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. 1994 Feb;112(1):115–124. doi: 10.1017/s0950268800057472

Patient and strain characteristics in relation to the outcome of meningococcal disease: a multivariate analysis.

R J Scholten 1, H A Bijlmer 1, H A Valkenburg 1, J Dankert 1
PMCID: PMC2271487  PMID: 8119350

Abstract

To investigate the joint association of patient and strain characteristics with the outcome of meningococcal disease (MD), data were collected on 563 consecutive cases of MD reported between 1989 and 1990 in The Netherlands. The meningococcal isolates were characterized with regard to their surface characteristics. Sequelae occurred in 8.5% of the patients, and were only associated with the presence of bacteraemia. The case-fatality rate was 7.7%. Infants aged < or = 5 months and patients in the age-groups of 10-19 years and > or = 50 years had an increased risk for a fatal outcome compared with children from 6 months to 9 years old (Odds Ratios [ORs]: 5.1, 3.4 and 9.8, respectively). The OR for females versus males was 2.3. The ORs for patients with bacteraemia, or a combination of bacteraemia and meningitis, compared with meningitic patients, were 2.3 and 3.1. Meningococcal strain characteristics did not influence the case-fatality rate substantially. In conclusion, host factors were found to be determinants for a fatal outcome of MD in The Netherlands from 1989 to 1990.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Andersen B. M. Endotoxin release from neisseria meningitidis. Relationship between key bacterial characteristics and meningococcal disease. Scand J Infect Dis Suppl. 1989;64:1–43. doi: 10.3109/inf.1989.21.suppl-64.01. [DOI] [PubMed] [Google Scholar]
  2. Andersen B. M. Mortality in meningococcal infections. Scand J Infect Dis. 1978;10(4):277–282. doi: 10.3109/inf.1978.10.issue-4.04. [DOI] [PubMed] [Google Scholar]
  3. Brandtzaeg P., Kierulf P., Gaustad P., Skulberg A., Bruun J. N., Halvorsen S., Sørensen E. Plasma endotoxin as a predictor of multiple organ failure and death in systemic meningococcal disease. J Infect Dis. 1989 Feb;159(2):195–204. doi: 10.1093/infdis/159.2.195. [DOI] [PubMed] [Google Scholar]
  4. Cartwright K., Reilly S., White D., Stuart J. Early treatment with parenteral penicillin in meningococcal disease. BMJ. 1992 Jul 18;305(6846):143–147. doi: 10.1136/bmj.305.6846.143. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. De Wals P., Hertoghe L., Reginster G., Borlee I., Bouckaert A., Dachy A., Lechat M. F. Mortality in meningococcal disease in Belgium. J Infect. 1984 May;8(3):264–273. doi: 10.1016/s0163-4453(84)94123-9. [DOI] [PubMed] [Google Scholar]
  6. Fallon R. J., Brown W. M., Lore W. Meningococcal infections in Scotland 1972-82. J Hyg (Lond) 1984 Oct;93(2):167–180. doi: 10.1017/s0022172400064688. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Fijen C. A., Kuijper E. J., Hannema A. J., Sjöholm A. G., van Putten J. P. Complement deficiencies in patients over ten years old with meningococcal disease due to uncommon serogroups. Lancet. 1989 Sep 9;2(8663):585–588. doi: 10.1016/s0140-6736(89)90712-5. [DOI] [PubMed] [Google Scholar]
  8. Frasch C. E. Vaccines for prevention of meningococcal disease. Clin Microbiol Rev. 1989 Apr;2 (Suppl):S134–S138. doi: 10.1128/cmr.2.suppl.s134. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Halstensen A., Pedersen S. H., Haneberg B., Bjorvatn B., Solberg C. O. Case fatality of meningococcal disease in western Norway. Scand J Infect Dis. 1987;19(1):35–42. doi: 10.3109/00365548709032375. [DOI] [PubMed] [Google Scholar]
  10. Havens P. L., Garland J. S., Brook M. M., Dewitz B. A., Stremski E. S., Troshynski T. J. Trends in mortality in children hospitalized with meningococcal infections, 1957 to 1987. Pediatr Infect Dis J. 1989 Jan;8(1):8–11. doi: 10.1097/00006454-198901000-00003. [DOI] [PubMed] [Google Scholar]
  11. Palmer S. R., Corson J., Hall R., Payne S., Ludlow J., Deere B., Jones H., Kaul S., Stubbins J., Williams R. Meningococcal disease in Wales: clinical features, outcome and public health management. J Infect. 1992 Nov;25(3):321–328. doi: 10.1016/0163-4453(92)91699-c. [DOI] [PubMed] [Google Scholar]
  12. Peltola H. Meningococcal disease: still with us. Rev Infect Dis. 1983 Jan-Feb;5(1):71–91. doi: 10.1093/clinids/5.1.71. [DOI] [PubMed] [Google Scholar]
  13. Poolman J. T. Polysaccharides and membrane vaccines. Adv Biotechnol Processes. 1990;13:57–86. [PubMed] [Google Scholar]
  14. SLATERUS K. W. Serological typing of meningococci by means of micro-precipitation. Antonie Van Leeuwenhoek. 1961;27:305–315. doi: 10.1007/BF02538460. [DOI] [PubMed] [Google Scholar]
  15. Samuelsson S., Ege P., Berthelsen L., Lind I. An outbreak of serogroup B:15:P1.16 meningococcal disease, Frederiksborg County, Denmark, 1987-9. Epidemiol Infect. 1992 Feb;108(1):19–30. doi: 10.1017/s0950268800049463. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Scholten R. J., Bijlmer H. A., Poolman J. T., Kuipers B., Caugant D. A., Van Alphen L., Dankert J., Valkenburg H. A. Meningococcal disease in The Netherlands, 1958-1990: a steady increase in the incidence since 1982 partially caused by new serotypes and subtypes of Neisseria meningitidis. Clin Infect Dis. 1993 Feb;16(2):237–246. doi: 10.1093/clind/16.2.237. [DOI] [PubMed] [Google Scholar]
  17. Spanjaard L., Bol P., de Marie S., Zanen H. C. Association of meningococcal serogroups with the course of disease in the Netherlands, 1959-83. Bull World Health Organ. 1987;65(6):861–868. [PMC free article] [PubMed] [Google Scholar]
  18. Spanjaard L., Bol P., de Marie S., Zanen H. C. Association of meningococcal serotypes with the course of disease: serotypes 2a and 2b in the Netherlands, 1959-1981. J Infect Dis. 1987 Feb;155(2):277–282. doi: 10.1093/infdis/155.2.277. [DOI] [PubMed] [Google Scholar]
  19. Strang J. R., Pugh E. J. Meningococcal infections: reducing the case fatality rate by giving penicillin before admission to hospital. BMJ. 1992 Jul 18;305(6846):141–143. doi: 10.1136/bmj.305.6846.141. [DOI] [PMC free article] [PubMed] [Google Scholar]

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