Risk of invasive meningococcal disease in preterm infants
Risk of invasive meningococcal disease in preterm infants
Background: invasive meningococcal disease (IMD) is most common in the first year of life. We hypothesized that preterm infants may have a higher risk of IMD and more severe disease than term infants. We compared the incidence, demographics, clinical presentation, and outcomes of IMD in preterm compared with term infants during the first 5 years after implementation of a national meningococcal group B vaccine (4CMenB) for infants in England.
Methods: the UK Health Security Agency conducts enhanced national IMD surveillance with detailed follow-up of all confirmed cases in England. Infants aged <1 year (uncorrected for gestational age) with IMD confirmed between 1 September 2015 and 31 August 2020 were included.
Results: there were 393 infant IMD cases (incidence, 12.4/100 000 live births). Among 363 (92.4%) of the infants with known gestational age, the IMD incidence was higher in preterm (<37 weeks' gestation) than in term infants (18.3/100 000 vs 10.9/100 000; incidence rate ratio [IRR], 1.68 [95% confidence interval, 1.23-2.29]; P = .001). The IMD incidence was highest in those born at <32 weeks' gestation (32.9/100 000; incidence rate ratio for <32 weeks' gestation vs term, 3.01 [95% confidence interval, 1.73-5.24]; P ≤ .001). There were no differences in demographics, clinical presentation, rate of intensive care admission, or case-fatality rate, but preterm infants were more likely than term infants to have ≥1 reported sequela (14 of 39 [35.9%] vs 51 of 268 [19.0%]; P = .02).
Conclusions: preterm infants had a higher incidence of IMD than term infants and the IMD incidence was highest in infants born at <32 weeks' gestation. Preterm infants also had a higher risk of IMD sequelae.
Calvert, Anna
350295a4-0bb1-4723-a7ea-585a5f9ec272
Campbell, Helen
b776b7ea-8f26-4a57-9a17-35ef8b434497
Heath, Paul T.
4ed3877a-bbc4-43ed-9208-902df7ae3ae0
Jones, Christine E.
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Le Doare, Kirsty
9424dc5c-4484-41d3-86dd-29cfaffb43f5
Mensah, Anna
079d9543-93ee-4180-bbca-dc9f50e02257
Ladhani, Shamez
b359e7e2-44f2-4b97-8a2c-54333217cab3
25 April 2024
Calvert, Anna
350295a4-0bb1-4723-a7ea-585a5f9ec272
Campbell, Helen
b776b7ea-8f26-4a57-9a17-35ef8b434497
Heath, Paul T.
4ed3877a-bbc4-43ed-9208-902df7ae3ae0
Jones, Christine E.
48229079-8b58-4dcb-8374-d9481fe7b426
Le Doare, Kirsty
9424dc5c-4484-41d3-86dd-29cfaffb43f5
Mensah, Anna
079d9543-93ee-4180-bbca-dc9f50e02257
Ladhani, Shamez
b359e7e2-44f2-4b97-8a2c-54333217cab3
Calvert, Anna, Campbell, Helen, Heath, Paul T., Jones, Christine E., Le Doare, Kirsty, Mensah, Anna and Ladhani, Shamez
(2024)
Risk of invasive meningococcal disease in preterm infants.
Open Forum Infectious Diseases, 11 (4), [ofae164].
(doi:10.1093/ofid/ofae164).
Abstract
Background: invasive meningococcal disease (IMD) is most common in the first year of life. We hypothesized that preterm infants may have a higher risk of IMD and more severe disease than term infants. We compared the incidence, demographics, clinical presentation, and outcomes of IMD in preterm compared with term infants during the first 5 years after implementation of a national meningococcal group B vaccine (4CMenB) for infants in England.
Methods: the UK Health Security Agency conducts enhanced national IMD surveillance with detailed follow-up of all confirmed cases in England. Infants aged <1 year (uncorrected for gestational age) with IMD confirmed between 1 September 2015 and 31 August 2020 were included.
Results: there were 393 infant IMD cases (incidence, 12.4/100 000 live births). Among 363 (92.4%) of the infants with known gestational age, the IMD incidence was higher in preterm (<37 weeks' gestation) than in term infants (18.3/100 000 vs 10.9/100 000; incidence rate ratio [IRR], 1.68 [95% confidence interval, 1.23-2.29]; P = .001). The IMD incidence was highest in those born at <32 weeks' gestation (32.9/100 000; incidence rate ratio for <32 weeks' gestation vs term, 3.01 [95% confidence interval, 1.73-5.24]; P ≤ .001). There were no differences in demographics, clinical presentation, rate of intensive care admission, or case-fatality rate, but preterm infants were more likely than term infants to have ≥1 reported sequela (14 of 39 [35.9%] vs 51 of 268 [19.0%]; P = .02).
Conclusions: preterm infants had a higher incidence of IMD than term infants and the IMD incidence was highest in infants born at <32 weeks' gestation. Preterm infants also had a higher risk of IMD sequelae.
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ofae164
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Accepted/In Press date: 12 March 2024
e-pub ahead of print date: 15 April 2024
Published date: 25 April 2024
Identifiers
Local EPrints ID: 489854
URI: http://eprints.soton.ac.uk/id/eprint/489854
ISSN: 2328-8957
PURE UUID: 87e606f0-9072-4bde-937b-7de8c37046f9
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Date deposited: 03 May 2024 16:45
Last modified: 04 May 2024 01:50
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Contributors
Author:
Anna Calvert
Author:
Helen Campbell
Author:
Paul T. Heath
Author:
Kirsty Le Doare
Author:
Anna Mensah
Author:
Shamez Ladhani
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