Rapid and fatal meningococcal disease due to a strain of Neisseria meningitidis containing the capsule null locus.
<p><strong>Background.</strong> <em>Neisseria meningitidis</em> continues to be an important cause of invasive bacterial disease among children and young adults worldwide. In Canada, <em>N. meningitidis</em> strains that bear serogroups B and C polysaccharid...
| Main Authors: | , , , , , , , , , |
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| Format: | Journal article |
| Language: | English |
| Published: |
Oxford University Press
2005
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| Subjects: |
| _version_ | 1797105086727454720 |
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| author | Hoang, L Thomas, E Tyler, S Pollard, A Stephens, G Gustafson, L McNabb, A Pocock, I Tsang, R Tan, R |
| author_facet | Hoang, L Thomas, E Tyler, S Pollard, A Stephens, G Gustafson, L McNabb, A Pocock, I Tsang, R Tan, R |
| author_sort | Hoang, L |
| collection | OXFORD |
| description | <p><strong>Background.</strong> <em>Neisseria meningitidis</em> continues to be an important cause of invasive bacterial disease among children and young adults worldwide. In Canada, <em>N. meningitidis</em> strains that bear serogroups B and C polysaccharide capsules predominate. We report the first documented case of invasive meningococcal disease in an immunocompetent host caused by an acapsular strain of <em>N. meningitidis</em> containing the capsule null locus (cnl).</p> <p><strong>Methods.</strong> Analysis of the isolate was performed with use of serological and molecular methods, including multilocus sequence typing and cnl gene identification. Analysis of 16S ribosomal RNA (rRNA) and <em>por</em>A genes was also performed to confirm the identity of the bacterium.</p> <p><strong>Results.</strong> The patient was a healthy, immunocompetent 13-year-old child, and <em>N. meningitidis</em> was recovered from a sample of her cerebrospinal fluid before death. The isolate was nontypeable by both conventional antisera and indirect whole-cell enzyme-linked immuosorbent assay methods using antibodies to serogroups B, C, Y, and W135. The isolate was further identified as a cnl strain, serotype 15 (ST-198). <em>N. meningitidis</em>–specific DNA was identified in the isolate and in the pre- and postmortem specimens by 16S rRNA and <em>por</em>A gene analysis.</p> <p><strong>Conclusions.</strong> This is the first reported case of fatal meningococcal disease caused by an acapsular <em>cnl</em> strain of <em>N. meningitidis</em> that was isolated from an immunocompetent host. Routine molecular diagnostic methods targeted at the <em>cnl</em> locus failed to detect this organism, indicating a need to determine the incidence of infection with <em>cnl</em> strains among patients with culture-negative invasive disease.</p> |
| first_indexed | 2024-03-07T06:42:30Z |
| format | Journal article |
| id | oxford-uuid:f9c4e91f-7583-422f-8dea-074620bdd283 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T06:42:30Z |
| publishDate | 2005 |
| publisher | Oxford University Press |
| record_format | dspace |
| spelling | oxford-uuid:f9c4e91f-7583-422f-8dea-074620bdd2832022-03-27T13:00:27ZRapid and fatal meningococcal disease due to a strain of Neisseria meningitidis containing the capsule null locus.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:f9c4e91f-7583-422f-8dea-074620bdd283MeningitisInfectious diseasesPathologyPaediatricsEnglishSymplectic Elements at OxfordOxford University Press2005Hoang, LThomas, ETyler, SPollard, AStephens, GGustafson, LMcNabb, APocock, ITsang, RTan, R<p><strong>Background.</strong> <em>Neisseria meningitidis</em> continues to be an important cause of invasive bacterial disease among children and young adults worldwide. In Canada, <em>N. meningitidis</em> strains that bear serogroups B and C polysaccharide capsules predominate. We report the first documented case of invasive meningococcal disease in an immunocompetent host caused by an acapsular strain of <em>N. meningitidis</em> containing the capsule null locus (cnl).</p> <p><strong>Methods.</strong> Analysis of the isolate was performed with use of serological and molecular methods, including multilocus sequence typing and cnl gene identification. Analysis of 16S ribosomal RNA (rRNA) and <em>por</em>A genes was also performed to confirm the identity of the bacterium.</p> <p><strong>Results.</strong> The patient was a healthy, immunocompetent 13-year-old child, and <em>N. meningitidis</em> was recovered from a sample of her cerebrospinal fluid before death. The isolate was nontypeable by both conventional antisera and indirect whole-cell enzyme-linked immuosorbent assay methods using antibodies to serogroups B, C, Y, and W135. The isolate was further identified as a cnl strain, serotype 15 (ST-198). <em>N. meningitidis</em>–specific DNA was identified in the isolate and in the pre- and postmortem specimens by 16S rRNA and <em>por</em>A gene analysis.</p> <p><strong>Conclusions.</strong> This is the first reported case of fatal meningococcal disease caused by an acapsular <em>cnl</em> strain of <em>N. meningitidis</em> that was isolated from an immunocompetent host. Routine molecular diagnostic methods targeted at the <em>cnl</em> locus failed to detect this organism, indicating a need to determine the incidence of infection with <em>cnl</em> strains among patients with culture-negative invasive disease.</p> |
| spellingShingle | Meningitis Infectious diseases Pathology Paediatrics Hoang, L Thomas, E Tyler, S Pollard, A Stephens, G Gustafson, L McNabb, A Pocock, I Tsang, R Tan, R Rapid and fatal meningococcal disease due to a strain of Neisseria meningitidis containing the capsule null locus. |
| title | Rapid and fatal meningococcal disease due to a strain of Neisseria meningitidis containing the capsule null locus. |
| title_full | Rapid and fatal meningococcal disease due to a strain of Neisseria meningitidis containing the capsule null locus. |
| title_fullStr | Rapid and fatal meningococcal disease due to a strain of Neisseria meningitidis containing the capsule null locus. |
| title_full_unstemmed | Rapid and fatal meningococcal disease due to a strain of Neisseria meningitidis containing the capsule null locus. |
| title_short | Rapid and fatal meningococcal disease due to a strain of Neisseria meningitidis containing the capsule null locus. |
| title_sort | rapid and fatal meningococcal disease due to a strain of neisseria meningitidis containing the capsule null locus |
| topic | Meningitis Infectious diseases Pathology Paediatrics |
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