疾病及处理

The availability of complete microbial genome sequences enormously facilitates experimental molecular investigations of the respective organisms by providing complete lists of genes, their genetic contexts, and their predicted functions. This can be used in a number of ways to f ...

Successful pathogens have evolved a variety of specific gene products that facilitate their survival and growth within the host, as well as mechanisms to regulate expression of these virulence-associated genes in response to their environment. In comparison with commensals, the pat ...

Comprehensive practical guidelines for the control of large-scale epidemic meningococcal disease were updated in 1998 by the World Health Organization (WHO) (1). The guidance in this chapter is designed to assist in the management of the smaller-scale outbreaks or clusters, particul ...

Seven years after meningococci were first grown from patients with meningitis (1), Kiefer reported the isolation of the organisms from the nasopharynx of cases of meningococcal disease, and from their contacts (2). The importance of nasopharyngeal acquisition and carriage as a key step in ...

The unambiguous identification of epidemic Neisseria meningitidis strains and their clear distinction from other less pathogenic meningococci is required for the global epidemiology of meningococcal disease. Until the recent development of multi-locus sequence typing ( ...

In 1887, Anton Weichselbaum, a Viennese doctor, was the first to report the isolation of meningococci from patients with meningitis (1). Shortly after, came the first description of lumbar puncture in living patients (2), leading to the isolation of meningococci from acute cases of meningiti ...

For a technique often now referred to as “the backbone of public health,” it is curious how only recently surveillance has come to be recognized as important. As soon as recording of disease events began, so of course did surveillance, but the first application of the term to “the ongoing scrutiny of dise ...

Invasive disease caused by Neisseria meningitidis is one of the leading infectious causes of death in childhood in North America (1), but its prevention has not received the same priority on the health agenda as in Europe, Australia, and New Zealand. There are several likely explanations, but the p ...

The word “surveillance” probably first referred to close supervision of individuals exposed to an infectious disease and their close contacts (1). Currently, though, surveillance refers more frequently to the ongoing accumulation of data so that it can be used for decision-making. A sur ...

The complementary fields of molecular evolution and population genetics are both complex and wide-ranging. In this chapter we review some of the basic concepts and describe the methods used to investigate bacterial population biology in general andNeisseria populations in partic ...

Disease caused by Neisseria meningitidis is a worldwide problem (1). Epi- demics of meningococcal disease regularly occur in the “meningitis belt” of sub-Saharan Africa and in Asia (2–5) and high or increasing levels of endemic meningococcal disease have been reported recently in the UK (6), N ...

Scoring systems used in meningococcal disease have been developed and validated to predict death or severity of illness in cohorts of patients, usually in the setting of intensive care. When using these scores, it is important to remember that any individual’s score is only of limited value in pro ...

The Gram-negative pathogen Neisseria meningitidis, is one of the leading causes of bacterial meningitis worldwide (1). The host range for this organism is restricted to humans, where it colonizes the mucosal epithelium of the upper airway. It occasionally disseminates causing invasi ...

Lipopolysaccharides (LPS) located to the outer leaflet of the outer membrane have been identified as the main common endotoxic component of Gramnegative bacteria (1–3). Although other constituents of the bacterial cell wall, i.e., peptidoglycan, may contribute, LPS is considered to be t ...

Cytokines are important mediators in inflammation, and play a key role in inflammation induced by Gram-negative bacteria. Cytokines are released into serum during different pathological conditions, such as meningococcal disease, and the cytokine levels in serum seem to correlate ...

Cytokines play a pivotal role in both defense against meningococcal infection and the pathophysiology of invasive meningococcal disease. These chemical messengers are crucial cogwheels in the machinery of the innate immune system and are also powerful forces in the antigen-speci ...

The genetic regulation of the host response to infection is crucial for understanding susceptibility to and outcome of meningococcal disease. The initial host response depends on the innate immune system, after which specific immunity is attained when antibodies from the adaptive im ...

Humans are the only natural reservoir for meningococci. The appropriate specimens that should be taken for isolation of meningococci are dependent on the clinical question. The most appropriate specimen and/or laboratory techniques for microbiological diagnosis in an acutely s ...

Disseminated intravascular coagulation (DIC) is a complex acquired, coagulopathy resulting from excessive thrombin formation. Abnormal tissue factor (TF) expression is a major mechanism initiating DIC in many disorders, including obstetric complications, sepsis, canc ...

Complement is an immunological effector system that bridges innate and acquired immunity in several ways. There is a striking association between susceptibility to meningococcal disease and various forms of complement deficiency (1,2). In defense against bacterial infection, ...