 10–14. [Glazkova SE, Nosova ES, Bakayeva TN, et al. Neisseria meningitidis molecular-and-genetic monitoring on territory of the Republic of Belarus (2006–2010). Zdravookhranenie (Minsk). 2011;(11)10-14. (In Russ.)]
  3. Глазкова С.Э., Носова Е.С., Титов Л.П. Молекулярно-генетический анализ хаускипинг генов adk и aroE штаммов Neisseria meningitidis, выделенных от больных менингитом // Медицинский журнал. – 2007. – № 4. – С. 47–50. [Glazkova SE, Nosova ES, Titov LP. Molekulyarno-geneticheskiy analiz khauskiping genov adk i aroE shtammov Neisseria meningitidis, vydelennykh ot bol’nykh meningitom Med Zhurnal. 2007;(4):47–50. (In Russ.)]
  4. Иванова М.В., Скрипченко Н.В., Вильниц А.А., и др. Особенности течения генерализованной менингококковой инфекции, вызванной менингококком серогруппы W135 // Детские инфекции. – 2016. – Т. 15. – № 4. – С. 57–60. [Ivanova MV, Skripchenko NV, Vilnits AA, et al. The Course of Generalized Meningococcal Infection Caused by Meningococcus Serogroup W135. Detskie infektsii. 2016;15(4): 57-60. (In Russ.)]
  5. Королева М.А. Эпидемиологический мониторинг за гнойными бактериальными менингитами в Российской Федерации: Автореф. дис. … канд. мед. наук. – М., 2014. [Koroleva MA. Epidemiologicheskiy monitoring za gnoynymi bakterial’nymi meningitami v Rossiyskoy Federatsii. Moscow; 2014. (In Russ.)]
  6. Костюкова Н.Н., Бехало В.А. Современные менингококковые вакцины: сильные и слабые стороны, ближайшие перспективы // Эпидемиология и вакцинопрофилактика. – 2016. – Т. 15. – № 4. – С. 64–73. [Kostyukova NN, Bekhalo VA. Current Meningococcal Vaccines: Advantages and Disadvantages and New Challenges. Epidemiol Vakcinoprofil. 2016;15(4): 64-73. (In Russ.)]
  7. Кригер Е.А., Самодова О.В., Рогушина Н.Л., и др. Отношение родителей к вакцинации детей и факторы, связанные с отказом от прививок // Педиатрия. Журнал им. Г.Н. Сперанского. – 2016. – Т. 95. – № 2. – С. 91–95. [Krieger EA, Samorodova OV, Rogushina NL, Borisova TA. Parents’ attitudes to vaccination of children and factors of vaccinations refuse. Pediatriia. 2016;95(2):91-95. (In Russ.)]
  8. Лобзин Ю.В., Скрипченко Н.В., Вильниц А.А., и др. Клинико-эпидемиологические аспекты генерализованной менингококковой инфекции у детей и подростков Санкт-Петербурга // Журнал инфектологии. – 2016. – Т. 8. – № 1. – С. 19–25. [Lobzin YuV, Skripchenko NV, Vilnits AA. Clinical and epidemiological aspectsof generalized meningococcal infectionsin children and adolescents of Saint Petersburg. Z Infektol. 2016;8(1):19-25. (In Russ.)]
  9. Лобзин Ю.В., Скрипченко Н.В., Середняков К.В., Баиндурашвили А.Г. Опыт применения селективной адсорбции липополисахарида в комплексной терапии менингококкового сепсиса у детей (клинические наблюдения) // Медицина: целевые проекты. – 2015. – № 22. – С. 56–59. [Lobzin YuV, Skripchenko NV, Serednyakov KV, Baindurashvili AG. Opyt primeneniya selektivnoy adsorbtsii lipopolisakharida v kompleksnoy terapii meningokokkovogo sepsisa u detey (klinicheskie nablyudeniya). Meditsina: tselevye proekty. 2015;(22):56-59. (In Russ.)]
  10. Нагибина М.В., Венгеров Ю.Я., Матосова С.В., и др. Генерализованная форма менингококковой инфекции, вызванная N. meningitidis серогруппы W, на территории г. Москвы в 2011–2016 гг. // Инфекционные болезни: новости, мнения, обучение. – 2018. – Т. 7. – № 1. – С. 100–105. [Nagibina MV, Vengerov YuYa, Matosova SV, et al. Generalized meningococcal disease caused by N. meningitidis serogroup W in Moscow in the years 2011–2016. Infektsionnye bolezni: novosti, mneniya, obuchenie. 2018;7(1):100-105. (In Russ.)]
  11. Скрипченко Н.В., Вильниц А.А. Менингококковая инфекция у детей: руководство для врачей. – СПб.: Тактик-Студио, 2015. – 840 с. [Skripchenko NV, Vil’nits AA. Meningokokkovaya infektsiya u detey: rukovodstvo dlya vrachey. Saint Petersburg: Taktik-Studio; 2015. 840 p. (In Russ.)]
  12. Фельдблюм И.В., Новгородова С.Д., Гореликова Е.В. Эпидемиология и новые возможности специфической профилактики менингококковой инфекции в условиях реального времени // Поликлиника. – 2018. – № 2. – С. 24–27. [Feldblyum IV, Novgorodova SD, Gorelikova EV. Epidemiology and new opportunities for real-time specific prevention of meningococcal infection. Poliklinika. 2018;(2):24-27. (In Russ.)]
  13. Ali A, Jafri RZ, Messonnier N, et al. Global practices of meningococcal vaccine use and impact on invasive disease. Pathog Glob Health. 2014;108(1):11-20. https://doi.org/10.1179/2047773214Y.0000000126.
  14. Aung M, Raith E, Williams E, Burrell AJ. Severe meningococcal serogroup W sepsis presenting as myocarditis: A case report and review of literature. J Intensive Care Soc. 2019;20(2):182-186. https://doi.org/10.1177/1751143718794127.
  15. Basta NE, Becker AB, Li Q, Nederhoff D. Parental awareness of Meningococcal B vaccines and willingness to vaccinate their teens. Vaccine. 2019;37(4):670-676. https://doi.org/10.1016/j.vaccine.2018.11.078.
  16. Bertrand S, Carion F, Wintjens R, et al. Evolutionary changes in antimicrobial resistance of invasive Neisseria meningitidis isolates in Belgium from 2000 to 2010: increasing prevalence of penicillin nonsusceptibility. Antimicrob Agents Chemother. 2012;56(5): 2268-2272. https://doi.org/10.1128/AAC.06310-11.
  17. Bethea J, Makki S, Gray S, et al. Clinical characteristics and public health management of invasive meningococcal group W disease in the East Midlands region of England, United Kingdom, 2011 to 2013. Euro Surveill. 2016;21(24). https://doi.org/10.2807/1560-7917.ES.2016.21.24.30259.
  18. Bijlsma MW, Bekker V, Brouwer MC, et al. Epidemiology of invasive meningococcal disease in the Netherlands, 1960–2012: an analysis of national surveillance data. Lancet Infect Dis. 2014;14(9):805-812. https://doi.org/10.1016/s1473-3099(14)70806-0.
  19. Braunova A, Krbkova L, Rainetova P, et al. Clinical and laboratory characteristics of enteroviral meningitis in children, including qRT-PCR and sequencing analysis. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2019;163(4):355-361. https://doi.org/10.5507/bp.2018.082.
  20. Campbell H, Ladhani S. The importance of surveillance: Group W meningococcal disease outbreak response and control in England. Int Health. 2016;8(6):369-371. https://doi.org/10.1093/inthealth/ihw037.
  21. Caugant DA, Tzanakaki G, Kriz P. Lessons from meningococcal carriage studies. FEMS Microbiol Rev. 2007;31(1):52-63. https://doi.org/10.1111/j.1574-6976.2006.00052.x.
  22. Christensen H, May M, Bowen L, et al. Meningococcal carriage by age: a systematic review and meta-analysis. Lancet Infect Dis. 2010;10(12):853-861. https://doi.org/10.1016/s1473-3099(10)70251-6.
  23. Claus H, Maiden MCJ, Maag R, et al. Many carried meningococci lack the genes required for capsule synthesis and transport. Microbiology. 2002;148(Pt 6):1813-1819. https://doi.org/10.1099/00221287-148-6-1813.
  24. Deghmane AE, Hong E, Taha MK. Emergence of meningococci with reduced susceptibility to third-generation cephalosporins. J Antimicrob Chemother. 2017;72(1): 95-98. https://doi.org/10.1093/jac/dkw400.
  25. Feavers IM, Maiden MCJ. Recent Progress in the Prevention of Serogroup B Meningococcal Disease. Clin Vaccine Immunol. 2017;24(5). https://doi.org/10.1128/CVI.00566-16.
  26. Findlow H, Vogel U, Mueller JE, et al. Three cases of invasive meningococcal disease caused by a capsule null locus strain circulating among healthy carriers in Burkina Faso. J Infect Dis. 2007;195(7):1071-1077. https://doi.org/10.1086/512084.
  27. Folaranmi T, Rubin L, Martin SW, et al. Centers for Disease Control (CDC). Use of Serogroup B Meningococcal Vaccines in Persons Aged ≥10 Years at Increased Risk for Serogroup B Meningococcal Disease: Recommendations of the Advisory Committee on Immunization Practices, 2015. MMWR Morb Mortal Wkly Rep. 2015;64(22):608-612.
  28. Gómez BO, Feito CR, Vázquez DG, et al. Primary Meningococcal Septic Arthritis Case Report and Literature Review of an Unusual Manifestation of Meningococcal Disease. Bull Hosp Jt Dis (2013). 2019;77(2):140-145.
  29. Harcourt BH, Anderson RD, Wu HM, et al. Population-Based Surveillance of Neisseria meningitidis Antimicrobial Resistance in the United States. Open Forum Infect Dis. 2015;2(3):ofv117. https://doi.org/10.1093/ofid/ofv117.
  30. Hoang LM, Thomas E, Tyler S, et al. Rapid and fatal meningococcal disease due to a strain of Neisseria meningitidis containing the capsule null locus. Clin Infect Dis. 2005;40(5):e38-42. https://doi.org/10.1086/427875.
  31. Hong E, Bakhalek Y, Taha MK. Identification of Neisseria meningitidis by MALDI-TOF MS may not be reliable. Clin Microbiol Infect. 2019;25(6):717-722. https://doi.org/10.1016/j.cmi.2018.09.015.
  32. Kawahara-Matsumizu M, Yamagishi Y, Mikamo H. Misidentification of Neisseria cinerea as Neisseria meningitidis by Matrix-Assisted Laser Desorption/Ionization Time of Flight Mass Spectrometry (MALDI-TOF MS). Jpn J Infect Dis. 2018;71(1):85-87. https://doi.org/10.7883/yoken.JJID.2017.183.
  33. Kempe A, Allison MA, MacNeil JR, et al. Adoption of Serogroup B Meningococcal Vaccine Recommendations. Pediatrics. 2018;142(3). https://doi.org/10.1542/peds.2018-0344.
  34. Knol M, Ruijs WLM, Melker HE, et al. Sudden increase of invasive meningococcal disease serogroup W in 2015 and 2016. Infectieziekten Bulletin. 2017;28(1):23-28.
  35. Kupferschmidt K. Infectious diseases. Bacterial meningitis finds new niche in gay communities. Science. 2013;341(6144):328. https://doi.org/10.1126/science.341.6144.328.
  36. Lucidarme J, Hill DM, Bratcher HB, et al. Genomic resolution of an aggressive, widespread, diverse and expanding meningococcal serogroup B, C and W lineage. J Infect. 2015;71(5):544-552. https://doi.org/10.1016/j.jinf.2015.07.007.
  37. Maujean G, Guinet T, Fanton L, Malicier D. The interest of postmortem bacteriology in putrefied bodies. J Forensic Sci. 2013;58(4):1069-1070. https://doi.org/10.1111/1556-4029.12155.
  38. McNamara LA, Potts CC, Blain A, et al. Invasive Meningococcal Disease due to Nongroupable Neisseria meningitidis-Active Bacterial Core Surveillance Sites, 2011-2016. Open Forum Infect Dis. 2019;6(5):ofz190. https://doi.org/10.1093/ofid/ofz190.
  39. Miglietta A, Innocenti F, Pezzotti P, et al. Carriage rates and risk factors during an outbreak of invasive meningococcal disease due to Neisseria meningitidis serogroup C ST-11 (cc11) in Tuscany, Italy: a cross-sectional study. BMC Infect Dis. 2019;19(1):29. https://doi.org/10.1186/s12879-018-3598-3.
  40. Morel F, Jacquier H, Desroches M, et al. Use of Andromas and Bruker MALDI-TOF MS in the identification of Neisseria. Eur J Clin Microbiol Infect Dis. 2018;37(12):2273-2277. https://doi.org/10.1007/s10096-018-3368-6.
  41. Mustapha MM, Marsh JW, Harrison LH. Global epidemiology of capsular group W meningococcal disease (1970–2015): Multifocal emergence and persistence of hypervirulent sequence type (ST)-11 clonal complex. Vaccine. 2016;34(13):1515-1523. https://doi.org/10.1016/j.vaccine.2016.02.014.
  42. Nemescu RE, Iancu LS, Dorneanu OS, et al. Influence of antibiotic therapy prior to admission on the efficacy of classical methods for the diagnosis of meningococcal disease. Rev Med Chir Soc Med Nat Iasi. 2014;118(2):497-502.
  43. Pathan N, Hemingway CA, Alizadeh AA, et al. Role of interleukin 6 in myocardial dysfunction of meningococcal septic shock. Lancet. 2004;363(9404):203-209. https://doi.org/10.1016/s0140-6736(03)15326-3.
  44. Purmohamad A, Abasi E, Azimi T, et al. Global estimate of Neisseria meningitidis serogroups proportion in invasive meningococcal disease: A systematic review and meta-analysis. Microb Pathog. 2019;134:103571. https://doi.org/10.1016/j.micpath.2019.103571.
  45. Racloz VN, Luiz SJ. The elusive meningococcal meningitis serogroup: a systematic review of serogroup B epidemiology. BMC Infect Dis. 2010;10:175. https://doi.org/10.1186/1471-2334-10-175.
  46. Sridhar S, Greenwood B, Head C, et al. Global incidence of serogroup B invasive meningococcal disease: a systematic review. Lancet Infect Dis. 2015;15(11):1334-1346. https://doi.org/10.1016/s1473-3099(15)00217-0.
  47. Stephens DS, Apicella MA. Neisseria meningitidis. In: Mandell, Douglas, and Bennett’s principles and practice of infectious diseases. Ed. by J.E. Bennett, R. Dolin, M.J. Blaser. Philadelphia: Elsevier Saunders; 2015. p. 2425-2445.
  48. Stephens DS. Biology and pathogenesis of the evolutionarily successful, obligate human bacterium Neisseria meningitidis. Vaccine. 2009;27: B71-B77. https://doi.org/10.1016/j.vaccine.2009.04.070.
  49. Taldir G, Parize P, Arvis P, Faisy C. Acute right-sided heart failure caused by Neisseria meningitidis. J Clin Microbiol. 2013;51(1):363-365. https://doi.org/10.1128/JCM.02264-12.
  50. Tsang R, Hoang L, Tyrrell GJ, et al. Increase in Neisseria meningitidis serogroup W invasive disease in Canada: 2009-2016. Can Commun Dis Rep. 2017;43(7-8):144-149.
  51. Vogel U, Claus H, von Muller L, et al. Bacteremia in an immunocompromised patient caused by a commensal Neisseria meningitidis strain harboring the capsule null locus (cnl). J Clin Microbiol. 2004;42(7):2898-2901. https://doi.org/10.1128/JCM.42.7.2898-2901.2004.
  52. Xu Z, Zhu B, Xu L, et al. First case of Neisseria meningitidis capsule null locus infection in China. Infect Dis (Lond). 2015;47(8):591-592. https://doi.org/10.3109/00365548.2015.1010228.

Supplementary files

Supplementary Files
Action
1. JATS XML

Copyright (c) 2020 Markova К.V., Skripchenko N.V., Lobzin Y.V., Karev V.E., Vilnits A.A., Gorelik E.Y., Martens E.A., Sidorenko S.V.

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: серия ПИ № ФС 77 - 69634 от 15.03.2021 г.


This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies