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Background: The increase in smartphone use and mobile health applications (apps) holds potential to use apps to reduce and detect healthcare-associated infections (HAIs) in clinical practice. Aim: To obtain an overview of available apps for HAI prevention, by selecting the clinically relevant apps and scoring functionality, quality and usefulness. Methods: This scoping review of available apps in the iOS and Android app stores uses an in-house-developed tool (scraper https://holtder.github.io/talos) to systematically aggregate available apps relevant for HAI prevention. The apps are evaluated on functionality, assessed on quality using the 'Mobile Application Rating Scale' (MARS), and assessed on potential use in clinical infection prevention. Findings: Using the scraper with CDC HAI topics through 146 search terms resulted in 92,726 potentially relevant apps, of which 28 apps met the inclusion criteria. The majority of these apps have the functionality to inform (27 of 28 apps) or to instruct (20/28). MARS scores for the 28 apps were high in the following domains: functionality (4.19/5), aesthetics (3.49/5), and information (3.74/5), with relatively low scores in engagement (2.97/5), resulting in a good average score (3.57/5). Conclusion: Low engagement scores restrict apps that intend to inform or instruct, possibly explained by the often-academic nature of the development of these apps. Although the number of HAI prevention apps increased by 60% in 5 years, the proportion of clinically relevant apps is limited. The variation in HAI app quality and lack of user engagement, could be improved by co-creation and development in the clinical setting. (c) 2021 The Author(s). Published by Elsevier Ltd on behalf of The Healthcare Infection Society. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

For more than 15 years, Norway has had the highest incidence of meningococcal disease in northern Europe, with 80% of cases being due to serogroup B meningococci. The case-fatality has remained high, at about 10%. In this study, an outer membrane vaccine, which had previously been shown to induce an increase in bactericidal antibodies to the parent strain, was assessed in a large-scale, randomised, double-blind trial. From October, 1988, 171,800 students in secondary schools volunteered to take part in a double-blind, placebo-controlled, efficacy trial with school as the randomisation unit. Hospitals and clinics that routinely receive patients with infectious disease were asked to report urgently all cases of suspected meningitis and/or septicaemia in 13-21-year-old students in Norway. These cases were registered and further investigated according to a detailed protocol. 89 out of the 221 cases investigated by June 3, 1991, were shown to be severe systemic disease due to group B meningococci. 36 cases in 35 schools took part in the trial (11 schools with vaccinated students and 24 with students given placebo). The calculated rate of protection was thus 57.2% (p = 0.012, one-sided test). The findings suggest that, although the vaccine conferred protection against group B meningococcal disease, the effect was insufficient to justify a public vaccination programme.

The inhibitory effect of sodium polyanethol sulfonate (0.05%) upon growth of Neisseria meningitidis was found to be neutralized by adding gelatin (l.1%) to the growth medium. The neutralizing effect was demonstrated in solid medium, as well as in nutrient broth for blood cultures. The findings parallel those of Wilkins and West (6) regarding gelatin neutralization of the inhibitory effect of sodium polyanethol sulfonate on Peptostreptococcus anaerobius.

During the first 6 months of 1978, 114 strains of Neisseria meningitidis isolated from patients in Norway were serotyped. Among 27 group C strains, type 2 was most common, whereas 82% of the 82 group B isolates did not react with antisera to the standard serotypes 1 to 12. These strains were shown to belong to a new serotype, type 15. Also some group A and C strains had the type 15 antigen. Investigations on a possible immunoprophylaxis against group B meningococcal disease in Norway should accordingly proceed with type 15 rather than with type 2 meningococci.

A combined serogroup B capsular polysaccharide and serotype 2a outer membrane complex meningococcal vaccine and a placebo preparation were tested double-blindly in 55 adult, male volunteers. The vaccine gave twofold increased binding antibodies, measured by ELISA, against non-capsular outer membrane antigen in 85 per cent of those vaccinated. Bactericidal antibodies towards a meningococcal serogroup C serotype 2a strain also increased fourfold or more among 85% vaccinated. New acquisition of meningococcal carriage was associated with antibody increase in one person from the placebo group.

In Norway group B meningococcal disease has remained at an epidemic level for 12 years. Whereas the incidence in Northern Norway, where the epidemic started, has been halved during this period, the number of cases has increased in other regions. A slow enhancement of natural immunity may occur, but development and testing of group B meningococcal vaccine have high priority. A major problem is whether serotype specific immunity will protect against disease.

The catabolism of glucose in selected Neisseria species was studied by radiorespirometry. The Entner-Doudoroff and pentose phosphate pathways were operating in all species, the greater part of the substrate being routed through the former, somewhat dependent on the medium used. Acetate was oxidized via the tricarboxylic acid cycle. In all species, a fraction of the triose was recycled through fructose phosphates to glucose 6-phosphate. Phosphate inhibited the oxidation of acetate. In media devoid of phosphate and sodium (N. meningitidis and N. gonorrhoeae) or of phosphate and potassium (other saccharolytic Neisseria), the conversion of triose to pyruvate was inhibited. In these media the catabolism of glucose proceeded slowly, and no substrate was used for biosynthetic purposes. The results point to a difference in the regulation of glucose metabolism in pathogenic and non-pathogenic Neisseria.

Treatment of agar-grown meningococci with dilute hydrochloric acid and suspension in saline after washing gave a preparation suitable for meningococcal serotyping by staphylococcal coagglutination with monoclonal antibodies. The monoclonal antibodies available for use and attached to protein A on the staphylococci were directed against the serotype protein antigens 2a, 2b (class 2), 15 (class 3) and the subtype protein antigens P1. 2 and P1. 16 (class 1). Ninety per cent of systemic strains and thirty-four per cent of a collection of carrier isolates, both from Norway late 1981/early 1982, were typable. The serotype antigen 15 alone or in combination with P1. 16 or P1. 16 alone were detected in about 85 per cent of the systemic strains. The quality of the whole-cell meningococcal antigen was important for the test to be easily read.

Thirteen systemic strains, i e strains isolated from systemic infections, and 77 carrier isolates of Neisseria meningitidis were serogrouped by agglutination and analyzed by gas chromatography (GC) of phenol extracts. For systemic strains the sugar patterns were in accordance with their group-specific capsular polysaccharides (CPS). Some carrier isolates revealed unexpected GC profiles. Upon immunological retesting with new sera, GC results were generally confirmed. Occasional isolates initially serogrouped as B or Y completely lacked neuraminic acid. Some non-groupable isolates were shown by ultracentrifugation and GC to have significant amounts of this sugar likely to originate from CPS of known composition or from unknown polysaccharides. One such originally non-groupable isolate showed a weak agglutination reaction specifically with group B antiserum when reexamined. Generally, carrier isolates had lower amounts of CPS than systemic strains of the same group. Five successive isolates from one carrier were first serogrouped as X, Z or non-groupable, but they had high amounts of galactosamine and 2-keto-3-deoxy octonate, sugars characterizing CPS of serogroup 29E. These isolates were confirmed by agglutination with recently available group 29E antiserum to be of this serogroup, which has not been reported before in Norway. Ultracentrifugation revealed the presence of unknown polysaccharides containing glucose, galactose or glucosamine, but further purification of these polymers is required to determine their composition and immunological importance.

SUMMARY: A rod-shaped, non-motile, Gram-negative, oxidase-positive and asaccharolytic organism found in the human nasopharynx is allotted to genus Neisseria and named Neisseria elongata. The strain M 2, which is the only isolate, is proposed as the type strain. The average guanine + cytosine (G + C) content of its DNA is 53 mole %. Genetic transformation of streptomycin resistance reveals a comparatively high compatibility with N. meningitidis and a strain designated N. flava, with ratios of interstrain to autologous transformation frequency in the range 0·01 to 0·1. On the other hand, there is no affinity in streptomycin-resistance transformation between N. elongata and members of genus Moraxella, including the old concepts N. catarrhalis and N. ovis. The family Neisseriaceae now appears to consist of two genera, Neisseria and Moraxella, each containing both coccal and rod-shaped species, which makes cell shape questionable as a highly weighted criterion in the construction of bacterial genera and higher taxa.