meningitis + diphtheria vaccine (TetraMenD / Menak Trapani / Menactra)

[Characteristics and outcomes of bacterial meningitis-associated hearing loss in children following implementation of a standardized hearing assessment process].

Dou Z Z ZZ, Liu G G, Shi J F JF, Wang Q Q et al.

Objective: To analyze the types and outcomes of hearing loss in children with bacterial meningitis following the implementation of a standardized hearing assessment process. Methods: This retrospective cohort study included 397 children with bacterial meningitis who were admitted to Beijing Children's Hospital, Capital Medical University, between January 2019 and December 2025, and who completed at least one hearing assessment during hospitalization. Hearing loss was evaluated. According to the type and causes of hearing loss, the ears were divided into 5 groups: bacterial meningitis-associated hearing loss, structural abnormality-associated sensorineural hearing loss, non-structural conductive hearing loss, structural abnormality-associated conductive hearing loss, and mixed hearing loss. The proportions of ears with hearing recovery to normal were compared between the bacterial meningitis-related hearing loss group and the non-structural conductive hearing loss group using a Chi-square test or Fisher's exact text. Results: Among the 397 children included, 63 cases (15.9%) had hearing loss, and 25 cases (6.3%) had bacterial meningitis-associated hearing loss. Hearing loss involved 85 ears, including 32 ears (37.6%) with bacterial meningitis-associated hearing loss, 17 ears (20.0%) with structural abnormality-associated sensorineural hearing loss, 32 ears (37.6%) with non-structural conductive hearing loss, 3 ears (3.5%) with structural abnormality-associated conductive hearing loss, and 1 ear (1.2%) with mixed hearing loss. Bacterial meningitis-associated hearing loss was predominantly severe to profound (78.1% (25/32)), whereas all non-structural conductive hearing loss was mild to moderate (100.0% (32/32)). The proportion of ears with hearing recovery to normal was lower in the bacterial meningitis-associated hearing loss group than in the non-structural conductive hearing loss group (P<0.001). Conclusions: A standardized hearing assessment process may help differentiate the type and possible causes of hearing loss. Although bacterial meningitis-associated hearing loss is identified in only a small proportion of patients, it is predominantly severe to profound and shows a low rate of recovery during follow-up.

Immunogenicity and protective efficacy of recombinant BCG expressing a multi-epitope vaccine against mycobacterium tuberculosis.

Zhang Xuan-Ji XJ, Luo Jia-Rui JR, Tian Ting-Ting TT, Shi Juan J et al.

Mycobacterium tuberculosis (Mtb) infects approximately one-quarter of the global population, of whom 5%-10% develop active tuberculosis (TB). Although Bacillus Calmette-Guérin (BCG) remains the cornerstone vaccine against severe infant TB, its efficacy in adults is limited, underscoring the need for novel TB vaccines. This study aimed to design a multi-epitope vaccine, tMEV, and validate its protective potential through bioinformatic prediction and in vivo experiments. tMEV was constructed from dominant T- and B-cell epitopes derived from Mtb ESAT-6, PE35, PPE38, and PE4 proteins, fused with an adjuvant. Its vaccine candidacy was assessed via physicochemical and solubility profiling, secondary and tertiary structure modeling, TLR-4 molecular docking, molecular dynamics simulation, and immune simulation. The tMEV coding sequence was cloned into pMV361 and transformed into BCG to generate recombinant BCG (rBCG-tMEV). Immunogenicity, antigenicity, and protective efficacy were evaluated in mouse immunization and Mtb challenge models. tMEV exhibited favorable vaccine-like properties in silico. In mice, both tMEV and rBCG-tMEV induced Mtb-specific immune responses. Compared with PBS, tMEV significantly enhanced cellular and humoral immunity with a Th2-biased profile. Relative to conventional BCG, rBCG-tMEV elicited a superior mixed Th1-Th2 response and higher antigen-specific immunity, accompanied by increased secretion of IFN-γ, IL-2, TNF-α, granzyme B, and perforin. Moreover, rBCG-tMEV markedly reduced bacterial loads in the lungs and spleens of Mtb-infected mice, conferring partial protection. These findings demonstrate that tMEV and rBCG-tMEV possess robust immunogenicity and protective potential against Mtb, representing promising novel TB vaccine candidates and providing a rationale for future vaccine development and optimization.

Pneumococcal meningitis secondary to chronic orbital inflammation with skull base erosion: a case report.

Tie Xinghua X, Sun Xiaoman X

This case report describes a 32-year-old female patient who developed acute pneumococcal meningitis following six-year chronic orbital inflammatory changes after strabismus corrective surgery. The patient experienced gradual deterioration of right-eye vision and recurrent retro-orbital headache; serial magnetic resonance imaging (MRI) from 2021 to 2023 demonstrated diffuse intraconal retrobulbar abnormalities and extraocular-muscle thickening. She subsequently presented with high fever, generalized seizures and impaired consciousness. Cerebrospinal fluid (CSF) metagenomic next-generation sequencing (mNGS) detected Streptococcus pneumoniae and low-abundance Epstein-Barr virus (EBV) DNA; Active EBV-associated central nervous system infection could not be confirmed in the absence of CSF quantitative EBV polymerase chain reaction (PCR), EBV serology and immune-status testing. The patient received broad-spectrum intravenous antimicrobial, antiviral and glucocorticoid therapy, followed by endoscopic endonasal resection of inflammatory lesions at the ethmoid-skull-base complex. Histopathological examination of surgical specimens revealed non-specific inflammatory granulation tissue, and Langerhans cell histiocytosis was excluded. At six-month follow-up, the patient remained seizure-free; infectious foci showed near-complete resolution on imaging, yet mild residual orbital-leptomeningeal abnormalities persisted with modest visual improvement. This case demonstrates the potential for delayed intracranial extension from long-standing chronic orbital inflammation and highlights both the diagnostic utility and interpretive limitations of CSF-mNGS in clinical practice.

Correction to "Screening Natural Cholesterol Analogs to Assemble Self-Adjuvant Lipid Nanoparticles for Antigens Tagging Guided Therapeutic Tumor Vaccine".