Neisseria meningitidis: epidemiology, treatment and prevention in adolescents.
OBJECTIVE
Neisseria meningitidis has been recognized as a cause of serious disease for centuries, but changing epidemiology and advances in treatment and prevention strategies mandate that providers be aware of ongoing developments with regard to this infection. Given the high burden of disease in adolescents, it is important for clinicians to be familiar with current recommendations regarding N. meningitidis.


RESULTS
Adolescents and young adults continue to have the second highest incidence of disease from N. meningitidis. New diagnostic techniques, including polymerase chain reaction, have shown promise for enhancing detection of meningococcal infection in selected scenarios. Whereas most isolates of meningococcus remain penicillin-susceptible, fluoroquinolone resistance has now been documented in the US for the first time. Routine immunization using the meningococcal conjugate vaccine continues to be recommended, despite ongoing concern about a possible association between vaccination and Guillain-Barré syndrome. Active research is ongoing to develop a serogroup B vaccine and meningococcal vaccines that are immunogenic in infants and toddlers.


CONCLUSIONS
Given the increased incidence of meningococcal infection among adolescents and the substantial morbidity and mortality associated with invasive disease, adolescent health providers must be familiar with current antibiotic treatment and prophylaxis guidelines and ongoing developments regarding meningococcal vaccination.
Division of Adolescent/Young Adult Medicine, Department of Medicine, Children's Hospital Boston, Harvard MedicalSchool, Boston, Massachusetts 02115, USA. kathryn.brigham@childrens.harvard.edu
Kathryn S
KS
Brigham
Thomas J
TJ
Sandora
D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D019072:Antibiotic Prophylaxis; D018562:Disease Transmission, Infectious; D020275:Guillain-Barre Syndrome / Q000139:chemically induced; D006801:Humans; D016233:Immunotherapy, Active / Q000009:adverse effects / Q000379:methods; D008585:Meningitis, Meningococcal / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology* / Q000517:prevention & control*; D022401:Meningococcal Vaccines / Q000009:adverse effects / Q000627:therapeutic use; D009345:Neisseria meningitidis; D012307:Risk Factors; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D022401:Meningococcal Vaccines