Pneumococcal meningitis in the North East Thames Region UK: epidemiology and molecular analysis of isolates

Urwin, Gillian; Yuan, Mei Fang; Hall, Lucinda M. C.; Brown, Kenneth R.; Efstratiou, Androulla; Feldman, Roger A.

doi:10.1017/s0950268800001175

Cited by 28 publications

(15 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We have demonstrated that the ST9 clone is 4.8 times more common in blood than in other sites and is therefore more invasive than the average S. pneumoniae isolate. The ST9 clone has also been identified as an important cause of meningitis throughout the United Kingdom (10,15,37), and this clone is now recognized as a cause of invasive disease in other countries (http://www.mlst.net). There are many virulence factors other than the capsule involved in the pathogenesis of pneumococcal infection (14), and there is evidence that particular strains of pneumococci have a predilection for blood and cerebrospinal fluid (16).…”

Section: Discussionmentioning

confidence: 99%

Molecular Epidemiology of Erythromycin Resistance in Streptococcus pneumoniae Isolates from Blood and Noninvasive Sites

et al. 2002

View full text Add to dashboard Cite

Erythromycin-resistant isolates of Streptococcus pneumoniae from blood cultures and noninvasive sites were studied over a 3-year period. The prevalence of erythromycin resistance was 11.9% (19 of 160) in blood culture isolates but 4.2% (60 of 1,435) in noninvasive-site isolates. Sixty-two of the 79 resistant isolates were available for study. The M phenotype was responsible for 76% (47 of 62) of resistance, largely due to a serotype 14 clone, characterized by multilocus sequence typing as ST9, which accounted for 79% (37 of 47) of M phenotype resistance. The ST9 clone was 4.8 times more common in blood than in noninvasive sites. All M phenotype isolates were PCR positive for mef(A), but sequencing revealed that the ST9 clone possessed the mef(A) sequence commonly associated with Streptococcus pyogenes. All M phenotype isolates with this mef(A) sequence also had sequences consistent with the presence of the Tn1207.1 genetic element inserted in the celB gene. In contrast, isolates with the mef(E) sequence normally associated with S. pneumoniae contained sequences consistent with the presence of the mega insertion element. All MLS B isolates carried erm(B), and two isolates carried both erm(B) and mef(E). Fourteen of the 15 MLS B isolates were tetracycline resistant and contained tet(M). However, six M phenotype isolates of serotypes 19 (two isolates) and 23 (four isolates) were also tetracycline resistant and contained tet(M). MICs for isolates with the mef(A) sequence were significantly higher than MICs for isolates with the mef(E) sequence (P < 0.001). Thus, the ST9 clone of S. pneumoniae is a significant cause of invasive pneumococcal disease in northeast Scotland and is the single most important contributor to M phenotype erythromycin resistance.

show abstract

Section: Discussionmentioning

confidence: 99%

Molecular Epidemiology of Erythromycin Resistance in Streptococcus pneumoniae Isolates from Blood and Noninvasive Sites

et al. 2002

View full text Add to dashboard Cite

show abstract

“…Former patients were identified from active surveillance for invasive S. pneumoniae disease in the Oxford and North East Thames regions of the UK [27,30]. Patients were defined as either (1) the isolation of S. pneumoniae from the cerebrospinal fluid (CSF) or (2) Gram-positive diplococci seen on Gram stain of a CSF sample in patients presenting with a clinical picture of meningitis.…”

Section: Methodsmentioning

confidence: 99%

Long-term outcomes of pneumococcal meningitis in childhood and adolescence

Christie¹,

Viner²,

Knox

et al. 2011

Eur J Pediatr

View full text Add to dashboard Cite

A vaccine to prevent pneumococcal meningitis (PM) has recently been introduced. However, contemporary data to inform cost-effectiveness analysis and justify its routine use are sparse. We examined the cognitive, educational, psychological and social outcomes of PM in childhood. We completed a population-based case-control study in two regions of the UK. Children and young people currently between 3 and 20 years of age that had been diagnosed with PM ≤14 years of age were identified from active regional surveillance. Controls were siblings or neighbours of similar age. Standardised questionnaires and neuropsychological testing was administered to assess IQ, educational attainments, memory, psychological distress, quality of life and hearing impairment. Data were available on 97 patients and 93 controls. Eighty-four patients had a sibling/neighbour-matched control. Both matched and unmatched analyses were completed, and results of the 84 matched comparisons were highly similar to the unmatched. For the total sample, controls were similar in age, ethnicity and socioeconomic status. Median age at meningitis was 11 months. Median time between meningitis and assessment was 6.0 years. In the matched analysis, partial or profound hearing impairment was reported in 14% of patients and 1% of controls. Patients had significantly lower mean full-scale IQ (p = 0.05), verbal IQ (p = 0.0008), numeracy (p = 0.02), total quality of life (p = 0.04), school functioning (p = 0.005), psychosocial functioning (p = 0.001) and psychological difficulties (p = 0.01). Parents of patients reported greater functional disability (p = 0.008), impairment in all aspects of quality of life (p = 0.001) and psychological difficulties (p < 0.0006). Findings for IQ were not materially different when analyses were repeated only in those without hearing impairment. In multivariate regression analysis that included both case-control status and hearing status, both being a patient (p = 0.001) and having profound hearing impairment (p = 0.001) were independently associated with lower full-scale IQ. Conclusions Pneumococcal meningitis is associated with major sequelae. Our findings strongly support the introduction of pneumococcal conjugate vaccine as part of routine childhood vaccination programmes internationally.

show abstract

“…Bacterial isolates were selected from those submitted to the Health Protection Agency in 2002 as well as from collections previously described [23][24][25][26]. Mutation frequencies were deter- b Resistance to erythromycin (ERY), sulphonamide (SUL), trimethoprim (TMP), chloramphenicol (CHL), penicillin (PEN), tetracycline (TET), streptomycin (STR), ciprofloxacin (CIP) and azithromycin (AZM), as described in Ref.…”

Section: Bacterial Isolates and Culturementioning

confidence: 99%

Mutation frequency in antibiotic-resistant and -susceptible isolates of Streptococcus pneumoniae

Henderson-Begg

Sheppard²,

George³

et al. 2010

International Journal of Antimicrobial Agents

View full text Add to dashboard Cite

Pneumococcal meningitis in the North East Thames Region UK: epidemiology and molecular analysis of isolates

Cited by 28 publications

References 33 publications

Molecular Epidemiology of Erythromycin Resistance in Streptococcus pneumoniae Isolates from Blood and Noninvasive Sites

Molecular Epidemiology of Erythromycin Resistance in Streptococcus pneumoniae Isolates from Blood and Noninvasive Sites

Long-term outcomes of pneumococcal meningitis in childhood and adolescence

Mutation frequency in antibiotic-resistant and -susceptible isolates of Streptococcus pneumoniae

Contact Info

Product

Resources

About