3. Würzburger Workshop zur Epidemiologie, Prävention und Therapie der invasiven Meningokokkenerkrankung 2006

Zusammenfassung

Am 5. Oktober 2006 veranstaltete das Nationale Referenzzentrum für Meningokokken (NRZM) in Zusammenarbeit mit der Deutschen Gesellschaft für Hygiene und Mikrobiologie (DGHM) den 3. Workshop zur Epidemiologie, Prävention und Therapie der invasiven Meningokokkenerkrankung. Anlässlich der neuen, im August 2006 von der Ständigen Impfkomission (STIKO) ausgesprochenen Empfehlung für eine Impfung gegen Meningokokken der Serogruppe C für alle Kinder im zweiten Lebensjahr wurden Erfahrungen aus unterschiedlichen Impfkampagnen europäischer Länder vorgestellt und mit der deutschen Situation verglichen. Die Tagung bot die Möglichkeit, am NRZM genützte computergestützte Clustererkennungsmethoden, sowie deren Integration in das interaktive Geografische Informationssystem EpiScanGIS kennen zu lernen. Interventionsmöglichkeiten von öffentlichen Gesundheitsbehörden wurden anhand regionaler Inzidenzerhöhungen in Oberallgäu, Sangerhausen und im Großraum Aachen veranschaulicht. Überdies wurden gegenwärtige Entwicklungen aus der Meningokokkenforschung und die Resistenzentwicklung auf europäischer Ebene beleuchtet, sowie die aktuelle Evidenzlage bezüglich des klinischen Managements und der Chemoprophylaxe dieser invasiven bakteriellen Erkrankung präsentiert.

Abstract

On October 5th, 2006, the German Reference Centre for Meningococci (NRZM) held the 3rd Workshop on Epidemiology, Prevention and Treatment of Invasive Meningococcal Disease, in collaboration with the German Society for Hygiene and Microbiology (DGHM). Given the recent recommendation of the German Standing Committee on Vaccination (STIKO) for conjugate meningococcal C vaccination of all children in the second year of life, observations from meningococcal C conjugate vaccination campaigns in other European countries were presented and compared to the German situation. Moreover, the newly implemented cluster detection routines employed at the NRZM and their integration into the interactive geographical information system EpiScanGIS were shown. Based on recent experiences from regional outbreaks in Oberallgäu, Sangerhausen, and Greater Aachen, examples for public health intervention were given at the conference. In addition, current developments in the area of meningococcal research, as well as trends in antimicrobial susceptibility were covered. Finally, the latest evidence concerning the clinical management and chemoprophylaxis of this invasive bacterial disease was discussed.

invasive Meningokokken-erkrankung - Sepsis - Meningitis

Invasive Meningococcal disease - sepsis - meningitis

Literatur

• 1 Ramsay ME, Andrews NJ, Trotter CL, Kaczmarski EB, Miller E. Herd immunity from meningococcal serogroup C conjugate vaccination in England: database analysis.  Bmj. 2003;  326 365-366
• 2 Trotter CL, Edmunds WJ. Reassessing the cost-effectiveness of meningococcal serogroup C conjugate (MCC) vaccines using a transmission dynamic model.  Med Decis Making. 2006;  26 38-47
• 3 Schrauder A, Claus H, Elias J. et al . Capture-recapture analysis to estimate the incidence of invasive meningococcal disease in Germany, 2003.  Epidemiol Infect. 2006;  1-8
• 4 Giuliani MM, Adu-Bobie J, Comanducci M. et al . A universal vaccine for serogroup B meningococcus.  Proc Natl Acad Sci USA. 2006;  103 10834-10839
• 5 Bille E, Zahar JR, Perrin A. et al . A chromosomally integrated bacteriophage in invasive meningococci.  J Exp Med. 2005;  201 1905-1913
• 6 Pearson N, Gunnell DJ, Dunn C. et al . Antibiotic prophylaxis for bacterial meningitis: overuse and uncertain efficacy.  J Public Health Med. 1995;  17 455-458
• 7 Hastings L, Stuart J, Andrews N, Begg N. A retrospective survey of clusters of meningococcal disease in England and Wales, 1993 to 1995: estimated risks of further cases in household and educational settings.  Commun Dis Rep CDR Rev. 1997;  7 R195-R200
• 8 Purcell B, Samuelsson S, Hahne SJ. et al . Effectiveness of antibiotics in preventing meningococcal disease after a case: systematic review.  Bmj. 2004;  328 1339
• 9 Fraser A, Gafter-Gvili A, Paul M, Leibovici L. Antibiotics for preventing meningococcal infections.  Cochrane Database Syst Rev. 2006;  CD004785
• 10 Girgis N, Sultan Y, Frenck Jr RW. et al . Azithromycin compared with rifampin for eradication of nasopharyngeal colonization by Neisseria meningitidis.  Pediatr Infect Dis J. 1998;  17 816-819
• 11 Boccia D, Andrews N, Samuelsson S. et al . Effectiveness of different policies in preventing meningococcal disease clusters following a single case in day-care and pre-school settings in Europe.  Epidemiol Infect. 2006;  134 872-877
• 12 Kulldorff M. A spatial scan statistic.  Communications in Statistics: Theory and Methods. 1997;  26 1481-1496
• 13 Mostashari F, Kulldorff M, Hartman JJ, Miller JR, Kulasekera V. Dead bird clusters as an early warning system for West Nile virus activity.  Emerg Infect Dis. 2003;  9 641-646
• 14 Cousens S, Smith PG, Ward H. et al . Geographical distribution of variant Creutzfeldt-Jakob disease in Great Britain, 1994-2000.  Lancet. 2001;  357 1002-1007
• 15 Sauders BD, Fortes ED, Morse DL. et al . Molecular subtyping to detect human listeriosis clusters.  Emerg Infect Dis. 2003;  9 672-680
• 16 Chaput EK, Meek JI, Heimer R. Spatial analysis of human granulocytic ehrlichiosis near Lyme, Connecticut.  Emerg Infect Dis. 2002;  8 943-948
• 17 Elias J, Harmsen D, Claus H. et al . Spatio-temporal analysis of invasive meningococcal disease, Germany.  Emerg Infect Dis. 2006;  12 1689-1694
• 18 Elias J, Claus H, Frosch M, Vogel U. Health Office in the Rural District Office Wartburgkreis . Evidence for indirect nosocomial transmission of Neisseria meningitidis resulting in two cases of invasive meningococcal disease.  J Clin Microbiol. 2006;  44 4276-4278
• 19 Snow J. On the mode of transmission of cholera. In: WH Frost (Ed) Snow on cholera (2nd ed) New York: The Commonwealth Fund 1936
• 20 Rolfhamre P, Janson A, Arneborn M, Ekdahl K. SmiNet-2: Description of an internet-based surveillance system for communicable diseases in Sweden.  Euro Surveill. 2006;  11 103-107
• 21 Shuai J, Buck P, Sockett P, Aramini J, Pollari F. A GIS-driven integrated real-time surveillance pilot system for national West Nile virus dead bird surveillance in Canada.  Int J Health Geogr. 2006;  5 17
• 22 Hautmann W, Harms I, Vogel U, Zirngibl A, Wildner M. Cluster of meningococcal diseases in Allgaeu - strategies for intervention].  Gesundheitswesen. 2005;  67 853-857
• 23 Oppermann H, Thriene B, Irmscher HM. et al . [Meningococcal carriage in high school students and possible risk factors].  Gesundheitswesen. 2006;  68 633-637
• 24 Schröter M, Elias J, Hellenbrand W. et al . Die Epidemiologie von Neisseria meningitidis in NRW.  Rheinisches Ärzteblatt. 2006;  4 19-21
• 25 Cano R, Larrauri A, Mateo S. et al . Impact of the meningococcal C conjugate vaccine in Spain: an epidemiological and microbiological decision.  Euro Surveill. 2004;  9 11-15
• 26 de Greeff SC, de Melker HE, Spanjaard L, van den Hof S, Dankert J. [The first effect of the national vaccination campaign against meningococcal-C disease: a rapid and sharp decrease in the number of patients].  Ned Tijdschr Geneeskd. 2003;  147 1132-1135
• 27 de Greeff SC, de Melker HE, Spanjaard L, Schouls LM, van Derende A. Protection from routine vaccination at the age of 14 months with meningococcal serogroup C conjugate vaccine in the Netherlands.  Pediatr Infect Dis J. 2006;  25 79-80
• 28 Martin DR, Walker SJ, Baker MG, Lennon DR. New Zealand epidemic of meningococcal disease identified by a strain with phenotype B:4:P1.4.  J Infect Dis. 1998;  177 497-500
• 29 Arreaza L, Salcedo C, Alcala B. et al . Sequencing of Neisseria meningitidis penA gene: the key to success in defining penicillin G breakpoints.  Antimicrob Agents Chemother. 2004;  48 358-359
• 30 Antignac A, Ducos-Galand M, Guiyoule A. et al . Neisseria meningitidis strains isolated from invasive infections in France (1999-2002): phenotypes and antibiotic susceptibility patterns.  Clin Infect Dis. 2003;  37 912-920
• 31 Taha MK, Zarantonelli ML, Ruckly C, Giorgini D, Alonso JM. Rifampin-resistant Neisseria meningitidis.  Emerg Infect Dis. 2006;  12 859-860
• 32 Zenz W, Zoehrer B, Levin M. et al . Use of recombinant tissue plasminogen activator in children with meningococcal purpura fulminans: a retrospective study.  Crit Care Med. 2004;  32 1777-1780
• 33 Alberio L, Lammle B, Esmon CT. Protein C replacement in severe meningococcemia: rationale and clinical experience.  Clin Infect Dis. 2001;  32 1338-1346
• 34 Vincent JL, Nadel S, Kutsogiannis DJ. et al . Drotrecogin alfa (activated) in patients with severe sepsis presenting with purpura fulminans, meningitis, or meningococcal disease: a retrospective analysis of patients enrolled in recent clinical studies.  Crit Care. 2005;  9 R331-R343
• 35 Casella EB, Cypel S, Osmo AA. et al . Sequelae from meningococcal meningitis in children: a critical analysis of dexamethasone therapy.  Arq Neuropsiquiatr. 2004;  62 421-428
• 36 Kurzai O, Schmitt C, Claus H. et al . Carbohydrate composition of meningococcal lipopolysaccharide modulates the interaction of Neisseria meningitidis with human dendritic cells.  Cell Microbiol. 2005;  7 1319-1334
• 37 Yazdankhah SP, Kriz P, Tzanakaki G. et al . Distribution of serogroups and genotypes among disease-associated and carried isolates of Neisseria meningitidis from the Czech Republic, Greece, and Norway.  J Clin Microbiol. 2004;  42 5146-5153
• 38 Smirnova I, Mann N, Dols A. et al . Assay of locus-specific genetic load implicates rare Toll-like receptor 4 mutations in meningococcal susceptibility.  Proc Natl Acad Sci USA. 2003;  100 6075-6080
• 39 Emonts M, Hazelzet JA, de Groot R, Hermans PW. Host genetic determinants of Neisseria meningitidis infections.  Lancet Infect Dis. 2003;  3 565-577
• 40 Zangwill KM, Schuchat A, Riedo FX. et al . School-based clusters of meningococcal disease in the United States. Descriptive epidemiology and a case-control analysis.  Jama. 1997;  277 389-395
• 41 Davison KL, Andrews N, White JM. et al . Clusters of meningococcal disease in school and preschool settings in England and Wales: what is the risk?.  Arch Dis Child. 2004;  89 256-260
• 42 Gilmore A, Stuart J, Andrews N. Risk of secondary meningococcal disease in health-care workers.  Lancet. 2000;  356 1654-1655

Korrespondenzadresse