Pneumococcal Meningitis with Serotype 7 Who Develops 12. Nerve Paralysis

Meningitis is an inflammatory disease of the leptomeninges surrounding the spinal cord and brain. Streptococcus pneumoniae (S. pneumoniae) is the most common cause of bacterial meningitis in infants and children older than one month. In this report, we present a 13-month-old infant who, after receiving three doses of the 13-valent conjugated pneumococcal vaccine, had nervus hypoglossus paralysis as a result of serotype 7 S. pneumoniae meningitis. She was admitted into our center with complaints of high fever for 2 days, apathy that started in the last 24 hours, and a tendency for sleeping. Penicillin and ceftriaxone susceptible S. pneumoniae grew in cerebrospinal fluid culture. Antibiotic treatment was completed in six weeks as she had a millimetric abscess in MR imaging. Considering common variable immunodeficiency in the patient who was examined for immunodeficiency, intravenous immunoglobulin treatment was started. The physical examination results of the patient were entirely improved. In conclusion, meningitis is a pediatric emergency with a high mortality and complication rate. If meningitis is managed on time and correctly it can heal without sequelae. Vaccination is crucial for prevention. Despite vaccination, although rare, infection with vaccine strains may occur. Patients infected with vaccine strains may require evaluation in terms of immunodeficiency

Molecular epidemiology and antibiotic susceptibility pattern of nozocomial acinetobacter baumannii isolates in children.

TEZ9148Tez (Yandal Uzmanlık) -- Çukurova Üniversitesi, Adana, 2011Kaynakça (s. 58-70) var.ix, 71 s. : res., tablo ; 29 cm.Amaç: Acinetobacter baumannii suŞları ile oluŞan hastane enfeksiyonları son yıllarda morbidite ve mortalitenin önemli bir sebebi haline gelmiŞtir. Biz bu çalıŞmada hastanemizde yatmakta olan çocuk hastalardan izole edilen Acinetobacter baumannii suŞlarının neden olduğu enfeksiyon tiplerini ve bu suŞların antibiyotik duyarlılığı, fenotipik ve genotipik özelliklerini değerlendirmeyi amaçladık. Yöntem: Bu çalıŞmaya klinik örneklerinde Acinetobacter Baumannii suŞu izole edilen 69 çocuk hasta dahil edildi. Gzole edilen suŞların neden olduğu enfeksiyon tipleri ve bu izolatların antibiyotik duyarlılıklarına bakıldı. Yanı sıra, bu suŞlarda antibiyotipleme yöntemi fenotipik ve pulsed field gel electroforesis yöntemi ile genotipik özellikleri değerlendirildi. Bulgular: ÇalıŞmaya dahil edilen 69 hastanın % 50‘sinde A. baumanni’ye bağlı enfeksiyon tespit edildi. Hastane kökenli pnömoni en fazla tespit edilen enfeksiyon tipi idi (% 58). Karbapenem direnci % 91.3 oranında tespit edildi. Tigesikline karŞı direnç oranı yalnızca % 18.84 idi ve kolistin direnci tespit edilen suŞ yoktu. Fenotipik bir yöntem olan antibiyotipleme sonucunda 69 A. baumannii izolatın; birisi 62 üyeden oluŞan diğeri 2 üyeden oluŞan 2 küme içerisine dağıldığını belirledik. Pulsed Field Gel Electrophoresis ile inceleme sonunda 8 majör küme ve 2 ayrı izolat olmak üzere toplam 10 küme belirlenmiŞtir. Sonuç: Acinetobacter baumannii hastane kaynaklı enfeksiyonlarda önemli bir role sahiptir ve antibiyotik direnci yüksek oranda izlenmektedir. Acinetobacter baumannii izolatlarının tiplendirilmesinde moleküler tiplendirme yöntemleri fenotipik yöntemlerden daha üstündür.Background: Acinetobacter baumannii have been a leading cause of nosocomial infections, causing significant morbidity and mortality. In the present study, we aimed to investigate the types of nosocomial infections caused by Acinetobacter baumannii and antibiotic susceptibility pattern, and phenotypic and genotypic characteristics of Acinetobacer Baumannii isolates in our center. Method: Sixty-nine children in whom Acinetobacter baumanii isolated from their clinical specimens were included in the present study. Types of nosocomial infections caused by these isolates were evaluated. In addition, antibiotic susceptibility pattern, and phenotypic and genotypic characteristics of those isolates were determined via antibiotyping and pulsed field gel electrophoresis methods, respectively. Results: Fifty of 69 children were considered to have nosocomial infection caused by Acinetobacter baumannii. Nosocomial pneumonia (50% ) was the commonest type of those infections. The rate of carbapenem resistance was determined as 91.3% . Tigecycline resistance was found as 18.84% , while no isolate was found to have colistine resistance. Following antibiotyping, 69 Acinetobacter baumannii isolates clustered into two groups of which the biggest have 62 members. Totally 10 groups which were consisted of 8 major and two minor groups were determined via pulsed field gel electrophoresis. Conclusion: Acinetobacter baumannii isolates are leading cause of nosocomial infections have high rate multi-drug antibiotic resistance. Molecular typing methods are over phenotyping methods in determining the type of Acinetobacter baumannii isolate

Characterization of invasive Neisseria meningitidis isolates recovered from children in Turkey during a period of increased serogroup B disease, 2013-2017

Diverse Neisseria meningitidis strains belonging to various serogroups and clonal complexes cause epidemic and endemic life-threatening disease worldwide. This study aimed to investigate the genetic diversity of recent invasive meningococci in Turkey with respect to multilocus sequence type (MLST) and also meningococcal serogroup B (MenB) vaccine antigens to enable assessment of potential MenB strain coverage using the genetic Meningococcal Antigen Typing System (gMATS). Fifty-four isolates, representing 37.5% of all pediatric (ages 0-18 years) invasive meningococcal disease cases in Turkey from January 2013 to December 2017, underwent genome sequence analysis. Thirty-six (66.7%) isolates were MenB, 10 (18.5%) were serogroup W (MenW), 4 (7.4%) were serogroup A (MenA), 3 (5.6%) were serogroup Y (MenY) and 1 (1.8%) was serogroup X (MenX). The MenB isolates were diverse with cc35 (19.4%), cc41/44 (19.4%) and cc32 (13.8%) as the most prevalent clonal complexes. The MenW isolates (n = 10) comprised cc11 (n = 5), ST-2754 (cc-unassigned; n = 4) and cc22 (n = 1). gMATS was indicative of high 4CMenB coverage (72.2-79.1%) of Turkish invasive MenB strains from pediatric patients. Strain coverage of several clonal complexes differed from that seen elsewhere in Europe highlighting the importance of performing local assessments and also the use of phenotypic methods, i.e. MATS, where possible. All of the isolates possessed in-frame fhbp alleles and so were potentially covered by MenB-fHbp. Continued surveillance is essential to guide recommendations for current and future vaccines as well as understanding changes in epidemiology. (C) 2020 Elsevier Ltd. All rights reserved

Multicenter Hospital-Based Prospective Surveillance Study of Bacterial Agents Causing Meningitis and Seroprevalence of Different Serogroups of Neisseria meningitidis, Haemophilus influenzae Type b, and Streptococcus pneumoniae during 2015 to 2018 in Turkey

The etiology of bacterial meningitis in Turkey changed after the implementation of conjugated vaccines against Streptococcus pneumoniae and Haemophilus influenzae type b (Hib) in the Turkish National Immunization Program (NIP). Administration of Hib vaccine and PCV-7 (7-valent pneumococcal conjugate vaccine) was implemented in NIP in 2006 and 2009, respectively. In 2011, PCV-7 was replaced with PCV-13. Meningococcal vaccines have not yet been included in Turkish NIP. This prospective study comprised 27 hospitals located in seven regions of Turkey and represented 45% of the population. Children aged between 1 month and 18 years who were hospitalized with suspected meningitis were included. Cerebrospinal fluid (CSF) samples were collected, and bacterial identification was made according to the multiplex PCR assay results. During the study period, 994 children were hospitalized for suspected meningitis, and Hib (n = 3, 2.4%), S. pneumoniae (n = 33, 26.4%), and Neisseria meningitidis (n = 89, 71%) were detected in 125 samples. The most common meningococcal serogroup was MenB. Serogroup W comprised 13.9% (n = 5) and 7.5% (n = 4) of the meningococci in 2015 to 2016 and 2017 to 2018, respectively. Serogroup C was not detected. There were four deaths in the study; one was a pneumococcus case, and the others were serogroup B meningococcus cases. The epidemiology of meningococcal diseases has varied over time in Turkey. Differing from the previous surveillance periods, MenB was the most common serogroup in the 2015-to-2018 period. Meningococcal epidemiology is so dynamic that, for vaccination policies, close monitoring is crucial