Meningitis caused by N. meningitidis: How to prevent this “younger generation killer”?
DOI:
https://doi.org/10.61173/angdeb71Keywords:
-Neisseria meningitidis, meningococcus, chemoprophylaxis, vaccination, combination therapyAbstract
Neisseria meningitidis is a gram-negative bacterium that inhabits the mucosal surface of the nasopharynx in approximately 10% of healthy persons. It stands out as a leading etiology of meningitis, particularly among children, adolescents, and young adults. Meningococcal infections account for an estimated 1.2 million cases annually worldwide, with a death toll exceeding 135,000. These infections are most prevalent in the “meningitis belt” of sub-Saharan Africa and have historically occurred in cyclic patterns in China. Chemoprophylaxis using antibiotics like rifampicin, ciprofloxacin, and ceftriaxone is effective in eliminating bacterial carriage and preventing disease spread. Vaccination represents another crucial preventive measure. This review provides an overview of meningococcal meningitis, emphasizing the importance of early diagnosis, chemoprophylaxis with antibiotics like ceftriaxone, and vaccination as key strategies to combat this deadly disease, particularly among vulnerable populations like infants, adolescents, and young adults.
References
[1] Hersi K, Gonzalez FJ, Kondamudi NP. Meningitis. [Updated 2023 Aug 12]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www. ncbi.nlm.nih.gov/books/NBK459360/
[2] Runde TJ, Anjum F, Hafner JW. Bacterial Meningitis. [Updated 2023 Aug 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https:// www.ncbi.nlm.nih.gov/books/NBK470351/
[3] Nguyen N, Ashong D. Meningococcal Disease (Neisseria meningitidis Infection) [Updated 2024 Feb 27]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/ NBK549849/
[4] Rouphael NG, Stephens DS. Neisseria meningitidis: biology, microbiology, and epidemiology. Methods Mol Biol. 2012;799:1-20. doi: 10.1007/978-1-61779-346-2_1. PMID: 21993636; PMCID: PMC4349422.
[5] Yadav S, Rammohan G. Meningococcal Meningitis. [Updated 2023 Aug 7]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www. ncbi.nlm.nih.gov/books/NBK560591/
[6] Global Burden of Disease 2016 Meningitis Collaborators. Global, regional, and national burden of meningitis, a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol. Dec 2018; 17: 1061–82. [Accessed 24 October 2022]
[7] Control and prevention of meningococcal disease: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 1997 Feb 14;46(RR- 5):1-10. PMID: 9048846.
[8] Zhang Y, Wei D, Guo X, Han M, Yuan L, Kyaw MH. Burden of Neisseria meningitidis infections in China: a systematic review and meta-analysis. J Glob Health. 2016 Dec;6(2):020409. doi: 10.7189/jogh.06.020409. PMID: 27909580; PMCID: PMC5112005.
[9] Xu Y, Li Y, Wang S, Li M, Xu M, Ye Q. Meningococcal vaccines in China. Hum Vaccin Immunother. 2021 Jul 3;17(7):2197-2204. doi: 10.1080/21645515.2020.1857201. Epub 2021 Feb 10. PMID: 33566720; PMCID: PMC8189055.
[10] Pathophysiology of meningococcal meningitis and septicaemia. J Clin Pathol. 2003 Dec;56(12):941. PMCID: PMC1770138.
[11] Schaad UB, Suter S, Gianella-Borradori A, et al. A comparison of ceftriaxone and cefuroxime for the treatment of bacterial meningitis in children. The New England Journal of Medicine. 1990 Jan;322(3):141-147. DOI: 10.1056/ nejm199001183220301. PMID: 2403654.
[12] Bui T, Patel P, Preuss CV. Cephalosporins. [Updated 2024 Feb 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www. ncbi.nlm.nih.gov/books/NBK551517/
[13] Ceftriaxone: Uses, Interactions, Mechanism of Action | DrugBank Online
[14] National Center for Biotechnology Information (2024). PubChem Compound Summary for CID 5479530, Ceftriaxone. Retrieved July 30, 2024 from https://pubchem.ncbi.nlm.nih.gov/ compound/Ceftriaxone.
[15] Lee S, Kim SK, Lee DY, Chae SY, Byun Y. Pharmacokinetics of a new, orally available ceftriaxone formulation in physical complexation with a cationic analogue of bile acid in rats. Antimicrob Agents Chemother. 2006 May;50(5):1869-71. doi: 10.1128/AAC.50.5.1869-1871.2006. PMID: 16641464; PMCID: PMC1472223.
[16] Judson FN, Ehret JM. Single-dose ceftriaxone to eradicate pharyngeal Neisseria meningitidis. Lancet. 1984 Dec 22;2(8417- 8418):1462-3. doi: 10.1016/s0140-6736(84)91647-7. PMID: 6151066.
[17] Viladrich PF, Cabellos C, Pallares R, Tubau F, Martínez- Lacasa J, Liñares J, Gudiol F. High doses of cefotaxime in treatment of adult meningitis due to Streptococcus pneumoniae Dean&Francis ISSN 2959-409X with decreased susceptibilities to broad-spectrum cephalosporins. Antimicrob Agents Chemother. 1996 Jan;40(1):218-20. doi: 10.1128/AAC.40.1.218. PMID: 8787909; PMCID: PMC163086.
[18] Godfrey L, Iannitelli A, Garrett NL, Moger J, Imbert I, King T, Porreca F, Soundararajan R, Lalatsa A, Schätzlein AG, Uchegbu IF. Nanoparticulate peptide delivery exclusively to the brain produces tolerance free analgesia. J Control Release. 2018 Jan 28;270:135-144. doi: 10.1016/j.jconrel.2017.11.041. Epub 2017 Nov 27. PMID: 29191784.
[19] Hathout RM, Abdelhamid SG, El-Housseiny GS, Metwally AA. Comparing cefotaxime and ceftriaxone in combating meningitis through nose-to-brain delivery using bio/ chemoinformatics tools. Sci Rep. 2020 Dec 4;10(1):21250. doi: 10.1038/s41598-020-78327-w. PMID: 33277611; PMCID: PMC7718871.
[20] Parikh SR, Campbell H, Bettinger JA, Harrison LH, Marshall HS, Martinon-Torres F, Safadi MA, Shao Z, Zhu B, von Gottberg A, Borrow R, Ramsay ME, Ladhani SN. The everchanging epidemiology of meningococcal disease worldwide and the potential for prevention through vaccination. J Infect. 2020 Oct;81(4):483-498. doi: 10.1016/j.jinf.2020.05.079. Epub 2020 Jun 3. PMID: 32504737.
[21] Topaz N, Caugant DA, Taha MK, Brynildsrud OB, Debech N, Hong E, Deghmane AE, Ouédraogo R, Ousmane S, Gamougame K, Njanpop-Lafourcade BM, Diarra S, Fox LM, Wang X. Phylogenetic relationships and regional spread of meningococcal strains in the meningitis belt, 2011-2016. EBioMedicine. 2019 Mar;41:488-496. doi: 19.1016/j.ebiom.2019.02.054. Epub 2019 Mar 4. Erratum in: EBioMedicine. 2020 Jan;51:102564. doi: 10.1016/ j.ebiom.2019.11.025. PMID: 30846392; PMCID: PMC6443582.
[22] American Academy of Pediatrics Committee on Infectious Diseases. Updated recommendations on the use of meningococcal vaccines. Pediatrics. 2014 Aug;134(2):400-3. doi: 10.1542/peds.2014-1383. PMID: 25070306.
[23] Pelton SI. The Global Evolution of Meningococcal Epidemiology Following the Introduction of Meningococcal Vaccines. J Adolesc Health. 2016 Aug;59(2 Suppl):S3-S11. doi: 10.1016/j.jadohealth.2016.04.012. PMID: 27449148.
[24] Daraghma R, Sapra A. Meningococcal Vaccine. [Updated 2023 Jun 21]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www. ncbi.nlm.nih.gov/books/NBK553102/
[25] Menomune-A/C/Y/W-135 (meningococcal polysaccharide vaccine groups A C, Y and W-135 combined) [package insert], 2005Swiftwater, PASanofi Pasteur
[26] Menomune–A/C/Y/W-135. Package insert. Swiftwater, PA: Sanofi Pasteur; 2016. https://www.fda.gov/media/83562/ download
[27] Vipond C, Care R, Feavers IM. History of meningococcal vaccines and their serological correlates of protection. Vaccine. 2012 May 30;30 Suppl 2:B10-7. doi: 10.1016/ j.vaccine.2011.12.060. PMID: 22607894.
[28] Keshavan, P., Pellegrini, M., Vadivelu-Pechai, K., & Nissen, M. (2018). An update of clinical experience with the quadrivalent meningococcal ACWY-CRM conjugate vaccine. Expert Review of Vaccines, 17(10), 865–880. https://doi.org/10. 1080/14760584.2018.1521280
[29] Zughaier SM. Analysis of novel meningococcal vaccine formulations. Hum Vaccin Immunother. 2017 Jul 3;13(7):1728- 1732. doi: 10.1080/21645515.2017.1305528. Epub 2017 Apr 10. PMID: 28394704; PMCID: PMC5512786.
[30] Kuhdari P, Stefanati A, Lupi S, Valente N, Gabutti G. Meningococcal B vaccination: real-world experience and future perspectives. Pathog Glob Health. 2016 Jun-Jul;110(4-5):148-56. doi: 10.1080/20477724.2016.1195072. Epub 2016 Jun 16. PMID: 27309042; PMCID: PMC5072112.
[31] Crum-Cianflone N, Sullivan E. Meningococcal Vaccinations. Infect Dis Ther. 2016 Jun;5(2):89-112. doi: 10.1007/s40121-016-0107-0. Epub 2016 Apr 16. PMID: 27086142; PMCID: PMC4929086.
[32] Zhang Y, Deng X, Jiang Y, Zhang J, Zhan L, Mei L, Lu H, Yao P, He H. The Epidemiology of Meningococcal Disease and Carriage, Genotypic Characteristics and Antibiotic Resistance of Neisseria meningitidis Isolates in Zhejiang Province, China, 2011-2021. Front Microbiol. 2022 Jan 24;12:801196. doi: 10.3389/fmicb.2021.801196. PMID: 35140696; PMCID: PMC8819144.
[33] Stefanelli P, Rezza G. Impact of vaccination on meningococcal epidemiology. Hum Vaccin Immunother. 2016 Apr 2;12(4):1051-5. doi: 10.1080/21645515.2015.1108502. Epub 2015 Oct 29. PMID: 26512927; PMCID: PMC4962961.
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