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( Elodie Descloux ),( Maguy Daures ),( Cecile Balter Veysseyre ),( Olivier Simon ),( Yann Barguil ),( Isabelle Missotte ),( Ann Claire Gourinat ),( Michele John ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Background: Invasive Meningococcal Disease (IMD) is three fold more common in New Caledonia (NC) than in metropolitan France. Many IMD cases (35. 7%) are due to serogroups Y and W135. The purpose of our study was to identify IMD risk factors in NC. Methods: A retrospective study of all IMD cases that occurred in NC between 2005 and 2011 was conducted. Socio-environmental and clinico-biological data were collected. A search for immune defi ciency was proposed to all cases. IMD presentation and outcome were compared according to meningoccal serogroups and the presence of complement defi ciency (C-defi ciency). Results: 66 sporadic IMD cases (29 B serogroup, 20 Y or W135, 6 C, 1 A, 10 unknown) occurred in 64 patients often <19 years-old and of Melanesian origin. five patients died (7. 8%). No socioenvironmental risk factors were identifi ed. No asplenia, HIV infection or immunoglobulin defi ciency were found. Two patients had diabetes and 28 of 53 (52. 8%) patients had a C-defi ciency including 20 (71. 4%) cases of late complement component defi ciency. Patients with C-defi ciency were mainly Melanesian (92. 8%) originating from Loyalty Islands (62. 1%). They were mostly infected with serogroup Y/W135 (42. 9%) or B (32. 1%). They often developed later and more severe disease than patients without C-defi ciency (need for intensive cares in 62% versus 28% of cases, p = 0. 01). Conclusions: A high prevalence of C-defi ciency in the Melanesian population may explain clinico-epidemiological features of IMD in NC. Our data are consistent with previous studies confi rming a higher age at fi rst infection, a risk of IMD recurrence and a high frequency of Y/W135 serogroups in C-defi cient patients. However our results do not match previous fi ndings regarding disease severity. Our fi ndings imply an adaptation of C-defi ciency screening and meningococcal vaccine strategies in NC.
Nisarga, R,Premalatha, R,Shivananda,Ravikumar, K L,Shivappa, U,Gopi, A,Chikkadasarahalli, S B,Batuwanthudawe, R,Kilgore, P E,Kim, S A,Balter, I,Jouve, S,Ye, J,Moscariello, M The Academy 2015 Indian pediatrics Vol.52 No.3
<P>To estimate the incidence of invasive pneumococcal disease and pneumonia, distribution of pneumococcal serotypes, and antibiotic susceptibility in children aged 28 days to <60 months.</P>