Association of chronic meningococcemia with infection by meningococci with underacylated lipopolysaccharide.

Objectives: Chronic meningococcemia is an uncommon manifestation of meningococcal disease. Our objective was to asses whether a bacterial factor, a mutation in the lpxL1 gene resulting in underacylated lipopolysaccharide, might be important in chronic meningococcemia.

Methods: We identified 15 patients with chronic meningococcemia over a 50-year period.

Genome sequence of Neisseria meningitidis serogroup B strain H44/76.

Neisseria meningitidis is an obligate human pathogen. While it is a frequent commensal of the upper respiratory tract, in some individuals the bacterium spreads to the bloodstream, causing meningitis and/or sepsis, which are serious conditions with high morbidity and mortality. Here we report the availability of the genome sequence of the widely used serogroup B laboratory strain H44/76.

Bacterial meningitis in pregnancy: report of six cases and review of the literature.

Few cases of bacterial meningitis during pregnancy have been reported in the literature, and the causative microorganisms and prognosis of bacterial meningitis during pregnancy are unclear. In a 6-year period we identified six cases of bacterial meningitis in pregnant women. All were multigravida and gestational age at presentation ranged from 5 to 39 weeks.

Hemodynamic efficacy of sequential hemoclip application using the Olympus HX-110/610 reloadable clipping device in spurting bleedings.

Background: Hemoclip application in GI-hemorrhage has proven to be effective. Clinical experience shows that multiple clips are frequently necessary. In 2005, an easily reloadable clip-applicator was introduced.

Multi locus sequence typing of Chlamydia reveals an association between Chlamydia psittaci genotypes and host species.

Chlamydia comprises a group of obligate intracellular bacterial parasites responsible for a variety of diseases in humans and animals, including several zoonoses. Chlamydia trachomatis causes diseases such as trachoma, urogenital infection and lymphogranuloma venereum with severe morbidity. Chlamydia pneumoniae is a common cause of community-acquired respiratory tract infections.

Characterization of diverse subvariants of the meningococcal factor H (fH) binding protein for their ability to bind fH, to mediate serum resistance, and to induce bactericidal antibodies.

Neisseria meningitidis is a commensal of the human nasopharynx but is also a major cause of septicemia and meningitis. The meningococcal factor H binding protein (fHbp) binds human factor H (fH), enabling downregulation of complement activation on the bacterial surface. fHbp is a component of two serogroup B meningococcal vaccines currently in clinical development.

Seroprevalence of IgG antibodies against 13 vaccine Streptococcus pneumoniae serotypes in the Netherlands.

In this study the seroprevalence of IgG antibodies against 13 vaccine serotypes of the pneumococcus was assessed in the Netherlands. Sera from 7904 persons obtained in a cross-sectional population-based study were analysed. The 13 serotype specific IgG concentrations were assessed simultaneously using a fluorescent bead-based multiplex immuno assay (MIA).

Pneumococcal conjugate vaccination and nasopharyngeal acquisition of pneumococcal serotype 19A strains.

Context: The rapid increase in multiresistant serotype 19A as a cause of invasive and respiratory pneumococcal disease has been associated in time with the widespread implementation of 7-valent pneumococcal conjugate vaccination (PCV-7) in several countries. Because spontaneous fluctuations in time and antibiotic selective pressure may have induced this serotype 19A increase, controlled studies are needed to assess the role of PCV-7.

Objective: To examine the association of PCV-7 vaccination and nasopharyngeal acquisition of serotype 19A pneumococci, their clonal distribution, and antibiotic susceptibility.

Hydrocephalus in adults with community-acquired bacterial meningitis.

Objective: To evaluate the occurrence, treatment, and outcome of hydrocephalus complicating community-acquired bacterial meningitis in adults.

Methods: Case series from a prospective nationwide cohort study from Dutch hospitals from 2006 to 2009.

Results: Hydrocephalus was diagnosed in 26 of 577 episodes (5%) and was classified as communicating hydrocephalus in all but 1 patient.

Identification of a novel anti-sigmaE factor in Neisseria meningitidis.

Background: Fine tuning expression of genes is a prerequisite for the strictly human pathogen Neisseria meningitidis to survive hostile growth conditions and establish disease. Many bacterial species respond to stress by using alternative sigma factors which, in complex with RNA polymerase holoenzyme, recognize specific promoter determinants. sigma(E), encoded by rpoE (NMB2144) in meningococci, is known to be essential in mounting responses to environmental challenges in many pathogens.

Cost effectiveness of pneumococcal vaccination among Dutch infants: economic analysis of the seven valent pneumococcal conjugated vaccine and forecast for the 10 valent and 13 valent vaccines.

Objectives: To update cost effectiveness estimates for the four dose (3+1) schedule of the seven valent pneumococcal conjugated vaccine (PCV-7) in the Netherlands and to explore the impact on cost effectiveness of reduced dose schedules and implementation of 10 valent and 13 valent pneumococcal vaccines (PCV-10 and PCV-13).

Design: Economic evaluation comparing PCV-7, PCV-10, and PCV-13 with no vaccination using a decision tree analytic model built from data in previous studies.

Setting: The Netherlands.

Targeted nanoparticles that deliver a sustained, specific release of Paclitaxel to irradiated tumors.

To capitalize on the response of tumor cells to XRT, we developed a controlled-release nanoparticle drug delivery system using a targeting peptide that recognizes a radiation-induced cell surface receptor. Phage display biopanning identified Gly-Ile-Arg-Leu-Arg-Gly (GIRLRG) as a peptide that selectively recognizes tumors responding to XRT. Membrane protein extracts of irradiated glioma cells identified glucose-regulated protein GRP78 as the receptor target for GIRLRG.

Effects of pneumococcal conjugate vaccine 2 years after its introduction, the Netherlands.

In the Netherlands, the 7-valent pneumococcal conjugate vaccine (PCV-7) was implemented in a 3+1-dose schedule in the national immunization program for infants born after April 1, 2006. To assess the vaccine's effectiveness, we compared disease incidence before and after vaccine implementation (June 2004-June 2006 and June 2006-June 2008, respectively). We serotyped 2,552 invasive pneumococcal isolates from throughout the Netherlands, covering 25% of the country's population.

Fonsecaea nubica sp. nov, a new agent of human chromoblastomycosis revealed using molecular data.

A new species of Fonsecaea, Fonsecaea nubica, morphologically similar to F. pedrosoi and F. monophora, is described using multilocus molecular data including AFLP profiles, sequences of the ribosomal internal transcribed spacers (ITS), and partial sequences of the cell division cycle (cdc42), beta-tubulin (tub1) and actin (act1) genes.

TEM characterization of a silorane composite bonded to enamel/dentin.

Objectives: The low-shrinking composite composed of combined siloxane-oxirane technology (Filtek Silorane, 3M ESPE, Seefeld, Germany) required the development of a specific adhesive (Silorane System Adhesive, 3M ESPE), in particular because of the high hydrophobicity of the silorane composite. The purpose of this study was to characterize the interfacial ultra-structure at enamel and dentin using transmission electron microscopy (TEM).

Methods: Non-demineralized/demineralized 70-90 nm sections were prepared following common TEM specimen processing procedures.

Vaccine preventability of meningococcal clone, Greater Aachen Region, Germany.

Emergence of serogroup B meningococci of clonal complex sequence type (ST) 41/44 can cause high levels of disease, as exemplified by a recent epidemic in New Zealand. Multiplication of annual incidence rates (3.1 cases/100,000 population) of meningococcal disease in a defined German region, the city of Aachen and 3 neighboring countries (Greater Aachen) prompted us to investigate and determine the source and nature of this outbreak.

Community-acquired bacterial meningitis in alcoholic patients.

Background: Alcoholism is associated with susceptibility to infectious disease, particularly bacterial pneumonia. In the present study we described characteristics in alcoholic patients with bacterial meningitis and delineate the differences with findings in non-alcoholic adults with bacterial meningitis.

Methods/principal Findings: This was a prospective nationwide observational cohort study including patients aged >16 years who had bacterial meningitis confirmed by culture of cerebrospinal fluid (696 episodes of bacterial meningitis occurring in 671 patients).

Medical and endoscopic treatment in peptic ulcer bleeding: a national German survey.

Objective: Peptic ulcers are the leading cause of upper gastrointestinal (GI) bleeding. The aim of this study was the evaluation of the recent clinical practice in drug therapy and endoscopic treatment of ulcer bleedings in Germany and to compare the results with the medical standard.

Methods: A structured questionnaire (cross-sectional study) was sent to 1371 German hospitals that provide an emergency service for upper GI bleeding.

Relationship between bond-strength tests and clinical outcomes.

One often alleges that laboratory bond-strength testing cannot predict clinical effectiveness of adhesives. Major argument to sustain this claim is the wide variation in bond-strength values recorded for one specific adhesive among different research institutes worldwide. The main reason for these inconsistent bond-strength measurements is supposedly the current lack of a standard bond-strength testing protocol.

Complement factor 7 gene mutations in relation to meningococcal infection and clinical recurrence of meningococcal disease.

Meningococcal disease is caused by Neisseria meningitidis which is associated with high morbidity and mortality. Recurrences of meningococcal infection have been observed in patients with terminal complement component defects, because of the inefficient formation of the lytic membrane attack complex (MAC), C5b-9. Complement component C7 is one of the five plasma proteins to form the MAC.

Does a low-shrinking composite induce less stress at the adhesive interface?

Objectives: Polymerization shrinkage of a composite in a high configuration-factor (C-factor) cavity leads to polymerization shrinkage stress. In the prevention of high polymerization shrinkage stress, a low-shrinking silorane composite (Filtek Silorane, FS, 3M ESPE) was recently marketed. Therefore, we investigated the effect of C-factor (flat surface vs.

Invasive pneumococcal disease among adults: associations among serotypes, disease characteristics, and outcome.

Background: The Streptococcus pneumoniae polysaccharide capsule may be related to invasive pneumococcal disease (IPD) course.

Methods: We performed a retrospective cohort study with nationally representative surveillance data from 1075 hospitalized patients with IPD from the Netherlands from 1 June 2004 through 31 May 2006 in the prevaccination era. Serotypes were grouped according to invasive disease potential, rate of the most serious clinical syndromes of meningitis and bacteremia without focus, and case-fatality rates.

Invasive pneumococcal disease in the Netherlands: Syndromes, outcome and potential vaccine benefits.

With a retrospective study of invasive pneumococcal disease (IPD) surveillance data representative for approximately 25% of the Dutch population (1275 hospitalized cases) over the period June 2004-June 2006 prior to the implementation of the 7-valent pneumococcal conjugate vaccine (PCV7), the aim was to provide baseline data on IPD for the interpretation of changes after implementation of conjugate vaccines. The IPD incidence peaked in 3-5-mnth-olds (63 cases per 100,000 persons yearly) and increased in adulthood, particularly after the age of 60yrs, from 26 cases in 60-64-yr-olds to 97 cases per 100,000 in persons > or =90yrs. Beyond the age of 4yrs, 19% of IPD patients were immunocompromised, and this considerable percentage may have implications for vaccine efficacy.

Naturally occurring lipid A mutants in neisseria meningitidis from patients with invasive meningococcal disease are associated with reduced coagulopathy.

Neisseria meningitidis is a major cause of bacterial meningitis and sepsis worldwide. Lipopolysaccharide (LPS), a major component of the Gram-negative bacterial outer membrane, is sensed by mammalian cells through Toll-like receptor 4 (TLR4), resulting in activation of proinflammatory cytokine pathways. TLR4 recognizes the lipid A moiety of the LPS molecule, and the chemical composition of the lipid A determines how well it is recognized by TLR4.