期刊
MICROORGANISMS
卷 9, 期 2, 页码 -出版社
MDPI
DOI: 10.3390/microorganisms9020449
关键词
bacterial meningitis; S; pneumoniae; N; meningitidis; H; influenzae; S; agalactiae; conjugate vaccines; post-vaccine surveillance
类别
资金
- Public Health Agency of Canada
The narrative review discusses the public health significance of four common bacterial meningitis agents, their colonization sites, and use of conjugate vaccines to provide protection, while also mentioning the bacterial adaptability to vaccine pressure and the need for surveillance of vaccine-preventable bacterial meningitis using genomic methods.
This narrative review describes the public health importance of four most common bacterial meningitis agents, Streptococcus pneumoniae, Neisseria meningitidis, Haemophilus influenzae, and S. agalactiae (group B Streptococcus). Three of them are strict human pathogens that normally colonize the nasopharynx and may invade the blood stream to cause systemic infections and meningitis. S. agalactiae colonizes the genito-gastrointestinal tract and is an important meningitis agent in newborns, but also causes invasive infections in infants or adults. These four bacteria have polysaccharide capsules that protect them against the host complement defense. Currently licensed conjugate vaccines (against S. pneumoniae, H. influenza, and N. meningitidis only but not S. agalactiae) can induce protective serum antibodies in infants as young as two months old offering protection to the most vulnerable groups, and the ability to eliminate carriage of homologous serotype strains in vaccinated subjects lending further protection to those not vaccinated through herd immunity. However, the serotype-specific nature of these vaccines have driven the bacteria to adapt by mechanisms that affect the capsule antigens through either capsule switching or capsule replacement in addition to the possibility of unmasking of strains or serotypes not covered by the vaccines. The post-vaccine molecular epidemiology of vaccine-preventable bacterial meningitis is discussed based on findings obtained with newer genomic laboratory surveillance methods.
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