Neonatal Sepsis and Meningitis in Mallorca, Spain, 1977-1991

Hervás, Juan A.; Alomar, A.; Salvá, Francisco; Reina, Jordi; Benedí, Vicente J.

doi:10.1093/clind/16.5.719

Cited by 48 publications

(25 citation statements)

References 25 publications

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“…Similar observations are evident in Europe, with disease incidence ranging from 0?26 per 1000 live births in Greece (Tsolia (Beardsall et al, 2000;Embleton et al, 1999;Halliday et al, 2000;Heath et al, 2004;Moses et al, 1998;Oddie & Embleton, 2002), 1?9 per 1000 in The Netherlands (Trijbels-Smeulders et al, 2002), and 2?4 per 1000 in Spain (Hervas et al, 1993). In view of the similarities in the structure of GBS populations from geographically diverse locations, it is reasonable to postulate that exposure to the organism is similar among pregnant women from the developing and the developed world.…”

Section: Discussionsupporting

confidence: 53%

Population structure of group B streptococcus from a low-incidence region for invasive neonatal disease

et al. 2005

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The population structure of group B streptococcus (GBS) from a low-incidence region for invasive neonatal disease (Israel) was investigated using multilocus genotype data. The strain collection consisted of isolates from maternal carriage (n=104) and invasive neonatal disease (n=50), resolving into 46 sequence types. The most prevalent sequence types were ST-1 (17?5 %), , , and . Serotype III was the most common, accounting for 29?2 % of the isolates. None of the serotypes was significantly associated with invasive neonatal disease. BURST analysis resolved the 46 sequence types into seven lineages (clonal complexes), from which only lineage ST-17, expressing serotype III only, was significantly associated with invasive neonatal disease. Lineage ST-22 expressed mainly serotype II, and was significantly associated with carriage. The distribution of the various sequence types and lineages, and the association of lineage ST-17 with invasive disease, are consistent with the results of analyses from a global GBS isolate collection. These findings could imply that the global variation in disease incidence is independent of the circulating GBS populations, and may be more affected by other risk factors for invasive GBS disease, or by different prevention strategies. INTRODUCTIONOver the last three decades, group B streptococcus (GBS) has become the leading cause of neonatal meningitis and septicaemia in North America, western Europe and Australia, causing considerable rates of morbidity and mortality (Baker, 2001; Isaacs et al., 1995;Schrag et al., 2000). The increasing incidence of invasive neonatal GBS disease has prompted measures to reduce its prevalence in the USA (American Academy of Pediatrics Committee on Infectious Diseases and Committee on Fetus and Newborn, 1997), Australia (Isaacs & Royle, 1999), and recently in the UK (www.hpa.org.uk/infections/). Interestingly, reports from many developing countries and some developed countries show rates of invasive neonatal GBS disease that are much lower than those reported from North America (Chong et al., 1993;Mayon-White, 1985;Schuchat, 1995;Stan et al., 2001;Stoll, 1997;Tsolia et al., 2003). An explanation for such variation is not apparent, and has not been systematically investigated. Low rates of GBS carriage among pregnant women have been suggested as a possible explanation, yet reports from developing countries have shown that, despite significant geographical variation in the proportion of GBS carriage, the range of colonization is similar to that identified in North America (Stoll & A possible explanation for such a low incidence of invasive neonatal GBS disease, despite the substantial carriage rate, is that invasive disease may be caused by a few virulent lineages (clones) within the total GBS population, such that measurement of the total GBS colonization rates may be misleading as to the true size of the population at risk. Secondly, virulent lineages may account for a different proportion of the vaginal GBS population in different geographical location...

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Section: Discussionsupporting

confidence: 53%

Population structure of group B streptococcus from a low-incidence region for invasive neonatal disease

et al. 2005

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“…E-mail: verakrebs@uol.com.br Low birth weight newborns present a 3-fold increased risk of acquiring meningitis when compared to those whose birth weight is ≥2500 g 1 . Among very low birth weight neonates (<1500 g) the risk is a 10 to 17-fold higher [2][3][4] . In addition to the immaturity of the immunological system, these neonates frequently present risk factors for infection related to maternal diseases or neonatal conditions 1,3,5 .…”

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confidence: 99%

Clinical outcome of neonatal bacterial meningitis according to birth weight

Krebs¹,

Costa²

2007

Arq. Neuro-Psiquiatr.

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-Objective: To describe the clinical outcome and the complications of bacterial meningitis according to birth weight of out born neonates admitted in intensive care unit during an 11 year-period. Method: Eighty-seven newborns were studied. Thirty-four infants were low birth weight newborn and 53 presented birth weight ≥2500 g. The clinical data were obtained through the analysis of patients' files. Fisher's exact test, the χ 2 and the Mann-Whitney test were applied. Results: Neurological symptoms were more common in infants weighed ≥2500 g (p<0.05). Complications affected half of the cases in both groups. Complications affected half of the cases in both groups, with an overall mortality rate of 11.5%. Conclusion: The rate of complications was high in both groups, regardless of the birth weight. No association was observed between the occurrence of death and birth weight. Infants with positive CSF culture had a poorer prognosis.KEY WORDS: newborn, neonatal meningitis, central nervous system. Evolução clínica da meningite bacteriana neonatal de acordo com o peso de nascimento RESUMO -Objetivo: Descrever a evolução clínica e as complicações da meningite bacteriana de acordo com o peso de nascimento em recém-nascidos admitidos em unidade de terapia intensiva externa durante o período de 11 anos. Método: Foram estudados 87 neonatos, dos quais 34 foram recém-nascidos de baixo peso e 53 apresentaram peso ≥2500 g. Os dados clínicos foram obtidos por análise dos prontuários médicos. Foram realizados teste exato de Fisher, teste do χ 2 e teste de Mann-Whitney. Resultados: Os sintomas neurológi-cos foram mais comuns em neonatos com peso ≥2500 g (p<0,05 ). As complicações ocorreram na metade dos casos em ambos os grupos, com mortalidade global de 11.5%. Conclusão: A freqüência de complicações foi alta em ambos os grupos, independentemente do peso de nascimento. Não houve associação entre óbito e peso de nascimento. Os neonatos com cultura de líquor positiva apresentaram pior prognóstico.PALAVRAS-CHAVE: recém-nascido, meningite neonatal, sistema nervoso central. SP -Brasil. E-mail: verakrebs@uol.com.br Low birth weight newborns present a 3-fold increased risk of acquiring meningitis when compared to those whose birth weight is ≥2500 g 1 . Among very low birth weight neonates (<1500 g) the risk is a 10 to 17-fold higher [2][3][4] . In addition to the immaturity of the immunological system, these neonates frequently present risk factors for infection related to maternal diseases or neonatal conditions 1,3,5 . Dra. Vera Lúcia Jornada Krebs -Rua Iara 123 / 51 -04542-030 São PauloThe objective of this study was to describe the clinical outcome and the complications of bacterial meningitis according to birth weight of out born neonates admitted in intensive care unit during an 11 year-period. METHODEighty-seven newborns with bacterial meningitis who were admitted to the Neonatal Intensive Care Unit (NICU) of the Instituto da Criança, Hospital das Clínicas, University of São Paulo, from January 1 st , 1994 to December ...

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“…(1)(2)(3)(4). K. pneumoniae typically express both smooth lipopolysaccharide (LPS) 3 and capsule polysaccharide (K-antigen) on its surface, and both antigens (LPS and capsule) contribute to the pathogenesis of this species.…”

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confidence: 99%

The Incorporation of Glucosamine into Enterobacterial Core Lipopolysaccharide

Regué

Izquierdo

Fresno

et al. 2005

Journal of Biological Chemistry

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The core lipopolysaccharide (LPS) of Klebsiella pneumoniae is characterized by the presence of disaccharide ␣GlcN-(1,4)-␣GalA attached by an ␣1,3 linkage to L-glycero-D-manno-heptopyranose II (LD-HeppII). Previously it has been shown that the WabH enzyme catalyzes the incorporation of GlcNAc from UDP-GlcNAc to outer core LPS. The presence of GlcNAc instead of GlcN and the lack of UDP-GlcN in bacteria indicate that an additional enzymatic step is required. In this work we identified a new gene (wabN) in the K. pneumoniae core LPS biosynthetic cluster. Chemical and structural analysis of K. pneumoniae non-polar wabN mutants showed truncated core LPS with GlcNAc instead of GlcN. In vitro assays using LPS truncated at the level of D-galacturonic acid (GalA) and cell-free extract containing WabH and WabN together led to the incorporation of GlcN, whereas none of them alone were able to do it. This result suggests that the later enzyme (WabN) catalyzes the deacetylation of the core LPS containing the GlcNAc residue. Thus, the incorporation of the GlcN residue to core LPS in K. pneumoniae requires two distinct enzymatic steps. WabN homologues are found in Serratia marcescens and some Proteus strains that show the same disaccharide ␣GlcN-(1,4)-␣GalA attached by an ␣1,3 linkage to LD-HeppII.

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Neonatal Sepsis and Meningitis in Mallorca, Spain, 1977-1991

Cited by 48 publications

References 25 publications

Population structure of group B streptococcus from a low-incidence region for invasive neonatal disease

Population structure of group B streptococcus from a low-incidence region for invasive neonatal disease

Clinical outcome of neonatal bacterial meningitis according to birth weight

The Incorporation of Glucosamine into Enterobacterial Core Lipopolysaccharide

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