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Broker M.,Novartis | Jacobsson S.,Orebro University | Kuusi M.,Finnish National Institute for Health and Welfare | Pace D.,Materials Dei Hospital | And 5 more authors.
Human Vaccines and Immunotherapeutics | Year: 2012

Neisseria meningitidis is differentiated into 12 distinct serogroups, of which A, B, C, W-135, X, and Y are medically most important and represent an important health problem in different parts of the world. The epidemiology of N. meningitidis is unpredictable over time and across geographic regions. Recent epidemiological surveillance has indicated an increase of serogroup Y invasive meningococcal disease in some parts of Europe as shown in the epidemiological data for 2010 from various European countries previously published in this journal.1 Here, data is reported indicating that the emergence of serogroup Y continued in 2011 in various regions of Europe. The average age of persons affected by N. meningitidis serogroup Y seems to have decreased in some countries in comparison to the previous decade. © 2012 Landes Bioscience. Source


Spoulou V.,National and Kapodistrian University of Athens | Tzanakaki G.,National Meningitis Reference Laboratory | Lekka S.,National and Kapodistrian University of Athens | Chouliaras G.,National and Kapodistrian University of Athens | And 2 more authors.
Vaccine | Year: 2011

Natural and vaccine-induced immunity to meningococcus C (MenC) was evaluated in asplenic adolescents and adults with β-thalassemia. At baseline 19.3% of patients and 22.8% age-matched controls had positive (>2. μg/ml) naturally acquired Men C- specific IgG antibodies; patients had a lower probability of having protective SBA compared to controls (OR = 21, p= 0.012). MenC conjugate vaccine (MCC) induced protective IgG concentrations in 63% of patients and 90.1% of controls. SBA increased significantly post vaccination and there were no differences between patients and controls; however patients had significantly lower IgG concentrations post vaccination compared to controls (4.52 vs 10.94. μg/ml, p<. 0.001, respectively). A second dose of MCC given to 11 patients who had received MCC in the past induced higher IgG compared to primary response (p= 0.001). Naturally- and vaccine-induced immunity to MenC is impaired in asplenic β-thalassemics; a second dose of MCC improves vaccine immunogenicity and is essential for their optimal protection. © 2011 Elsevier Ltd. Source


Priftis K.N.,National and Kapodistrian University of Athens | Litt D.,Public Health England | Manglani S.,Public Health England | Anthracopoulos M.B.,University of Patras | And 7 more authors.
Chest | Year: 2013

Background: Protracted bacterial bronchitis is a major cause of persistent cough in childhood. The organisms most commonly isolated are nontypable Haemophilus infl uenzae and Streptococcus pneumoniae. There are no studies addressing typing of these organisms when recovered from the lower airways. Methods: Isolates of these two organisms (identified in BAL samples from children undergoing routine investigation of a chronic cough thought to be attributable to a protracted bacterial bronchitis) were subject to typing. Samples were collected in Sheffield, England, and Athens, Greece. The majority of the children from Sheffield had received pneumococcal-conjugate vaccines 7 or 13 (PCV-7 or PCV-13) conjugate vaccine but only a minority of Greek children had received PCV-7. Results: All 18 S pneumoniae isolates from Greek BAL samples are serotypes contained in PCV-13 while 10 are contained in PCV-7. In contrast, 28 of the 39 samples from Sheffield contained serotypes that are not included in PCV-13. All 26 of the nontypable H influenzae samples obtained in Sheffield produced distinct multilocus variable-number tandem repeat analysis profiles. There was a significant difference between children from Athens and Sheffield in the distribution of serotypes contained or not contained in the pneumococcal vaccine (P = .04). More specifically, immunization with pneumococcal vaccine was related with isolation of S pneumoniae serotypes not included in the vaccine (OR, 0.021; CI, 0.003-0.115; P ≥.001). Conclusions: The data suggest that both vaccine and nonvaccine S pneumoniae serotypes may play a role in protracted bacterial bronchitis and provide some hints that serotype replacement may occur in response to the introduction of conjugate vaccines. © 2013 American College of Chest Physicians. Source


Papavasileiou K.,Penteli Childrens Hospital | Papavasileiou E.,Penteli Childrens Hospital | Tzanakaki G.,National Meningitis Reference Laboratory | Voyatzi A.,Penteli Childrens Hospital | And 2 more authors.
Molecular Diagnosis and Therapy | Year: 2011

Background and Objectives: Acute bacterial meningitis is one of the most severe infectious diseases, affecting mainly infants and, secondarily, older children and adolescents. Diagnosis in the early stages is often difficult and despite treatment with appropriate antibiotic therapy, the case fatality rate remains high. In the present study, the incidence of bacterial meningitis was registered in a general pediatric hospital in Athens, Greece, during a 9-year period (2000-2008), and the use of molecular methods in the diagnosis of bacterial meningitis versus the conventional cultural methods was evaluated. The impact of vaccination against meningitiscausing bacteria on the incidence of bacterial meningitis was also assessed. Methods: From a total of 1833 children hospitalized with suspected clinical symptoms and signs of meningitis, all cerebrospinal fluid (CSF) and blood samples were analyzed by white blood cell (WBC) count, measurement of glucose, protein, and C-reactive protein (CRP) levels, as well as by conventional bacteriologic culture methods. If samples showed altered CSF markers that were consistent with meningitis in general, they were further investigated by PCR for bacterial pathogens. Results: Of the 1833 patients, 289 (15.76%) were found to be positive for meningitis after CSF examination, based on white blood cell count and differentiation, glucose, protein, and CRP. Fifty-six of the 289 (19.37%) had confirmed bacterial meningitis, as diagnosed by either culture and/or PCR. Of these 56 cases, 44 (78.6%) were detected only by PCR, and 12 cases (21.4%) were confirmed by PCR and culture. The predominant microorganism was Neisseria meningitidis serogroup B (n = 40; 71.4%), followed by Streptococcus pneumoniae not typed [NT] (n = 7; 12.5%), Streptococcus spp. (n = 4; 7.1%), Haemophilus influenzae NT (n = 2; 3.6%), and S. pneumoniae serotype 3, Streptococcus group B, and S. pneumoniae serotype 18C (each n = 1; 1.8%). Conclusion: In Greece, according to data from the National Meningitis Reference Laboratory, vaccination against N. meningitidis serogroup C since 2001 led to a 10-fold decrease in the incidence of meningitis cases, vaccination against S. pneumoniae serotypes included in the heptavalent conjugate vaccine since 2005 led to a 3.4-fold incidence decrease, and vaccination against H. influenzae type b since 1992 led almost to an absence of cases. In the population of the present study, none of the cases were caused by the abovementioned vaccine pathogens, except for one S. pneumoniae serotype 18C case with no history of past vaccination. The introduction of vaccination against meningitis-causing bacteria has drastically decreased the emergence of the infection. The improved molecular amplification assays proved to be superior to conventional bacteriologic methods and should be introduced into routine diagnosis, as well as the epidemiologic surveillance of bacterial meningitis. © 2011 Adis Data Information BV. All rights reserved. Source


Blackwell C.C.,University of Newcastle | Titmarsh C.J.,University of Newcastle | Moscovis S.M.,University of Newcastle | Hall S.,University of Newcastle | And 6 more authors.
Journal of Medical Microbiology | Year: 2013

High levels of pro-inflammatory cytokines are implicated in the severity of invasive meningococcal disease (IMD) and viral meningitis (VM). This study compared single-nucleotide polymorphisms (SNPs) in pro- and anti-inflammatory cytokine genes among patients with VM or IMD. Patient DNA samples were prepared by the National Meningitis Reference Laboratory in Athens: n=98 for IMD and n=53 for VM. The results for both patient groups were compared with data published for healthy Greek control data. Real-time PCR was used to assess the interleukin (IL) gene SNPs IL6 G-174C, IL1B C-511T, IL1RN T+2018C, IL10 G-1082A and IL8 A-251T and the tumour necrosis factor α (TNF-α) SNP TNFA G-308A. Differences were compared by Fisher's exact test. The genotype for high IL-6 responses was predominant among IMD (51 %, P=0.0008) and VM (74.5 %, P<0.0001) patients compared with the controls (31 %). The genotype associated with high TNF-α responses was 5 % among controls and lower for IMD (1.1 %, P=0.0014) and VM (0 %, P=0.052). There was no difference for IL-8 SNPs between controls and IMD (P=0.162), but the difference was significant for VM (P=0.0025). IL-6 (P=0.024) and IL-8 (P=0.00004) SNPs differed between IMD and VM. Reports on associations between IL-8 SNPs and cytokine responses differ. Because of its role in neutrophil attraction, differences in frequencies of the IL-8 SNP for IMD and VM require further investigation. © 2013 SGM. Source

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