Laboratory methods for the diagnosis of meningitis caused by. Neisseria meningitidis is immediately reportable on first knowledge or. Neisseria meningitidis is a causative agent of lifethreatening cases of meningitis and sepsis, but it can also cause mild and selflimiting bacteraemia. Neisseria meningitidis is prevented through two types of vaccines. The isolates were assigned to 3 clonal complexes cc. Osmon, in goldmans cecil medicine twenty fourth edition, 2012 epidemiology.
About 10% of adults are carriers of the bacteria in. The spread of chloramphenicolresistant neisseria meningitidis in. It is now clear that neissera meningitidis has evolved a number of surface structures to mediate interaction with host cells and a number of mechanisms to subvert the immune system and escape. Neisseria meningitidis haemophilus influenzae streptococcus pneumoniae streptococcus pyogenes group a strep neisseria meningitidis is immediately reportable on first knowledge or suspicion of the diagnosis due to the potential need for prophylaxis of close contacts within 24 hours of suspected diagnosis suspicion is. In the united states, serogroup b is the predominant cause of disease and. Meningococcal disease plan utah department of health. This is normally caused by infection but can also have noninfectious causes. Demographic data, clinical syndrome, antibiotic treatment and status on discharge were obtained from laboratory records and patient charts where available. May 03, 2012 chemoprophylaxis of healthcare workers exposed to neisseria meningitidis 11 recommendations for the management of laboratory worker exposed to n. Update to cdcs sexually transmitted of meningococcal disease outbreaks caused dis 2001.
Neisseria meningitidis is a leading worldwide cause of sepsis and meningitis, with the highest increase in infants, young children, and adolescents resulting in significant morbidity and mortality. Neisseria meningitidis isolates in the united states have been largely susceptible to the antibiotics. Infection with the bacterial pathogen neisseria meningitidis is. Mar 21, 2019 meningitis occurs when the membranes that cover the brain and spinal cord become inflamed. Oklahoma state department of health 012018 revised neisseria meningitidis meningococcal disease 3 b. Meningitis due to neisseria meningitidis is a notifiable condition. Neisseria meningitidis serogroup y isolates from the united states, south africa, and. Primary adherence to mucosal epithelial cells occurs via pili and other surface components. These hyperinvasive disease lineages were associated with endemic disease, outbreaks, and high casefatality rates. Jul 10, 2017 neisseria meningitidis haemophilus influenzae streptococcus pneumoniae streptococcus pyogenes group a strep neisseria meningitidis is immediately reportable on first knowledge or suspicion of the diagnosis due to the potential need for prophylaxis of close contacts within 24 hours of suspected diagnosis suspicion is.
Neisseria meningitidis is one of the many bacteria that cause the disease. Antibiotic treatment of the disease is usually successful, especially if it is started. Feb 17, 2014 treatment empiric therapy ceftriaxone cefotaxime vancomycin until s pneumoniae is ruled out ampicillin to be added if listeria is suspected if severe penicillin allergies, meropenem is used instead acyclovir is to be added if viral infection is suspected. Appropriate suspending vehicle or syrup vehicle can be used for liquid suspension rifampin orders. Treatment of neisseria meningitidis prosthetic joint. Jan 15, 2010 in the period 19982007, a total of 2262 cases of meningococcal disease were reported from abcs sites. Meningococcal disease caused by the gram negative diplococcus neisseria meningitidis is a relatively common infectious. Neisseria meningitidis the meningococcus causes significant morbidity and mortality in children and young adults worldwide through epidemic or sporadic meningitis andor septicemia. Neisseria meningitidis and streptococcus pneumoniae are causative agents of meningitis. Meningitis due to neisseria meningitidis may begin with an influenza. Diagnosis, initial management, and prevention of meningitis. Vaccination is used for close contacts of patients with meningococcal disease due to a, c, y, or w5 serogroups, to prevent secondary cases.
Immediate recognition and treatment of meningococcal disease is critical. Common types of invasive meningococcal disease include meningitis infection of the meninges, which is a system of membranes surrounding the brain and spinal cord, septicemia blood. These cover neisseria meningitides, streptococcus pneumoniae, and haemophilus influenzae, and penetrate csf well. Other bacterial causes of meningitis include haemophilus influenza type b, streptococcus pneumoniae, streptococcus agalactiae, escherichia coli k1, listeria monocytogenes, and staphylococcus aureus. Invasive disease caused by neisseria meningitidis includes meningitis. Diagnosis and treatment of bacterial meningitis archives of. Neisseria meningitidis investigation and reporting. Recently, we demonstrated that a surprisingly large fraction of neisseria meningitidis disease isolates are lipid a mutants, due to inactivating mutations in the lpxl1 gene. Meningococcal disease reporting and investigation guideline. What is the optimal type, duration and method of administration of antibiotic treatment when started empirically, after the pathogen has been identi.
Pharyngolaryngitis caused by neisseria meningitidis. Neisseria meningitidis nm causes the majority of meningitis epidemics in africa, as well as the more severe meningococcal septicaemia. Current meningococcal vaccines are indicated for active immunization to prevent invasive meningococcal disease caused by neisseria meningitidis. Urine culture was positive for neisseria meningitidis. However in about 15% of these individuals, the organism invades the blood and disseminates, causing septicemia and from the there may cross the bloodbrain barrier causing meningitis def. Invasive meningococcal disease in the university of malaya medical. Invasive neisseria meningitis facts for health professionals surveillance invasive disease caused by neisseria meningitidis includes meningitis, septicemia, and other infections. Rare sporadic cases of meningococcal urogenital and anorectal infections, including urethritis. Sometimes the bacteria invade the body and cause certain illnesses, which are known as meningococcal disease.
Neisseria gonorrhoeae chapter 307 is a common cause of polyarthralgias and arthritis as well as oligoarticular arthritis and tenosynovitis in young, healthy patients. Neisseria meningitidis antimicrobial resistance in the united stat. Most patients recover completely on their own, and physicians will often recommend bed rest, fluids, and. Neisseria meningitidis a gramnegative diplococcal bacterium with nine. Bacterial meningitis texas department of state health. Neisseria gonorrhoeae an overview sciencedirect topics. Meningococcal disease is caused by bacteria called neisseria meningitidis. Bacterial meningitis can be caused by multiple organisms. Sep 22, 2016 meningococcal disease is an infection caused by the bacteria neisseria meningitidis, also known as the meningococcus bacteria. Diagnosis and treatment of bacterial meningitis archives. Neisseria meningitidis isolates in the united states have been largely susceptible to the antibiotics recommended for treatment and prophylaxis.
Treatment for meningococcal disease included serum therapy introduced in 19. Public health management of sporadic cases of invasive. Does the addition of vancomycin or rifampicin to a third. See epidemiology of neisseria meningitidis infection and bacterial meningitis in children older than one month. Rouphael n g and stephens d s neisseria meningitidis. Persontoperson transmission occurs via direct contact or through dispersion of respiratory droplets from a carrier of the bacteria, and can lead to invasive meningococcal disease. Changes in neisseria meningitidis disease epidemiology in. Meningococcal disease is a suddenonset, lifethreatening illness caused by the bacterium neisseria meningitidis. Neisseria meningitidis georgia department of public health. We report on three cases of meningococcal disease caused by ciprofloxacinresistant neisseria meningitidis, one in north dakota and two in minnesota. Antibiotic prophylaxis for close contacts can also decrease the risk of transmission.
If lumbar puncture is delayed, should we start treatment. Neisseria meningitidis causes meningitis, fulminant septicemia or mild meningococcemia attacking. Clinical features and diagnosis, section on causative organisms and epidemiology of bacterial meningitis. Emergence of ciprofloxacinresistant neisseria meningitidis. Specimen submission criteria for primary specimens to be forwarded to and tested. Traveling to areas outside of the united states, such as the meningitis bel. Urethritis caused by novel neisseria meningitidis serogroup w. The structure of neisseria meningitidis lipid a determines. Cartwright neisseria meningitidis who manual laboratory methods for diagnosis of meningitis caused by n. The first is a meningococcal conjugate vaccine which protects against four serogroups a, c, w, and y and is referred to as mcv4. Clinical features and diagnosis, section on causative organisms and epidemiology of bacterial. Molecular characteristics of neisseria meningitidis in. Neisseria meningitidis, often referred to as meningococcus, is a gramnegative bacterium that.
The bacterium is referred to as a coccus because it is round, and more specifically, a diplococcus because of its tendency to form pairs. Fomite transmission is not important as the organism does not survive in the environment 2. Information in this guidance is meant to inform both laboratory staff and health professionals about the risks and treatment in the event of an infectious agent exposure. Bacterial meningitis is an inflammation of the meninges, including the pia, arachnoid, and subarachnoid space, that occurs in response to infection with bacteria andor bacterial products.
When a single instance of neisseria meningitidis occurs, the state and county health departments work together to insure that appropriate contacts obtain antibiotics. This pathogen may also cause overwhelming sepsis, purpura fulminans, or rarely benign meningococcemia. Neisseria meningitidis is still a cause of endemic and epidemic disease in many countries and chemoprophylaxis is indicated to eradicate the carrier state and to prevent secondary diseases. Treatment and prevention of communityacquired bacterial. Neisseria meningitidis journal of medical microbiology. Neisseria meningitidis exposure medical response guidance. The bacteria cause illness sporadically, either in isolated cases or epidemics. The treatment of choice for gram negative bacillary meningitis is cefotaxime or ceftriaxone. Chemoprophylaxis of healthcare workers exposed to neisseria meningitidis 11 recommendations for the management of laboratory worker exposed to n. The 2751nucleotide sequence of the gyra gene is depicted to scale with the use of an isolate from patient 1 infected with ciprofloxacinresistant neisseria meningitidis and amplified bacterial. This may result from the phase variability of some neisseria genes. Ciprofloxacin for the treatment of uncomplicated gonorrhea infection i. Neisseria meningitidis is a common commensal bacterium of the human pharyngeal mucosa. About 1 in 10 people have these bacteria in the back of their nose and throat without being ill.
Browning et al treatment of neisseria meningitidis prosthetic joint infections 2 case presentations 2. However, 11 meningococcal disease cases reported in the. Two common types are streptococcus pneumoniae, with over 80 serogroups that can cause illness, and neisseria meningitidis, with 5 serogroups that most commonly cause meningitis. The second is a vaccine against neisseria meningitidis serogroup b and is referred to as menb. Prompt empiric antibiotic treatment can reduce morbidity and mortality among patients, and antibiotic prophylaxis can prevent secondary disease in close contacts. Serogroup c meningococcal outbreaks in the united states. Neisseria meningitidis an overview sciencedirect topics.
There is no specific treatment for viral meningitis at this time. Neisseria meningitidis culture and isolates laboratory. This study performed an epidemiological survey of neisseria meningitidis strains. Neisseria meningitidis infectious disease and antimicrobial. Oklahoma state department of health 012018 revised neisseria meningitidis meningococcal disease 4 recommended rifampin1,2 dosages for chemoprophylaxis regimen of highrisk contacts of invasive meningococcal disease. Neisseria meningitidis, often referred to as meningococcus, is a gramnegative bacterium that can cause meningitis and other forms of meningococcal disease such as meningococcemia, a lifethreatening sepsis. May 31, 2019 bacteria called neisseria meningitidis cause meningococcal disease.
Changes in neisseria meningitidis disease epidemiology in the. Only people who have been in close contact with saliva or respiratory. Neisseria meningitidis is fastidious and should be grown overnight on horse blood agar from glycerol stocks for a maximum of 16 h before use to ensure minimal mutation rates or downregulation of virulence factors. A latex agglutination test may be positive in meningitis caused by streptococcus pneumoniae, neisseria meningitidis, haemophilus influenzae, escherichia coli and group b streptococci. Ceftriaxone given in a single intramuscular dose is effective in eradicating carriage. Pdf serogroup diversity and antibiotic susceptibility of neisseria.
Biology, microbiology, and epidemiology methods mol biol. Practice guidelines for the management of bacterial. Neisseria meningitidis listeria monocytogenes if no organism can be isolated with routine culture and sensitivity assays of cerebrospinal fluid csf, the condition is called aseptic meningitis, and the etiology is likely viral e. During the 1990s, the serogroup c st11et37 complex was prominent in europe. Should antibiotics, apart from those used in clinical treatment, be given to a case. Neisseria meningitidis is an obligate human commensal bacterium that frequently colonises the upper respiratory tract. It is an uncommon disease but requires urgent treatment with antibiotics to prevent permanent damage or death. Prompt antibiotic treatment can reduce morbidity and mortality among patients and antibiotic. Early diagnosis and treatment are critical as meningococcal meningitis can reach 50% lethality. Treatment and prevention of meningococcal infection uptodate.
Department of health and human services division of public. The pathogen has a unique ability among the different etiologic agents of bacterial meningitis to cause major epidemics, case clusters, and. The estimated united states average annual incidence of meningococcal disease was 0. Rapid onset and progression of symptoms over hours is typical and can be helpful to distinguish this condition from self. Meningococcal disease bacterial meningitis fact sheet. Ampicillin should be added in young infants less than 3 months old to cover listeria monocytogenes. Sequelae associated with meningococcal disease occur in 1020% of survivors and include hearing loss. Neisseria meningitidis is a bacterium hosted only by humans and is a leading cause of bacterial meningitis in the united states. Neisseria meningitidis is a common cause of communityacquired bacterial meningitis in children and adults in the united states and in many other countries.
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