Pneumococcal meningitis post-cochlear implantation: Preventative measures

Wei, Benjamin; Shepherd, Robert K.; Robins-Browne, Roy M.; Clark, Graeme M.; O’Leary, Stephen

doi:10.1016/j.otohns.2010.08.011

Cited by 20 publications

(12 citation statements)

References 51 publications

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“…A special population at increased risk for S. pneumoniae meningitis are patients with cochlear implants who were found to have 30 times more the incidence of pneumococcal meningitis than that of an age-matched cohort in the general population in the U.S. 85 Studies have shown that pneumococcal vaccination was effective in preventing meningitis induced via the hematogenous route but not through direct extension from the middle ear. [86][87][88] So the current recommendation is that all current and future recipients of cochlear implants should be immunized against S. pneumoniae. In addition to vaccination, providing chemoprophylaxis to close contacts of patients with H. influenzae and N. meningitidis should be provided to prevent and eradicate carrier state and secondary cases.…”

Section: Preventionmentioning

confidence: 99%

<p>Management of Acute Bacterial Meningitis in Children</p>

Alamarat¹,

Hasbun²

2020

IDR

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Acute community-acquired bacterial meningitis (ABM) in children continues to have high rates of neurological morbidity and mortality despite the overall declining rates of infection attributed to the use of vaccines and intrapartum Group B Streptococcus prophylaxis. Prompt diagnosis and early antibiotic therapy are crucial and should not be delayed to obtain cranial imaging. Differentiating bacterial from viral meningitis continues to be a clinical dilemma especially in patients with previous antibiotic exposure. Clinical models and inflammatory biomarkers can aid clinicians in their diagnostic approach. Multiplex polymerase chain reaction and metagenomic next-generation sequencing are promising tools that can help in early and accurate diagnosis. This review will present the epidemiology of ABM in children, indications of cranial imaging, role of different models and serum biomarkers in diagnosing ABM, and management including the use of adjunctive therapies and methods of prevention.

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Section: Preventionmentioning

confidence: 99%

<p>Management of Acute Bacterial Meningitis in Children</p>

Alamarat¹,

Hasbun²

2020

IDR

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“…(2013) found that 13% of elderly CI patients experience flap thinning over long-term follow up, although this is rarely significant enough to require implant removal. Meningitis in the post-surgical CI patient is rare and compliance with CI vaccination protocols, specifically against Streptococcus pneumonia , is crucial at all ages ( Wei et al., 2010 ).…”

Section: Safetymentioning

confidence: 99%

Safety and outcomes of cochlear implantation in the elderly: A review of recent literature

Yang

Cosetti

2016

Journal of Otology

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Global demographic changes related to longevity are leading to increasing numbers of the elderly, for whom hearing loss is a significant cause of morbidity and disability. Once met with reticence, severely hearing impaired older adults are increasingly being considered for cochlear implantation (CI). Significant data indicate that CI in the elderly population is safe, well-tolerated, and effective. Risks from CI surgery and anesthesia are low and generally comparable to rates in other age groups. Outcomes studies regarding CI in older adults have shown excellent improvements to speech perception, quality of life, and even cognition. Overall, currently available data suggests that advanced age should not, in itself, be considered a barrier to implantation. This review paper will highlight selected articles from recent medical literature regarding the safety and efficacy of CI in the elderly population.

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“…This chagrin was also reflected in the ICM 2018 voting, in which only 62% of GA delegates agreed that immunotherapy and immunoprophylaxis can be used to prevent biofilm formation and implant‐associated infections (https://www.ors.org/wp-content/uploads/2019/01/Question-5.pdf). Despite the optimistic rationale written in response to this question, which cites: (i) pre‐clinical evidence, (ii) successful human vaccines against other bacterial pathogens (e.g., Bordetella pertussis, Clostridium tetanii, Corynebacterium diphtheriae , Haemophilus influenzae type b, Neisseria meningiditis , Streptococcus pneumoniae ), and (iii) the specific example of S. pneumoniae vaccines (Prevnar ® , Wyeth Pharmaceuticals Inc. and Pneumovax ® , Merck & Co., Inc.) that are Food and Drug Administration (FDA)‐approved for the prevention of meningitis in cochlear implant recipients, this skepticism in response to immunotherapy and immunoprophylaxis for MSKI is appropriate based on the failure of all clinical trials to date that have evaluated immunizations against S. aureus. …”

Section: Resultsmentioning

confidence: 99%

2018 International Consensus Meeting on Musculoskeletal Infection: Research Priorities from the General Assembly Questions

Schwarz

Parvızı

Gehrke

et al. 2019

Journal Orthopaedic Research

231

200

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Musculoskeletal infections (MSKI) remain the bane of orthopedic surgery, and result in grievous illness and inordinate costs that threaten healthcare systems. As prevention, diagnosis, and treatment has remained largely unchanged over the last 50 years, a 2nd International Consensus Meeting on Musculoskeletal Infection (ICM 2018, https://icmphilly.com) was completed. Questions pertaining to all areas of MSKI were extensively researched to prepare recommendations, which were discussed and voted on by the delegates using the Delphi methodology. The questions, including the General Assembly (GA) results, have been published (GA questions). However, as critical outcomes include: (i) incidence and cost data that substantiate the problems, and (ii) establishment of research priorities; an ICM 2018 research workgroup (RW) was assembled to accomplish these tasks. Here, we present the result of the RW consensus on the current and projected incidence of infection, and the costs per patient, for all orthopedic subspecialties, which range from 0.1% to 30%, and $17,000 to $150,000. The RW also identified the most important research questions. The Delphi methodology was utilized to initially derive four objective criteria to define a subset of the 164 GA questions that are high priority for future research. Thirty-eight questions (23% of all GA questions) achieved the requisite > 70% agreement vote, and are highlighted in this Consensus article within six thematic categories: acute versus chronic infection, host immunity, antibiotics, diagnosis, research caveats, and modifiable factors. Finally, the RW emphasizes that without appropriate funding to address these high priority research questions, a 3rd ICM on MSKI to address similar issues at greater cost is inevitable. ICM, International Consensus Meeting; MSKI, musculoskeletal infections; RW, research workgroup. * 2018 ICM RW consensus on the current and projected incidences of infection, and costs per patient, for all orthopedic subspecialties. These estimates, which were compiled from information were obtained from: (i) recent peer-reviewed publications, (ii) analysis of 2015 national administrative data using HCUPNet (https://hcupnet.ahrq.gov/#setup), and (iii) RW expertise. 998 SCHWARZ ET AL.

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Pneumococcal meningitis post-cochlear implantation: Preventative measures

Cited by 20 publications

References 51 publications

<p>Management of Acute Bacterial Meningitis in Children</p>

<p>Management of Acute Bacterial Meningitis in Children</p>

Safety and outcomes of cochlear implantation in the elderly: A review of recent literature

2018 International Consensus Meeting on Musculoskeletal Infection: Research Priorities from the General Assembly Questions

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