Hospital-based surveillance of meningococcal meningitis in Salvador, Brazil

Cordeiro, Soraia Machado; Neves, Alan B.; Ribeiro, Cássio T.; Petersen, Maya; Gouveia, Edilane Lins; Ribeiro, Guilherme S.; Lôbo, T. S.; Reis, Joice Neves; Salgado, Katia; Reis, Mitermayer Galvão dos; Ko, Albert I.

doi:10.1016/j.trstmh.2007.06.012

Cited by 16 publications

(23 citation statements)

References 29 publications

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“…However, approximately 20% of patients did not present with concomitant alterations in these three parameters, which may complicate the diagnosis in this subset of patients. Our CSF data are similar with another study 10 . The positivity of the Gram staining method was very high in our sample (90%), reinforcing the value of this inexpensive, easy, and widely-available method.…”

Section: Discussionsupporting

confidence: 92%

“…When we combined these three clinical characteristics, we observed that 89% of our patients presented with this triad. In addition, petechial exanthem was present in 73% of our patients, while only 41% to 56% of patients, excluding individuals with isolated meningococcemia, showed this feature in the other studies 9,10,11 . This classic presentation of MM probably facilitated the diagnostic suspicion in most patients.…”

Section: Discussioncontrasting

confidence: 53%

“…On the other hand, a focal deficit was present in 11% of our patients while this alteration was reported in 5% to 7% of the Brazilian series 10,11 and 22% to 33% in other studies 2,12 . A change in mental status was present in 55% of our patients, similar to the 50% and 57% described in another studies 9,11 .…”

Section: Discussioncontrasting

confidence: 51%

“…These figures were 62%, 91%, and 81% respectively, in another study 9 . In a Brazilian series, these features occurred in 92%-98%, 82%-86% and 41%-90% in the adult population 10,11 . When we combined these three clinical characteristics, we observed that 89% of our patients presented with this triad.…”

Section: Discussionmentioning

confidence: 90%

“…In contrast, two prior studies reported 1% and 5% of seizures 9,12 . The Brazilian series found 14% to 16% 10,11 . One of these two Brazilian studies found a predominance of seizure among subjects with ages > 49 years 11 .…”

Section: Discussionmentioning

confidence: 99%

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Meningococcal meningitis: clinical and laboratorial characteristics, fatality rate and variables associated with in-hospital mortality

Strelow

Miranda

Kolbe

et al. 2016

Arq. Neuro-Psiquiatr.

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Meningococcal meningitis is a public health problem. The aim of this study was to describe the clinical characteristics of patients with meningococcal meningitis, and to identify associated factors with mortality. This was a retrospective study, between 2006 and 2011, at a referral center in São Paulo, Brazil. Logistic regression analysis was used to identify factors associated with mortality. We included 316 patients. The median age was 16 years (IQR: 7–27) and 60% were male. The clinical triad: fever, headache and neck stiffness was observed in 89% of the patients. The cerebrospinal triad: pleocytosis, elevated protein levels and low glucose levels was present in 79% of patients. Factors associated with mortality in the multivariate model were age above 50 years, seizures, tachycardia, hypotension and neck stiffness. The classic clinical and laboratory triads of meningococcal meningitis were variable. The fatality rate was low. Age, seizures and shock signs were independently associated with mortality.

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Section: Discussionsupporting

confidence: 92%

Section: Discussioncontrasting

confidence: 53%

Section: Discussioncontrasting

confidence: 51%

Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Meningococcal meningitis: clinical and laboratorial characteristics, fatality rate and variables associated with in-hospital mortality

Strelow

Miranda

Kolbe

et al. 2016

Arq. Neuro-Psiquiatr.

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Epidemiological burden of meningococcal disease in Brazil: A systematic literature review and database analysis

Almeida¹,

Spinardi²,

Cané³

2019

International Journal of Infectious Diseases

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The aim of this study was to evaluate the epidemiological profile of invasive meningococcal disease (IMD) in Brazil, the first Latin American country to introduce the group C meningococcal conjugate vaccine (included in the vaccination schedule in 2010). Methods: A systematic review was conducted, covering the years 2005-2017, to identify epidemiological information on IMD and Neisseria meningitidis carriers in Brazil. Documents from the Brazilian Ministry of Health and two public databases were analyzed to determine annual incidence rates, absolute numbers of diagnosed cases, serogroups identified, the relative distribution of cases per serogroup, and the case fatality rate (CFR). Results: Sixteen studies were selected. The incidence rate ranged from 0.88 to 5.3 cases per 100 000 inhabitants per year. According to secondary data, the annual incidence of IMD in 2015 was highest in males <1 year old (7.1/100 000). The number of diagnosed cases declined significantly over the years. In the literature, IMD showed a CFR from 20.0% to 50.0%, and a higher CFR for serogroup W (17.8%). Secondary data showed an absolute reduction in meningitis-attributable deaths between 2007 and 2015; however, the CFR remained stable (11.1% in 2007 and 8.4% in 2015). In 2015, serogroup W showed the highest CFR (24.1%), followed by serogroups C (19.2%), B (17.7%), and Y (14.3%). Conclusions: Despite a reduction in cases, the CFR remained stable and similar in the different age groups, even for disease caused by different serogroups. The highest CFR was found to be associated with serogroup W.

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Dissemination of the ST-103 clonal complex serogroup C meningococci in Salvador, Brazil

Cordeiro

Cardoso

Araújo

et al. 2018

Microbes and Infection

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Invasive meningococcal disease (IMD) is a major public health problem worldwide. An epidemic of serogroup C (NmC) IMD occurred in 2010 in the city of Salvador. In this study, we describe the antigenic and genetic characterization of meningococcal isolates collected from meningitis cases in Salvador from 2001 to 2012. Pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST) were performed for the analysis of IMD isolates. A total of 733 cases were identified, and the serogroup was determined for 391 (53.0%) of these. Most cases were caused by NmC (53%) or B (47%). The most prevalent strains were B:4,7:P1.19,15 (32.9%; 129/391) and C:23:P1.14-6 (28.6%; 112/391). Based on PFGE/MLST analysis, 71.3% (77/108 PFGE-tested isolates) clustered as two clones of sequence type ST-3779 and ST-3780, both belonging to the ST-103 clonal complex. ST-3779 has been detected in Salvador since 1996 and together with ST-3780 became predominant after 2005. There was a predominance of C:23:P1.14-6, ST-3779/3780 in Salvador during the period of 2007-2012, establishing a major clonal lineage, which remained in the community for a long time; this has serious implications for public health, particularly in terms of prevention and control strategies of IMD.

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Hospital-based surveillance of meningococcal meningitis in Salvador, Brazil

Cited by 16 publications

References 29 publications

Meningococcal meningitis: clinical and laboratorial characteristics, fatality rate and variables associated with in-hospital mortality

Meningococcal meningitis: clinical and laboratorial characteristics, fatality rate and variables associated with in-hospital mortality

Epidemiological burden of meningococcal disease in Brazil: A systematic literature review and database analysis

Dissemination of the ST-103 clonal complex serogroup C meningococci in Salvador, Brazil

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