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Invasive meningococcal disease: Timing and cause of death in England, 2008-2015.
Journal of Infection ( IF 28.2 ) Pub Date : 2020-01-02 , DOI: 10.1016/j.jinf.2019.12.008
Kazim Beebeejaun 1 , Sydel R Parikh 1 , Helen Campbell 1 , Steve Gray 2 , Ray Borrow 2 , Mary E Ramsay 1 , Shamez N Ladhani 3
Affiliation  

BACKGROUND Neisseria meningitidis is a major cause of bacterial meningitis and septicaemia, with death often occurring rapidly after onset of the first symptoms. Later death can also occur, but may be due to other causes, such as underlying comorbidities. The study aimed to assess the timing and cause of death in patients with invasive meningococcal disease (IMD) prior to the introduction of two new meningococcal immunisation programmes in England. METHODS Public Health England (PHE) conducts IMD surveillance in England through its national meningococcal reference unit. Laboratory-confirmed IMD cases diagnosed during 2008-2015 were linked to weekly and annual electronic death registration records as well as the Patient Demographic Service (PDS) database. RESULTS Overall, 6734 of 6808 (99%) laboratory-confirmed IMD cases matched to PDS, including 668 fatalities. Of these, 667 linked to an annual death registration record compared to 405 reports linked to weekly death registrations. In total, 429/667 (64%) of all deaths and 428/502 (85%) of IMD-related deaths occurred within one day of diagnosis. In total, 498/667 (75%) deaths had occured by 30 days after IMD diagnosis and 98% (490/498) of these were IMD-related. Serogroup B contributed to 64% (323/502) of IMD-related deaths, followed by serogroup W (84/502, 17%) and serogroup Y (70/502, 14%). Deaths occurring after 30 days were less likely to be IMD-related, mainly amongst ≥65 year-olds, with malignancy, chronic respiratory and cardiac conditions predominating. CONCLUSIONS Most IMD-related deaths occurred within a day of diagnosis and nearly all IMD-related deaths occurred within 30 days of diagnosis. The rapidity of death highlights the importance of prevention through vaccination.

中文翻译:

侵袭性脑膜炎球菌疾病:2008-2015年英格兰的时间安排和死亡原因。

背景技术脑膜炎奈瑟氏球菌是细菌性脑膜炎和败血病的主要原因,通常在出现第一症状后迅速死亡。以后也可能死亡,但可能是由于其他原因引起的,例如潜在的合并症。该研究旨在评估在英国引入两个新的脑膜炎球菌免疫计划之前,侵袭性脑膜炎球菌病(IMD)患者的时间和死亡原因。方法英国公共卫生部(PHE)通过其国家脑膜炎球菌参考单位在英国进行IMD监视。在2008-2015年期间诊断的经实验室确认的IMD病例与每周和每年的电子死亡登记记录以及患者人口统计服务(PDS)数据库相关联。结果总的来说,在实验室确认的IMD病例中,有6808例中有6734例与99例PDS相匹配,包括668人死亡。其中,有667项与年度死亡登记记录相关联,而有405项报告与每周死亡登记相关。在诊断的一天之内,所有死亡总数中有429/667(64%)和428/502(85%)个与IMD相关的死亡。在IMD诊断后30天,总共有498/667(75%)人死亡,其中98%(490/498)与IMD相关。血清群B导致IMD相关死亡的64%(323/502),其次是血清群W(84/502,17%)和血清群Y(70/502,14%)。30天后发生的死亡不太可能与IMD相关,主要是≥65岁的人群,以恶性肿瘤,慢性呼吸道疾病和心脏疾病为主。结论大多数与IMD相关的死亡发生在诊断的一天之内,几乎所有与IMD相关的死亡发生在诊断的30天之内。
更新日期:2020-01-02
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