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Arteta-Acosta C, Villena R, Hormazabal JC, Fernández J, Santolaya ME. Whole-genome sequencing of Neisseria meningitidis collected in Chile from pediatric patients during 2016-2019 and coverage vaccine prediction. Vaccine 2024; 42:126311. [PMID: 39276620 DOI: 10.1016/j.vaccine.2024.126311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2024] [Revised: 08/05/2024] [Accepted: 08/29/2024] [Indexed: 09/17/2024]
Abstract
BACKGROUND Over the past few years, whole-genome sequencing (WGS) has become a valuable tool for global meningococcal surveillance. The objective of this study was to genetically characterize Neisseria meningitidis strains isolated from children in Chile through WGS and predicting potential vaccine coverage using gMATS and MenDeVAR. METHODS WGS of 42 N.meningitidis from pediatric patients were processed and assembled using different software. We analyzed genomes with BIGSdb platform hosted at PubMLST.org, and predicted vaccine coverage using MenDeVAR and gMATS tools. RESULTS Among 42 strains, 25 were MenB, 16 MenW, and 1 MenC. The cc11 and cc 41/44 were the most frequents. The main frequent deduced peptide sequence for PorA was P1.5,2 (40 %), peptide P1.4 was present in one MenB strain; NHBA-29 (64 %), none having peptide 2; fHbp-2 (76 %), one strain had peptide-1, and two had peptide 45; NadA was detected in 52 %, peptide-6 was present in 84 %, none had peptide 8. The MenDeVAR index predicted a coverage in MenB strains for 4CMenB 8 % exact matches, 12 % cross-reactivity, 8 % not coverage and 64 % had insufficient data. gMATS predicted 16 % was covered, 8 % not covered and 76 % unpredictable, and overall coverage of 54 %. For rLP2086-fHbp, the MenDeVAR index predicted exact match in 8 %, cross-reactivity in 64 %, and insufficient data in 28 % and an overall coverage of 72 %. In non-MenB strains, the MenDeVAR index predicted for 4CMenB vaccine: cross-reactivity 88 %, 6 % for not covered and insufficient data. For rLP2086-fHbp, predicted cross-reactivity 12 % and insufficient data in 88 %. gMATS predicted an overall coverage of 50 % for Non-MenB. CONCLUSION genetic variability of the Chilean strains that its different from other countries, and until now limit the coverage prediction of vaccine with the available tools like gMATS and MenDeVAR.
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Affiliation(s)
- Cindy Arteta-Acosta
- MD, MPH Epidemiology, PhD (c) Medical Science, Universidad de Chile, 8380453, Chile.
| | - Rodolfo Villena
- Infectious Diseases Unit, Hospital de niños Dr. Exequiel González Cortés, 8900000, Chile; Department of Pediatrics, Faculty of Medicine, Universidad de Chile, 8380453, Chile.
| | | | | | - María Elena Santolaya
- Department of Pediatrics, Faculty of Medicine, Universidad de Chile, 8380453, Chile; Infectious Diseases Unit, Hospital de niños Dr. Luis Calvo Mackenna, 7500000, Chile.
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Savitskaya VY, Dolinnaya NG, Strekalovskikh VV, Peskovatskova ES, Snyga VG, Trefilov VS, Monakhova MV, Kubareva EA. Bioinformatics Analysis of Global Diversity in Meningococcal Vaccine Antigens over the Past 10 Years: Vaccine Efficacy Prognosis. Med Sci (Basel) 2023; 11:76. [PMID: 38132917 PMCID: PMC10744425 DOI: 10.3390/medsci11040076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 11/17/2023] [Accepted: 11/27/2023] [Indexed: 12/23/2023] Open
Abstract
Neisseria meningitidis (N. meningitidis) serogroup B (MenB) is the leading cause of invasive meningococcal disease worldwide. The pathogen has a wide range of virulence factors, which are potential vaccine components. Studying the genetic variability of antigens within a population, especially their long-term persistence, is necessary to develop new vaccines and predict the effectiveness of existing ones. The multicomponent 4CMenB vaccine (Bexsero), used since 2014, contains three major genome-derived recombinant proteins: factor H-binding protein (fHbp), Neisserial Heparin-Binding Antigen (NHBA) and Neisserial adhesin A (NadA). Here, we assessed the prevalence and sequence variations of these vaccine antigens in a panel of 5667 meningococcal isolates collected worldwide over the past 10 years and deposited in the PubMLST database. Using multiple amino acid sequence alignments and Random Forest Classifier machine learning methods, we estimated the potential strain coverage of fHbp and NHBA vaccine variants (51 and about 25%, respectively); the NadA antigen sequence was found in only 18% of MenB genomes analyzed, but cross-reactive variants were present in less than 1% of isolates. Based on our findings, we proposed various strategies to improve the 4CMenB vaccine and broaden the coverage of N. meningitidis strains.
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Affiliation(s)
- Viktoriia Yu. Savitskaya
- Department of Chemistry, Lomonosov Moscow State University, Leninskie Gory 1, Moscow 119991, Russia
| | - Nina G. Dolinnaya
- Department of Chemistry, Lomonosov Moscow State University, Leninskie Gory 1, Moscow 119991, Russia
| | - Vadim V. Strekalovskikh
- Department of Bioengineering and Bioinformatics, Lomonosov Moscow State University, Leninskie Gory 1, Moscow 119234, Russia; (V.V.S.); (E.S.P.)
| | - Elizaveta S. Peskovatskova
- Department of Bioengineering and Bioinformatics, Lomonosov Moscow State University, Leninskie Gory 1, Moscow 119234, Russia; (V.V.S.); (E.S.P.)
| | - Viktoriia G. Snyga
- Department of Chemistry, Lomonosov Moscow State University, Leninskie Gory 1, Moscow 119991, Russia
| | - Vadim S. Trefilov
- Department of Chemistry, Lomonosov Moscow State University, Leninskie Gory 1, Moscow 119991, Russia
| | - Mayya V. Monakhova
- Belozersky Institute of Physico-Chemical Biology, Lomonosov Moscow State University, Leninskie Gory 1, Moscow 119992, Russia
| | - Elena A. Kubareva
- Belozersky Institute of Physico-Chemical Biology, Lomonosov Moscow State University, Leninskie Gory 1, Moscow 119992, Russia
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Kassianos G, Barasheed O, Abbing-Karahagopian V, Khalaf M, Ozturk S, Banzhoff A, Badur S. Meningococcal B Immunisation in Adults and Potential Broader Immunisation Strategies: A Narrative Review. Infect Dis Ther 2023; 12:2193-2219. [PMID: 37428339 PMCID: PMC10581987 DOI: 10.1007/s40121-023-00836-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 06/08/2023] [Indexed: 07/11/2023] Open
Abstract
Recombinant vaccines against invasive meningococcal disease due to Neisseria meningitidis serogroup B (MenB) have shown substantial impact in reducing MenB disease in targeted populations. 4CMenB targets four key N. meningitidis protein antigens; human factor H binding protein (fHbp), Neisserial heparin binding antigen (NHBA), Neisseria adhesin A (NadA) and the porin A protein (PorA P1.4), with one or more of these expressed by most pathogenic MenB strains, while MenB-FHbp targets two distinct fHbp variants. While many countries recommend MenB immunisation in adults considered at high risk due to underlying medical conditions or immunosuppression, there are no recommendations for routine use in the general adult population. We reviewed the burden of MenB in adults, where, while incidence rates remain low (and far lower than in young children < 5 years of age at greatest risk), a substantial proportion of MenB cases (20% or more) is now observed in the adult population; evident in Europe, Australia, and in the United States. We also reviewed immunogenicity data in adults from clinical studies conducted during MenB vaccine development and subsequent post-licensure studies. A 2-dose schedule of 4CMenB generates hSBA titres ≥ 1:4 towards all four key vaccine target antigens in up to 98-100% of subjects. For MenB-FHbp, a ≥ fourfold rise in hSBA titres against the four primary representative test strains was observed in 70-95% of recipients following a 3-dose schedule. While this suggests potential benefits for MenB immunisation if used in adult populations, data are limited (especially for adults > 50 years) and key aspects relating to duration of protection remain unclear. Although a broader adult MenB immunisation policy could provide greater protection of the adult population, additional data are required to support policy decision-making.
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Affiliation(s)
- George Kassianos
- Royal College of General Practitioners, London, UK
- The British Global and Travel Health Association, London, UK
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van Soest TM, Chekrouni N, van Sorge NM, Bijlsma MW, Brouwer MC, van de Beek D. Epidemiology, clinical features and outcome of adults with meningococcal meningitis: a 15-year prospective nationwide cohort study. THE LANCET REGIONAL HEALTH. EUROPE 2023; 30:100640. [PMID: 37181455 PMCID: PMC10173179 DOI: 10.1016/j.lanepe.2023.100640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 03/30/2023] [Accepted: 04/06/2023] [Indexed: 05/16/2023]
Abstract
Background We describe the epidemiology, clinical features and outcome of adult meningococcal meningitis in the Netherlands over a 15-year period. Methods We studied adults (age ≥ 16 years) who were listed by the Netherlands Reference Laboratory for Bacterial Meningitis and/or included in the prospective nationwide cohort study (MeninGene) between January 2006 and July 2021. Incidences were calculated per epidemiological year (July-June). Findings We identified 442 episodes of adult meningococcal meningitis. The median patient age was 32 years (IQR 18-55) and 226 episodes (51%) occurred in female patients. The annual incidence per 100,000 adults fluctuated, from 0.33 in 2006-2007 to 0.05 in 2020-2021, with a temporal increase up to 0.30 from 2016 to 2018, driven by an outbreak of serogroup W (MenW). Of 442 episodes, 274 episodes (62%) in 273 patients were included in the clinical cohort study. The overall case fatality rate was 4% (10 of 274) and 16% (43 of 274) had an unfavourable outcome (Glasgow Outcome Scale score 1-4). Compared to other serogroups, MenW was associated with higher rates of unfavourable outcome (6 of 16 [38%] vs. 37 of 251 [15%], P = 0.03) and death (4 of 16 [25%] vs. 6 of 251 [2%], P = 0.001). Interpretation The overall incidence of adult meningococcal meningitis in the Netherlands is low and outcome is generally favourable. An increase of MenW meningitis occurred from 2016 to 2018, which was associated with more unfavourable outcome and death. Funding Netherlands Organisation for Health Research and Development, European Research Council, National Institute of Public Health and Environmental protection.
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Affiliation(s)
- Thijs M. van Soest
- Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC, Location University of Amsterdam, Meibergdreef, Amsterdam, the Netherlands
| | - Nora Chekrouni
- Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC, Location University of Amsterdam, Meibergdreef, Amsterdam, the Netherlands
| | - Nina M. van Sorge
- Department of Medical Microbiology and Infection Prevention, Amsterdam UMC Location University of Amsterdam, Amsterdam Institute for Infection and Immunity, Meibergdreef, Amsterdam, the Netherlands
- Netherlands Reference Laboratory for Bacterial Meningitis, Amsterdam UMC Location AMC, Amsterdam, the Netherlands
| | - Merijn W. Bijlsma
- Department of Paediatrics, Amsterdam Neuroscience, Amsterdam UMC Location University of Amsterdam, Meibergdreef, Amsterdam, the Netherlands
| | - Matthijs C. Brouwer
- Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC, Location University of Amsterdam, Meibergdreef, Amsterdam, the Netherlands
| | - Diederik van de Beek
- Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC, Location University of Amsterdam, Meibergdreef, Amsterdam, the Netherlands
- Corresponding author. Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC, University of Amsterdam, PO Box 22660, 1100DD, Amsterdam, the Netherlands.
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Honskus M, Krizova P, Okonji Z, Musilek M, Kozakova J. Whole genome analysis of Neisseria meningitidis isolates from invasive meningococcal disease collected in the Czech Republic over 28 years (1993-2020). PLoS One 2023; 18:e0282971. [PMID: 36913385 PMCID: PMC10010514 DOI: 10.1371/journal.pone.0282971] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 02/17/2023] [Indexed: 03/14/2023] Open
Abstract
Invasive meningococcal disease belongs among the most dangerous infectious diseases in the world. Several polysaccharide conjugate vaccines against serogroups A, C, W and Y are available and two recombinant peptide vaccines against serogroup B (MenB vaccines) have been developed: MenB-4C (Bexsero) and MenB-fHbp (Trumenba). The aim of this study was to define the clonal composition of the Neisseria meningitidis population in the Czech Republic, to determine changes in this population over time and to estimate the theoretical coverage of isolates by MenB vaccines. This study presents the analysis of whole genome sequencing data of 369 Czech N. meningitidis isolates from invasive meningococcal disease covering 28 years. Serogroup B isolates (MenB) showed high heterogeneity and the most common clonal complexes were cc18, cc32, cc35, cc41/44, and cc269. Isolates of clonal complex cc11 were predominately serogroup C (MenC). The highest number of serogroup W isolates (MenW) belonged to clonal complex cc865, which we described as exclusive to the Czech Republic. Our study supports the theory that this cc865 subpopulation originated in the Czech Republic from MenB isolates by a capsule switching mechanism. A dominant clonal complex of serogroup Y isolates (MenY) was cc23, which formed two genetically quite distant subpopulations and which showed constant representation throughout the observed period. The theoretical coverage of isolates by two MenB vaccines was determined using the Meningococcal Deduced Vaccine Antigen Reactivity Index (MenDeVAR). Estimated Bexsero vaccine coverage was 70.6% (for MenB) and 62.2% (for MenC, W, Y). For Trumenba vaccine, estimated coverage was 74.6% (for MenB) and 65.7% (for MenC, W, Y). Our results demonstrated sufficient coverage of Czech heterogeneous population of N. meningitidis with MenB vaccines and, together with surveillance data on invasive meningococcal disease in the Czech Republic, were the basis for updating recommendations for vaccination against invasive meningococcal disease.
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Affiliation(s)
- Michal Honskus
- National Reference Laboratory for Meningococcal Infections, Centre for Epidemiology and Microbiology, National Institute of Public Health, Prague, Czech Republic
- Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Pavla Krizova
- National Reference Laboratory for Meningococcal Infections, Centre for Epidemiology and Microbiology, National Institute of Public Health, Prague, Czech Republic
| | - Zuzana Okonji
- National Reference Laboratory for Meningococcal Infections, Centre for Epidemiology and Microbiology, National Institute of Public Health, Prague, Czech Republic
| | - Martin Musilek
- National Reference Laboratory for Meningococcal Infections, Centre for Epidemiology and Microbiology, National Institute of Public Health, Prague, Czech Republic
| | - Jana Kozakova
- National Reference Laboratory for Meningococcal Infections, Centre for Epidemiology and Microbiology, National Institute of Public Health, Prague, Czech Republic
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Tsang RSW, Law DKS, Zhou J, Haldane D, Garceau R, Zahariadis G, Mead K, Alexander D. Characterization of invasive meningococcal disease case isolates in Atlantic Canada, 2014 to 2020: spatial-temporal variations of clones and predicted meningococcal B vaccine coverage. J Med Microbiol 2022; 71. [PMID: 36748536 DOI: 10.1099/jmm.0.001615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Introduction. Invasive meningococcal disease (IMD) caused by Neisseria meningitidis may show temporal and geographical changes in both the epidemiology and the characteristics of the strains involved.Gap statement. A study that examined invasive N. meningitidis causing IMD in Atlantic Canada from 2009 to 2013 was published in 2014. Data from subsequent years have not been described.Aim. This study examined the molecular epidemiology of IMD in four Atlantic Provinces of Canada as well as potential serogroup B (MenB) vaccine coverage.Methods. Individual IMD case isolates recovered from 2014 to 2020 were analysed for serotype and serosubtype antigens as well as by whole-genome sequencing (WGS) for prediction of potential MenB vaccine coverage.Results. Of the 56 IMD isolates, 42, 8, 5 and 1 were MenB, serogroup Y, serogroup W (MenW) and serogroup C, respectively. Geographical differences in the distribution of MenB clones revealed concentration of sequence type (ST)-269 clonal complex (cc) and ST-60 cc in Newfoundland and Labrador, while ST-41/44 cc (particularly ST-154) was predominantly found in New Brunswick and Nova Scotia. Core genome multi-locus sequence typing (cgMLST) also separated the New Brunswick and Nova Scotia ST-154 isolates into two clusters, with differences in their nhba and penA alleles. Furthermore, cgMLST also separated the ST-269 cc isolates in Atlantic Canada into the ST-1611 and the ST-269/ST-8924 clusters, with the latter showing high similarity to the ST-269 that first emerged in the Province of Quebec. Genetic Meningococcal Antigen Typing System showed that 54.8 % of MenB were predicted to be covered by the MenB vaccine Bexsero, with a further 38.1 % potentially covered by virtue of the presence of genes that encoded factor H-binding protein variant 1 proteins. Meningococcal deduced vaccine antigen reactivity predicted from WGS data showed that 95.3 % of MenB were covered by Trumenba. Four cases of IMD due to MenW ST-11 cc were also identified, with the first case found in 2018.Conclusions. This study provided evidence concerning the dynamics of N. meningitidis strains causing IMD in Atlantic Canada, with both geographical and temporal differences found. MenB vaccine appeared to provide good coverage of MenB IMD, especially towards the predominant strain of ST-154.
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Affiliation(s)
- Raymond S W Tsang
- Vaccine Preventable Bacterial Diseases, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Dennis K S Law
- Vaccine Preventable Bacterial Diseases, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Jianwei Zhou
- Vaccine Preventable Bacterial Diseases, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - David Haldane
- Nova Scotia Health Authority, Government of Nova Scotia, Halifax, Nova Scotia, Canada.,Department of Pathology, Dalhouse University, Halifax, Nova Scotia, Canada
| | - Richard Garceau
- Communicable Disease Control Unit, Department of Health, Government of New Brunswick, Fredericton, New Brunswick, Canada
| | - George Zahariadis
- Provincial Public Health Laboratory, Eastern Health Microbiology Services, Government of Newfoundland and Labrador, St. John's, Newfoundland, Canada.,Department of Laboratory Medicine, Faculty of Medicine, Memorial University of Newfoundland, St John's, Newfoundland and Labrador, Canada
| | - Kristen Mead
- Department of Health, Government of Prince Edward Island, Charlottetown, Prince Edward Island, Canada
| | - David Alexander
- Cadham Provincial Labortory, Government of Manitoba, Winnipeg, Manitoba, Canada.,Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Manitoba, Canada
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Findlow J, Borrow R, Stephens DS, Liberator P, Anderson AS, Balmer P, Jodar L. Correlates of protection for meningococcal surface protein vaccines; current approaches for the determination of breadth of coverage. Expert Rev Vaccines 2022; 21:753-769. [PMID: 35469524 DOI: 10.1080/14760584.2022.2064850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION The two currently licensed surface protein non capsular meningococcal serogroup B (MenB) vaccines both have the purpose of providing broad coverage against diverse MenB strains. However, the different antigen compositions and approaches used to assess breadth of coverage currently make direct comparisons complex. AREAS COVERED In the second of two companion papers, we comprehensively review the serology and factors influencing breadth of coverage assessments for two currently licensed MenB vaccines. EXPERT OPINION Surface protein MenB vaccines were developed using different approaches, resulting in unique formulations and thus their breadth of coverage. The surface proteins used as vaccine antigens can vary among meningococcal strains due to gene presence/absence, sequence diversity and differences in protein expression. Assessment of the breadth of coverage provided by vaccines is influenced by the ability to induce cross-reactive functional immune responses to sequence diverse protein variants; the characteristics of the circulating invasive strains from specific geographic locations; methodological differences in the immunogenicity assays; differences in human immune responses between individuals; and the maintenance of protective antibody levels over time. Understanding the proportion of meningococcal strains which are covered by the two licensed vaccines is important in understanding protection from disease and public health use.
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Affiliation(s)
- Jamie Findlow
- Vaccine Medical Development, Scientific and Clinical Affairs, Pfizer Ltd, Tadworth, UK
| | - Ray Borrow
- Meningococcal Reference Unit, Public Health England, Manchester Royal Infirmary, Manchester, UK
| | - David S Stephens
- Woodruff Health Sciences Center, Emory University, Atlanta, Georgia, USA
| | - Paul Liberator
- Vaccine Research and Development, Pfizer Inc, Pearl River, New York, USA
| | | | - Paul Balmer
- Vaccine Medical Development, Scientific and Clinical Affairs, Pfizer Inc, Collegeville, PA, USA
| | - Luis Jodar
- Vaccine Medical Development, Scientific and Clinical Affairs, Pfizer Inc, Collegeville, PA, USA
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8
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Honskus M, Okonji Z, Musilek M, Krizova P. Whole genome sequencing of Neisseria meningitidis Y isolates collected in the Czech Republic in 1993-2018. PLoS One 2022; 17:e0265066. [PMID: 35271677 PMCID: PMC8912901 DOI: 10.1371/journal.pone.0265066] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 02/22/2022] [Indexed: 11/22/2022] Open
Abstract
Introduction The study presents the analysis of whole genome sequencing (WGS) data for Neisseria meningitidis serogroup Y isolates collected in the Czech Republic and their comparison to other countries. The aim of the study was to determine whether there are lineages of N. meningitidis serogroup Y in the Czech Republic genetically related to foreign ones that have been causing an increase of the morbidity and the mortality of invasive meningococcal disease (IMD) world-wide recently. Material and methods The WGS data of 43 Czech N. meningitidis Y isolates, 35 from IMD and 8 from healthy carriers were analysed. Due to the potential of meningococcal B vaccines to induce protection against non-B serogroups, the coverage of Czech isolates of N. meningitidis Y by these vaccines was studied. The WGS data of Czech, European and non-European isolates of N. meningitidis serogroup Y were compared. Results WGS assigned 36 isolates of N. meningitidis Y to five clonal complexes: cc23, cc92, cc167, cc103, and cc174, while seven isolates remained unassigned to any clonal complexes (ccUA). Eighteen invasive isolates belonged to clonal complex cc23, which was detected throughout the studied years. The occurrence of cc23 was recorded in all age groups of IMD patients, with the highest found in those aged 15–19 years. On the phylogenetic network isolates of cc23 form a separate lineage, distinct from all other isolates of N. meningitidis Y. The remaining isolates were assigned to other clonal complexes and have very low relatedness to cc23 isolates and to each other. The comparison with foreign WGS data showed that within the main genetic lineages, which are defined by clonal complexes, Czech isolates of N. meningitidis Y, similar to European ones, mostly cluster together and form geographical sublineages. Conclusions WGS analysis showed the population of Czech N. meningitidis Y isolates as relatively heterogeneous, containing a large number of genetic lineages. The Czech isolates of N. meningitidis Y follow the trend observed for European isolates. Our result was one of the bases for updating the recommended vaccination strategy in the Czech Republic.
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Affiliation(s)
- Michal Honskus
- National Reference Laboratory for Meningococcal Infections, Centre for Epidemiology and Microbiology, National Institute of Public Health, Prague, Czech Republic
- Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Zuzana Okonji
- National Reference Laboratory for Meningococcal Infections, Centre for Epidemiology and Microbiology, National Institute of Public Health, Prague, Czech Republic
| | - Martin Musilek
- National Reference Laboratory for Meningococcal Infections, Centre for Epidemiology and Microbiology, National Institute of Public Health, Prague, Czech Republic
| | - Pavla Krizova
- National Reference Laboratory for Meningococcal Infections, Centre for Epidemiology and Microbiology, National Institute of Public Health, Prague, Czech Republic
- * E-mail:
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Viviani V, Biolchi A, Pizza M. Synergistic activity of antibodies in the multicomponent 4CMenB vaccine. Expert Rev Vaccines 2022; 21:645-658. [PMID: 35257644 DOI: 10.1080/14760584.2022.2050697] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION : Vaccines based on multiple antigens often induce an immune response which is higher than that triggered by each single component, with antibodies acting cooperatively and synergistically in tackling the infection. AREAS COVERED An interesting example is the antibody response induced by the 4CMenB vaccine, currently licensed for the prevention of Neisseria meningitidis serogroup B (MenB). It contains four antigenic components: Factor H binding protein (fHbp), Neisseria adhesin A (NadA), Neisserial Heparin Binding Antigen (NHBA) and Outer Membrane Vesicles (OMV). Monoclonal and polyclonal antibodies raised by vaccination with 4CMenB show synergistic activity in complement-dependent bacterial killing. This review summarizes published and unpublished data and provides evidence of the added value of multicomponent vaccines. EXPERT OPINION : The ability of 4CMenB vaccine to elicit antibodies targeting multiple surface-exposed antigens is corroborated by the recent data on real world evidences. Bactericidal activity is generally mediated by antibodies that bind to antigens highly expressed on the bacterial surface and immunologically related. However, simultaneous binding of antibodies to various surface-exposed antigens can overcome the threshold density of antigen-antibody complexes needed for complement activation. The data discussed in this review highlight the interplay between antibodies targeting major and minor antigens and their effect on functionality. Clinical trial registration: www.clinicaltrials.gov identifiers of studies with original data mentioned in the article: NCT00937521, NCT00433914, NCT02140762 and NCT02285777.
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Affiliation(s)
| | | | - Mariagrazia Pizza
- Bacterial Vaccines, GSK, Siena, Italy.,GVGH, GSK Vaccine Institute for Global Health, Siena, Italy
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10
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Delic S, Mijac V, Gajic I, Kekic D, Ranin L, Jegorovic B, Culic D, Cirkovic V, Siljic M, Stanojevic M, Paragi M, Markovic M, Opavski N. A Laboratory-Based Surveillance Study of Invasive Neisseria meningitidis, Streptococcus pneumoniae, and Haemophilus influenzae Diseases in a Serbian Pediatric Population-Implications for Vaccination. Diagnostics (Basel) 2021; 11:1059. [PMID: 34207530 PMCID: PMC8228891 DOI: 10.3390/diagnostics11061059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 05/29/2021] [Accepted: 06/04/2021] [Indexed: 11/16/2022] Open
Abstract
The aim of this study was to present the epidemiology of invasive diseases caused by Neisseria meningitidis and Streptococcus pneumoniae in the pre-vaccine period, and Haemophilus influenzae in the post-vaccine period in a pediatric population from Serbia. Among the meningococci, serogroup B dominated (83%), followed by serogroup C (11.3%). High antigenic diversity was found, with fine type P1.5-1,10-4 being the most frequent. Moderate susceptibility to penicillin was common (55%). Within pneumococci, serotypes 19F, 14, 6B, 6A, 18C, 23F, 3, and 7F prevailed, while 19A was rare (3.6%). The coverages of PCV10 and PCV13 were 68% and 84%, respectively. Major sequence types were ST320, ST15, ST273, ST271, and ST81. Non-susceptibility to penicillin (66.7%), cefotaxime (37%), and macrolides (55%) was predominantly detected in vaccine-related serotypes. Among the 11 invasive H. influenzae isolates collected, there were six Hib, three non-type b, and two non-typeable strains (ntHi) that were antibiotic susceptible. These results imply a potential benefit of future Men-B vaccine implementations. For pneumococci, as PCV10 was recently introduced, a significant reduction of morbidity and antibiotic resistance might be expected. The efficiency of Hib vaccination is evident, but a shift towards non-type b and ntHi strains may be anticipated.
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Affiliation(s)
- Snezana Delic
- Centre for Microbiology, National Reference Laboratory for Meningococcus and Haemophilus, Institute of Public Health, 25101 Sombor, Serbia
| | - Vera Mijac
- Faculty of Medicine, Institute of Microbiology and Immunology, University of Belgrade, 11000 Belgrade, Serbia
- National Reference Laboratory for Streptococci, Faculty of Medicine, Institute of Microbiology and Immunology, University of Belgrade, 11000 Belgrade, Serbia
| | - Ina Gajic
- Faculty of Medicine, Institute of Microbiology and Immunology, University of Belgrade, 11000 Belgrade, Serbia
- National Reference Laboratory for Streptococci, Faculty of Medicine, Institute of Microbiology and Immunology, University of Belgrade, 11000 Belgrade, Serbia
| | - Dusan Kekic
- Faculty of Medicine, Institute of Microbiology and Immunology, University of Belgrade, 11000 Belgrade, Serbia
- National Reference Laboratory for Streptococci, Faculty of Medicine, Institute of Microbiology and Immunology, University of Belgrade, 11000 Belgrade, Serbia
| | - Lazar Ranin
- Faculty of Medicine, Institute of Microbiology and Immunology, University of Belgrade, 11000 Belgrade, Serbia
- National Reference Laboratory for Streptococci, Faculty of Medicine, Institute of Microbiology and Immunology, University of Belgrade, 11000 Belgrade, Serbia
| | - Boris Jegorovic
- Clinical Centre of Serbia, University Hospital for Infectious and Tropical Diseases, 11000 Belgrade, Serbia
| | - Davor Culic
- Centre for Microbiology, National Reference Laboratory for Meningococcus and Haemophilus, Institute of Public Health, 25101 Sombor, Serbia
| | - Valentina Cirkovic
- Faculty of Medicine, Institute of Microbiology and Immunology, University of Belgrade, 11000 Belgrade, Serbia
| | - Marina Siljic
- Faculty of Medicine, Institute of Microbiology and Immunology, University of Belgrade, 11000 Belgrade, Serbia
| | - Maja Stanojevic
- Faculty of Medicine, Institute of Microbiology and Immunology, University of Belgrade, 11000 Belgrade, Serbia
| | - Metka Paragi
- National Laboratory of Health Environment and Food, Department for Public Health Microbiology, 1000 Ljubljana, Slovenia
| | - Milos Markovic
- Faculty of Medicine, Institute of Microbiology and Immunology, University of Belgrade, 11000 Belgrade, Serbia
| | - Natasa Opavski
- Faculty of Medicine, Institute of Microbiology and Immunology, University of Belgrade, 11000 Belgrade, Serbia
- National Reference Laboratory for Streptococci, Faculty of Medicine, Institute of Microbiology and Immunology, University of Belgrade, 11000 Belgrade, Serbia
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Marshall HS, Andraweera PH, Wang B, McMillan M, Koehler AP, Lally N, Almond S, Denehy E, A’Houre M, Giles LC, Flood L. Evaluating the effectiveness of the 4CMenB vaccine against invasive meningococcal disease and gonorrhoea in an infant, child and adolescent program: protocol. Hum Vaccin Immunother 2021; 17:1450-1454. [PMID: 33428528 PMCID: PMC8078704 DOI: 10.1080/21645515.2020.1827614] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 08/25/2020] [Accepted: 09/20/2020] [Indexed: 12/30/2022] Open
Abstract
Invasive meningococcal disease causes significant morbidity and mortality worldwide, with serogroup B being one of the predominant serogroups in Australia for many years. The South Australian (SA) State Government recently funded the introduction of a 4CMenB vaccination program for infants, children and adolescents. In addition to protecting against invasive meningococcal disease, emerging evidence suggests the 4CMenB vaccine may also be effective against gonorrhoea due to genetic similarities between Neisseria meningitidis and Neisseria gonorrhoeae. The proposed project aims to evaluate the effectiveness of the SA 4CMenB vaccination program against invasive meningococcal disease and gonorrhoea through a combination of observational studies using routine surveillance and research data. The main methodological approaches involve an interrupted time series regression model, screening, and case-control analyses with different sets of controls to estimate vaccine impact and effectiveness. These analyses are designed to minimize potential biases inherent in all observational studies and to provide critical data on the effectiveness of the 4CMenB vaccine against two diseases of major global public health concern.
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Affiliation(s)
- Helen S. Marshall
- Vaccinology and Immunology Research Trials Unit, Women’s and Children’s Hospital, SA Health, Adelaide, Australia
- Robinson Research Institute, The University of Adelaide, Adelaide, Australia
- Adelaide Medical School, The University of Adelaide, Adelaide, Australia
| | - Prabha H. Andraweera
- Vaccinology and Immunology Research Trials Unit, Women’s and Children’s Hospital, SA Health, Adelaide, Australia
- Robinson Research Institute, The University of Adelaide, Adelaide, Australia
- Adelaide Medical School, The University of Adelaide, Adelaide, Australia
| | - Bing Wang
- Vaccinology and Immunology Research Trials Unit, Women’s and Children’s Hospital, SA Health, Adelaide, Australia
- Robinson Research Institute, The University of Adelaide, Adelaide, Australia
- Adelaide Medical School, The University of Adelaide, Adelaide, Australia
| | - Mark McMillan
- Vaccinology and Immunology Research Trials Unit, Women’s and Children’s Hospital, SA Health, Adelaide, Australia
- Robinson Research Institute, The University of Adelaide, Adelaide, Australia
- Adelaide Medical School, The University of Adelaide, Adelaide, Australia
| | - Ann P. Koehler
- Communicable Disease Control Branch, SA Health, Adelaide, Australia
| | - Noel Lally
- Communicable Disease Control Branch, SA Health, Adelaide, Australia
| | - Sara Almond
- Communicable Disease Control Branch, SA Health, Adelaide, Australia
| | - Emma Denehy
- Communicable Disease Control Branch, SA Health, Adelaide, Australia
| | - Michele A’Houre
- Communicable Disease Control Branch, SA Health, Adelaide, Australia
| | - Lynne C. Giles
- Robinson Research Institute, The University of Adelaide, Adelaide, Australia
- School of Public Health, The University of Adelaide, Adelaide, Australia
| | - Louise Flood
- Communicable Disease Control Branch, SA Health, Adelaide, Australia
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12
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Lodi L, Moriondo M, Nieddu F, Ricci S, Guiducci S, Lippi F, Canessa C, Calistri E, Citera F, Giovannini M, Indolfi G, Resti M, Azzari C. Molecular typing of group B Neisseria meningitidis'subcapsular antigens directly on biological samples demonstrates epidemiological congruence between culture-positive and -negative cases: A surveillance study of invasive disease over a 13-year period. J Infect 2021; 82:28-36. [PMID: 33610687 DOI: 10.1016/j.jinf.2020.12.034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 12/07/2020] [Accepted: 12/22/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Surveillance of serogroup B Neisseria meningitidis (MenB) subcapsular antigen variant distribution in invasive disease (IMD) is fundamental for multicomponent vaccine coverage prediction. IMD incidence in Tuscany in 2018 was 0.37/100,000 inhabitants, with MenB representing 57% of cases. More than 50% of MenB responsible for IMD cannot be grown in culture, and molecular characterization of these cases is often lacking. The aim of the present study was to describe the distribution of MenB subcapsular antigens, comparing their distribution in culture-positive and culture-negative cases. METHODS Molecular data regarding clonal complexes and subcapsular antigen variants of the 55 MenB-IMD occurring in Tuscany from 2007 to 2019 were made available, and their distribution between culture-positive and culture-negative cases was compared. Genetic-MATS and MenDeVAR prediction systems were used to assess multicomponent vaccine coverage predictions. RESULTS Culture-positive and culture-negative cases presented a similar percentage representation of fHbp subfamilies. Clonal complex 162 was almost constantly associated with fHbp B231/v1.390, Neisserial-heparin-binding-antigen (NHBA) peptide 20, and PorinA P1.22,14 (BAST-3033): these were the most represented antigenic variants, both in culture-positive and culture-negative groups. Point-estimate 4CMenB coverage prediction was 88.5% (84.6%-92.3%). CONCLUSIONS Our data demonstrate that non-cultivable meningococci, responsible for IMD, possess genetic variants of subcapsular antigens that are representative of what has been observed in culture. The vaccine-related antigenic epidemiology of MenB is thus similar in both groups. One of the first on-field applications of gMATS and MenDeVAR identifies their major advantage in their accessibility and in the possibility of dynamic data implementation that must be pursued continuously in the future.
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Affiliation(s)
- Lorenzo Lodi
- Department of Health Sciences, University of Florence and Meyer Children's University Hospital, viale Pieraccini 24, 50139 Florence, Italy
| | - Maria Moriondo
- Department of Health Sciences, University of Florence and Meyer Children's University Hospital, viale Pieraccini 24, 50139 Florence, Italy
| | - Francesco Nieddu
- Department of Health Sciences, University of Florence and Meyer Children's University Hospital, viale Pieraccini 24, 50139 Florence, Italy
| | - Silvia Ricci
- Department of Health Sciences, University of Florence and Meyer Children's University Hospital, viale Pieraccini 24, 50139 Florence, Italy.
| | - Sara Guiducci
- Department of Health Sciences, University of Florence and Meyer Children's University Hospital, viale Pieraccini 24, 50139 Florence, Italy
| | - Francesca Lippi
- Department of Health Sciences, University of Florence and Meyer Children's University Hospital, viale Pieraccini 24, 50139 Florence, Italy
| | - Clementina Canessa
- Department of Health Sciences, University of Florence and Meyer Children's University Hospital, viale Pieraccini 24, 50139 Florence, Italy
| | - Elisa Calistri
- Department of Health Sciences, University of Florence and Meyer Children's University Hospital, viale Pieraccini 24, 50139 Florence, Italy
| | - Francesco Citera
- Department of Health Sciences, University of Florence and Meyer Children's University Hospital, viale Pieraccini 24, 50139 Florence, Italy
| | - Mattia Giovannini
- Department of Health Sciences, University of Florence and Meyer Children's University Hospital, viale Pieraccini 24, 50139 Florence, Italy
| | - Giuseppe Indolfi
- Department of Pediatrics, Meyer Children's University Hospital, viale Pieraccini 24, 50139 Florence, Italy
| | - Massimo Resti
- Department of Pediatrics, Meyer Children's University Hospital, viale Pieraccini 24, 50139 Florence, Italy
| | - Chiara Azzari
- Department of Health Sciences, University of Florence and Meyer Children's University Hospital, viale Pieraccini 24, 50139 Florence, Italy
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13
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Tzanakaki G, Xirogianni A, Tsitsika A, Clark SA, Kesanopoulos K, Bratcher HB, Papandreou A, Rodrigues CMC, Maiden MCJ, Borrow R, Tsolia M. Estimated strain coverage of serogroup B meningococcal vaccines: A retrospective study for disease and carrier strains in Greece (2010-2017). Vaccine 2021; 39:1621-1630. [PMID: 33597116 DOI: 10.1016/j.vaccine.2021.01.073] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 01/07/2021] [Accepted: 01/30/2021] [Indexed: 11/17/2022]
Abstract
Invasive meningococcal disease (IMD) is associated with high case fatality rates and long-term sequelae among survivors. Meningococci belonging to six serogroups (A, B, C, W, X, and Y) cause nearly all IMD worldwide, with serogroup B meningococci (MenB) the predominant cause in many European countries, including Greece (~80% of all IMD). In the absence of protein-conjugate polysaccharide MenB vaccines, two protein-based vaccines are available to prevent MenB IMD in Greece: 4CMenB (Bexsero™, GlaxoSmithKline), available since 2014; and MenB-FHbp, (Trumenba™, Pfizer), since 2018. This study investigated the potential coverage of MenB vaccines in Greece using 107 MenB specimens, collected from 2010 to 2017 (66 IMD isolates and 41 clinical samples identified solely by non-culture PCR), alongside 6 MenB isolates from a carriage study conducted during 2017-2018. All isolates were characterized by multilocus sequence typing (MLST), PorA, and FetA antigen typing. Whole Genome Sequencing (WGS) was performed on 66 isolates to define the sequences of vaccine components factor H-binding protein (fHbp), Neisserial Heparin Binding Antigen (NHBA), and Neisseria adhesin A (NadA). The expression of fHbp was investigated with flow cytometric meningococcal antigen surface expression (MEASURE) assay. The fHbp gene was present in-frame in all isolates tested by WGS and in 41 MenB clinical samples. All three variant families of fHbp peptides were present, with subfamily B peptides (variant 1) occurring in 69.2% and subfamily A in 30.8% of the samples respectively. Sixty three of 66 (95.5%) MenB isolates expressed sufficient fHbp to be susceptible to bactericidal killing by MenB-fHbp induced antibodies, highlighting its potential to protect against most IMD in Greece.
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Affiliation(s)
- G Tzanakaki
- National Meningitis Reference Laboratory (NMRL), Dept of Public Health Policy, School of Public Health, University of West Attica, Athens, Greece.
| | - A Xirogianni
- National Meningitis Reference Laboratory (NMRL), Dept of Public Health Policy, School of Public Health, University of West Attica, Athens, Greece
| | - A Tsitsika
- Second Dept of Paediatrics, Medical School, National Kapodistrian University, Athens, Greece
| | - S A Clark
- Meningococcal Reference Unit, Public Health England, Manchester Royal Infirmary, Manchester, UK
| | - K Kesanopoulos
- National Meningitis Reference Laboratory (NMRL), Dept of Public Health Policy, School of Public Health, University of West Attica, Athens, Greece
| | - H B Bratcher
- Department of Zoology, Peter Medawar Building for Pathogen Research, University of Oxford, South Parks Road, Oxford, UK
| | - A Papandreou
- National Meningitis Reference Laboratory (NMRL), Dept of Public Health Policy, School of Public Health, University of West Attica, Athens, Greece
| | - C M C Rodrigues
- Department of Zoology, Peter Medawar Building for Pathogen Research, University of Oxford, South Parks Road, Oxford, UK
| | - M C J Maiden
- Department of Zoology, Peter Medawar Building for Pathogen Research, University of Oxford, South Parks Road, Oxford, UK
| | - R Borrow
- Meningococcal Reference Unit, Public Health England, Manchester Royal Infirmary, Manchester, UK
| | - M Tsolia
- Second Dept of Paediatrics, Medical School, National Kapodistrian University, Athens, Greece
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Fazio C, Biolchi A, Neri A, Tomei S, Vacca P, Ambrosio L, Palmieri A, Mori E, La Gaetana R, Pizza M, Giuliani MM, Serino L, Stefanelli P. Cross-reactivity of 4CMenB vaccine-induced antibodies against meningococci belonging to non-B serogroups in Italy. Hum Vaccin Immunother 2021; 17:2225-2231. [PMID: 33522380 PMCID: PMC8189125 DOI: 10.1080/21645515.2020.1855951] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
The four-component meningococcal serogroup B vaccine (4CMenB) contains antigens present in the majority of meningococci causing invasive meningococcal disease (IMD) and may potentially offer protection against strains belonging to non-B serogroups.This study aimed to evaluate the ability of 4CMenB-induced antibodies to kill, in a human serum bactericidal assay (hSBA), non-B meningococci belonging to the main genotypes responsible for IMD in Italy.Meningococci, collected between 2015 and 2017, was characterized for PorA, FetA and sequence type, and for clonal complex. Twenty non-B isolates, representative of the most frequent genotypes, were molecularly characterized for 4CMenB antigens and tested in hSBA with sera from 4CMenB-vaccinated infants and adolescents.Among twenty isolates, eleven were serogroup C, five were Y, two W and two X. All isolates contained genes encoding for fHbp and NHBA antigens and four harbored the NadA full-length encoding gene. Positive hSBA titers were obtained against all serogroup W, X and Y isolates and against five serogroup C isolates.These data show that the 4CMenB vaccine can induce bactericidal antibodies against genetically representative meningococcal W, Y and X strains from Italy. For serogroup C, different susceptibilities to killing were observed for strains with similar antigenic repertoires.
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Affiliation(s)
- Cecilia Fazio
- Department Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | | | - Arianna Neri
- Department Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | | | - Paola Vacca
- Department Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Luigina Ambrosio
- Department Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Annapina Palmieri
- Department Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | | | | | | | | | | | - Paola Stefanelli
- Department Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
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15
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Thangarajah D, Guglielmino CJD, Lambert SB, Khandaker G, Vasant BR, Malo JA, Smith HV, Jennison AV. Genomic Characterization of Recent and Historic Meningococcal Serogroup E Invasive Disease in Australia: A Case Series. Clin Infect Dis 2021; 70:1761-1763. [PMID: 31420664 DOI: 10.1093/cid/ciz767] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Accepted: 08/08/2019] [Indexed: 11/14/2022] Open
Abstract
We report the recent emergence of invasive meningococcal disease due to serogroup E in Queensland, Australia, in previously healthy patients. Molecular typing revealed the genotype of these strains to be E:P1.21-7,16:F5-36:ST-1157 (cc1157); when analyzed phylogenetically, compared with international cc1157 strains, they were relatively unrelated to each other.
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Affiliation(s)
- Dharshi Thangarajah
- Communicable Diseases Branch, Queensland Health, Brisbane.,National Centre for Epidemiology and Population Health, Australian National University, Brisbane
| | | | - Stephen B Lambert
- Communicable Diseases Branch, Queensland Health, Brisbane.,Centre for Child Health Research, The University of Queensland, Brisbane
| | - Gulam Khandaker
- Central Queensland Public Health Unit, Queensland Health, Rockhampton, Australia
| | - Bhakti R Vasant
- Metro South Public Health Unit, Queensland Health, Brisbane, Australia
| | | | - Helen V Smith
- Queensland Health Forensic and Scientific Services, Brisbane
| | - Amy V Jennison
- Queensland Health Forensic and Scientific Services, Brisbane
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16
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de Lemos APS, Sacchi CT, Gonçalves CR, Camargo CH, Andrade AL. Genomic surveillance of Neisseria meningitidis serogroup B invasive strains: Diversity of vaccine antigen types, Brazil, 2016-2018. PLoS One 2020; 15:e0243375. [PMID: 33347452 PMCID: PMC7751880 DOI: 10.1371/journal.pone.0243375] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 11/19/2020] [Indexed: 11/19/2022] Open
Abstract
Background Neisseria meningitidis serogroup B remains a prominent cause of invasive meningococcal disease (IMD) in Brazil. Because two novel protein-based vaccines against serogroup B are available, the main purpose of this study was to provide data on the diversity and distribution of meningococcal vaccine antigen types circulating in Brazil. Methodology Genetic lineages, vaccine antigen types, and allele types of antimicrobial-associated resistance genes based on whole-genome sequencing of a collection of 145 Neisseria meningitidis serogroup B invasive strains recovered in Brazil from 2016 to 2018 were collected. Results A total of 11 clonal complexes (ccs) were identified among the 145 isolates, four of which were predominant, namely, cc461, cc35, cc32, and cc213, accounting for 72.0% of isolates. The most prevalent fHbp peptides were 24 (subfamily A/variant 2), 47 (subfamily A/variant 3), 1 (subfamily B/variant 1) and 45 (subfamily A/variant 3), which were predominantly associated with cc35, cc461, cc32, and cc213, respectively. The NadA peptide was detected in only 26.2% of the isolates. The most frequent NadA peptide 1 was found almost exclusively in cc32. We found seven NHBA peptides that accounted for 74.5% of isolates, and the newly described peptide 1390 was the most prevalent peptide exclusively associated with cc461. Mutated penA alleles were detected in 56.5% of the isolates, whereas no rpoB and gyrA mutant alleles were found. Conclusion During the study period, changes in the clonal structure of circulating strains were observed, without a predominance of a single hyperinvasive lineage, indicating that an epidemiologic shift has occurred that led to a diversity of vaccine antigen types in recent years in Brazil.
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Affiliation(s)
| | | | | | | | - Ana Lúcia Andrade
- Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiânia, Brazil
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17
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Meningococcal Deduced Vaccine Antigen Reactivity (MenDeVAR) Index: a Rapid and Accessible Tool That Exploits Genomic Data in Public Health and Clinical Microbiology Applications. J Clin Microbiol 2020; 59:JCM.02161-20. [PMID: 33055180 PMCID: PMC7771438 DOI: 10.1128/jcm.02161-20] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 10/09/2020] [Indexed: 12/24/2022] Open
Abstract
As microbial genomics makes increasingly important contributions to clinical and public health microbiology, the interpretation of whole-genome sequence data by nonspecialists becomes essential. In the absence of capsule-based vaccines, two protein-based vaccines have been used for the prevention of invasive serogroup B meningococcal disease (IMD) since their licensure in 2013 and 2014. These vaccines have different components and different levels of coverage of meningococcal variants. Hence, decisions regarding which vaccine to use in managing serogroup B IMD outbreaks require information about the index case isolate, including (i) the presence of particular vaccine antigen variants, (ii) the expression of vaccine antigens, and (iii) the likely susceptibility of its antigen variants to antibody-dependent bactericidal killing. As microbial genomics makes increasingly important contributions to clinical and public health microbiology, the interpretation of whole-genome sequence data by nonspecialists becomes essential. In the absence of capsule-based vaccines, two protein-based vaccines have been used for the prevention of invasive serogroup B meningococcal disease (IMD) since their licensure in 2013 and 2014. These vaccines have different components and different levels of coverage of meningococcal variants. Hence, decisions regarding which vaccine to use in managing serogroup B IMD outbreaks require information about the index case isolate, including (i) the presence of particular vaccine antigen variants, (ii) the expression of vaccine antigens, and (iii) the likely susceptibility of its antigen variants to antibody-dependent bactericidal killing. To obtain this information requires a multitude of laboratory assays, impractical in real-time clinical settings, where the information is most urgently needed. To facilitate assessment for public health and clinical purposes, we synthesized genomic and experimental data from published sources to develop and implement the Meningococcal Deduced Vaccine Antigen Reactivity (MenDeVAR) Index, which is publicly available on PubMLST (https://pubmlst.org). Using whole-genome sequences or individual gene sequences obtained from IMD isolates or clinical specimens, the MenDeVAR Index provides rapid evidence-based information on the presence and possible immunological cross-reactivity of different meningococcal vaccine antigen variants. The MenDeVAR Index enables practitioners who are not genomics specialists to assess the likely reactivity of vaccines for individual cases, outbreak management, or the assessment of public health vaccine programs. The MenDeVAR Index has been developed in consultation with, but independently of, both the 4CMenB (Bexsero; GSK) and rLP2086 (Trumenba; Pfizer, Inc.) vaccine manufacturers.
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18
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Predicted coverage by 4CMenB vaccine against invasive meningococcal disease cases in the Netherlands. Vaccine 2020; 38:7850-7857. [PMID: 33097311 DOI: 10.1016/j.vaccine.2020.10.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 09/30/2020] [Accepted: 10/02/2020] [Indexed: 11/23/2022]
Abstract
Neisseria meningitidis serogroup B is a major cause of invasive meningococcal disease in Europe. In the absence of a conjugate serogroup B vaccine, a subcapsular 4CMenB vaccine was developed. Data on 4CMenB vaccine efficacy is still limited. Recently, genomic MATS (Meningococcal Antigen Typing System) was developed as a tool to predict strain coverage, using vaccine antigens sequence data. We characterized all invasive meningococcal isolates received by the Netherlands Reference Laboratory for Bacterial Meningitis (NRLBM) in two epidemiological years 2017-2019 using whole-genome sequencing and determined serogroup, clonal complex (cc) and estimated 4CMenB vaccine coverage by gMATS. Of 396 cases of invasive meningococcal disease, corresponding to an incidence of 1.22 cases/105 inhabitants, 180 (45%) were serogroup W, 155 (39%) serogroup B, 46 (12%) serogroup Y, 10 (3%) serogroup C, 2 non-groupable (0.5%) and 3 (0.7%) unknown. The incidence was the highest among 0-4 years olds (4 cases/105 inhabitants), and 57/72 (79%) of these cases were serogroup B. Serogroup W predominated among persons 45 years of age or older with 110/187 (59%) cases. Serogroup B isolates comprised 11 different clonal complexes, with 103/122 (84%) isolates belonging to 4 clonal complexes: cc32, cc41/44, cc269 and cc213. In contrast, serogroup W isolates were genetically similar with 95% belonging to cc11. Of 122 serogroup B isolates, 89 (73%; 95% CI: 64-80%) were estimated to be covered by 4CMenB and the degree of coverage varied largely by clonal complex and age. Among the 0-4 year olds, 25 of 43 (58%; 95% CI: 43-72%) MenB isolates were estimated to be covered. Since the coverage of the 4CMenB vaccine is dependent on circulating clonal complexes, our findings emphasize the need for surveillance of circulating meningococcal strains. In addition, estimation of age specific coverage is relevant to determine the right target age group for vaccination.
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Mbaeyi SA, Bozio CH, Duffy J, Rubin LG, Hariri S, Stephens DS, MacNeil JR. Meningococcal Vaccination: Recommendations of the Advisory Committee on Immunization Practices, United States, 2020. MMWR Recomm Rep 2020; 69:1-41. [PMID: 33417592 PMCID: PMC7527029 DOI: 10.15585/mmwr.rr6909a1] [Citation(s) in RCA: 113] [Impact Index Per Article: 28.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
This report compiles and summarizes all recommendations from CDC's Advisory Committee on Immunization Practices (ACIP) for use of meningococcal vaccines in the United States. As a comprehensive summary and update of previously published recommendations, it replaces all previously published reports and policy notes. This report also contains new recommendations for administration of booster doses of serogroup B meningococcal (MenB) vaccine for persons at increased risk for serogroup B meningococcal disease. These guidelines will be updated as needed on the basis of availability of new data or licensure of new meningococcal vaccines. ACIP recommends routine vaccination with a quadrivalent meningococcal conjugate vaccine (MenACWY) for adolescents aged 11 or 12 years, with a booster dose at age 16 years. ACIP also recommends routine vaccination with MenACWY for persons aged ≥2 months at increased risk for meningococcal disease caused by serogroups A, C, W, or Y, including persons who have persistent complement component deficiencies; persons receiving a complement inhibitor (e.g., eculizumab [Soliris] or ravulizumab [Ultomiris]); persons who have anatomic or functional asplenia; persons with human immunodeficiency virus infection; microbiologists routinely exposed to isolates of Neisseria meningitidis; persons identified to be at increased risk because of a meningococcal disease outbreak caused by serogroups A, C, W, or Y; persons who travel to or live in areas in which meningococcal disease is hyperendemic or epidemic; unvaccinated or incompletely vaccinated first-year college students living in residence halls; and military recruits. ACIP recommends MenACWY booster doses for previously vaccinated persons who become or remain at increased risk.In addition, ACIP recommends routine use of MenB vaccine series among persons aged ≥10 years who are at increased risk for serogroup B meningococcal disease, including persons who have persistent complement component deficiencies; persons receiving a complement inhibitor; persons who have anatomic or functional asplenia; microbiologists who are routinely exposed to isolates of N. meningitidis; and persons identified to be at increased risk because of a meningococcal disease outbreak caused by serogroup B. ACIP recommends MenB booster doses for previously vaccinated persons who become or remain at increased risk. In addition, ACIP recommends a MenB series for adolescents and young adults aged 16-23 years on the basis of shared clinical decision-making to provide short-term protection against disease caused by most strains of serogroup B N. meningitidis.
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20
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Methods to evaluate serogroup B meningococcal vaccines: From predictions to real-world evidence. J Infect 2020; 81:862-872. [PMID: 32745637 DOI: 10.1016/j.jinf.2020.07.034] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 07/24/2020] [Accepted: 07/28/2020] [Indexed: 01/19/2023]
Abstract
Serogroup B meningococci (MenB) remain a prominent cause of invasive meningococcal disease (IMD). The protein-based multicomponent 4CMenB and the bivalent MenB-FHbp are the only currently available vaccines against MenB-caused IMD. Efficacy studies are not possible, due to the low incidence of IMD. Therefore, the vaccines' immunogenicity has been evaluated against several target strains chosen to quantify complement-mediated killing induced by each vaccine component in the serum bactericidal antibody assay. However, due to the wide genetic diversity and different expression levels of vaccine antigens across MenB strains, vaccine performance may differ from one strain to another. Here, we review the methods used to predict MenB strain coverage for 4CMenB and MenB-FHbp. Phenotypic assays such as the meningococcal antigen typing system (MATS, 4CMenB-specific) and the flow cytometric meningococcal antigen surface expression assay (MEASURE; MenB-FHbp-specific) were developed. Genomic approaches are also available, such as genetic MATS (gMATS) and the Bexsero antigen sequence type (BAST) scheme, both 4CMenB-specific. All methods allow tentative predictions of coverage across MenB strains, including that afforded by each vaccine antigen, and are rapid and reproducible. Real-world data on vaccine effectiveness are needed to confirm predictions obtained by these methods.
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21
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Leo S, Lazarevic V, Girard M, Getaz-Jimenez Velasco GC, Gaïa N, Renzi G, Cherkaoui A, Hong E, Taha MK, Schrenzel J. Strain coverage of Bexsero vaccine assessed by whole-genome sequencing over a cohort of invasive meningococci of serogroups B and W isolated in Switzerland. Vaccine 2020; 38:5324-5331. [PMID: 32561121 DOI: 10.1016/j.vaccine.2020.05.071] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 05/22/2020] [Accepted: 05/26/2020] [Indexed: 12/27/2022]
Abstract
Invasive meningococcal disease (IMD), caused by Neisseria meningitidis (Nm) strains, is a life-threatening but vaccine-preventable condition. Bexsero is a four-component vaccine that offers broad protection against Nm of serogroup B (NmB), particularly common in Europe. In Switzerland, Bexsero has not yet been licensed and no information is available concerning the predicted vaccine coverage on isolates of circulating Nm. We performed genotyping of Bexsero antigen loci by whole-genome sequencing (WGS) on 104 NmB collected in Switzerland in the 2010-2015 period. We searched for antigen variants previously defined as predictors of strain coverage and estimated that 50% of IMD NmB strains were potentially covered by the vaccine. Clonal complexes (cc) 32, 41/44 and 269, considered the best covered lineages, were further sub-typed according to Bexsero Antigen Sequence Type (BAST) scheme. We also genotyped by WGS 40 Nm of serogroup W (NmW) collected in the country between 2010 and 2016. NmW cc22 isolates appeared to be covered by the vaccine, which was not the case for cc11 isolates, whose incidence has recently increased in Switzerland and all over Europe. Our work underlines the benefit of using WGS for surveillance of vaccine antigen variant distribution in local Nm population and taking proper measures to prevent the spread of NmB.
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Affiliation(s)
- Stefano Leo
- Genomic Research Laboratory, Division of Infectious Diseases, University Hospitals and University of Geneva, Geneva, Switzerland
| | - Vladimir Lazarevic
- Genomic Research Laboratory, Division of Infectious Diseases, University Hospitals and University of Geneva, Geneva, Switzerland
| | - Myriam Girard
- Genomic Research Laboratory, Division of Infectious Diseases, University Hospitals and University of Geneva, Geneva, Switzerland
| | - Gisela C Getaz-Jimenez Velasco
- Swiss National Reference Center for Meningococci (www.meningo.ch), Bacteriology Laboratory, Geneva University Hospitals, Geneva, Switzerland
| | - Nadia Gaïa
- Genomic Research Laboratory, Division of Infectious Diseases, University Hospitals and University of Geneva, Geneva, Switzerland
| | - Gesuele Renzi
- Swiss National Reference Center for Meningococci (www.meningo.ch), Bacteriology Laboratory, Geneva University Hospitals, Geneva, Switzerland
| | - Abdessalam Cherkaoui
- Swiss National Reference Center for Meningococci (www.meningo.ch), Bacteriology Laboratory, Geneva University Hospitals, Geneva, Switzerland
| | - Eva Hong
- Invasive Bacterial Infection and National Reference Centre for Meningococci, Institut Pasteur, Paris, France
| | - Muhamed-Kheir Taha
- Invasive Bacterial Infection and National Reference Centre for Meningococci, Institut Pasteur, Paris, France
| | - Jacques Schrenzel
- Genomic Research Laboratory, Division of Infectious Diseases, University Hospitals and University of Geneva, Geneva, Switzerland; Swiss National Reference Center for Meningococci (www.meningo.ch), Bacteriology Laboratory, Geneva University Hospitals, Geneva, Switzerland.
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22
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Säll O, Olofsson E, Jacobsson S. High genomic-based predicted strain coverage among invasive meningococcal isolates when combining Bexsero and Trumenba vaccines. Vaccine 2020; 38:4374-4378. [PMID: 32414653 DOI: 10.1016/j.vaccine.2020.04.074] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 04/16/2020] [Accepted: 04/28/2020] [Indexed: 01/16/2023]
Abstract
Two protein-based vaccines (Bexsero® and Trumenba®) are licensed for invasive meningococcal disease (IMD) caused by Neisseria meningitidis serogroup B (MenB). The aim of this study was to evaluate the possible protection of these vaccines, based on the genomic profiles of IMD isolates. All invasive meningococcal isolates in Sweden during 2014-2018 (n = 242) were analyzed with the vaccine coverage scheme available at the PubMLST database. The overall estimated genomic strain coverage among the Swedish invasive meningococcal isolates was 55% for Bexsero and 57% for Trumenba (p = 0.714). The estimated serogroup-specific coverage for Bexsero respectively Trumenba was: MenB; 67% and 90% (p < 0.05), MenW; 93% and 4% (p < 0.05), MenC; 87% and 30% (p < 0.05) and MenY; 1% and 96% (p < 0.05). With the combination of the two vaccines, the potential genomic-based strain coverage was 95%, indicating a possible additive effect of combining Bexsero and Trumenba, which, however, needs to be confirmed by analysis of phenotypic antigen expression.
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Affiliation(s)
- Olof Säll
- Department of Infectious Diseases, Faculty of Medicine and Health, Örebro University, Örebro University Hospital, S-701 85 Örebro, Sweden.
| | - Emma Olofsson
- Faculty of Medicine and Health, Örebro University, Campus USÖ, S-701 82 Örebro, Sweden
| | - Susanne Jacobsson
- Department of Laboratory Medicine, Clinical Microbiology, Faculty of Medicine and Health, Örebro University, Örebro University Hospital, S-701 85 Örebro, Sweden.
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23
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Epidemiology of two decades of invasive meningococcal disease in the Republic of Ireland: an analysis of national surveillance data on laboratory-confirmed cases from 1996 to 2016. Epidemiol Infect 2020; 147:e142. [PMID: 30869045 PMCID: PMC6518514 DOI: 10.1017/s0950268819000396] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
We examined the epidemiology of invasive meningococcal disease (IMD) in the Republic of Ireland (ROI) between epidemiological year (EY) 1996/1997 and EY2015/2016. Over the 20 EYs, 3707 cases were reported with annual incidence rates per 100 000 peaking at 11.6 in EY1999/2000, decreasing significantly to 1.5 in EY2015/2016. The highest disease burden was in infants and children <5, whereas adults aged ⩾65 years experienced the highest case fatality ratio (CFR) of 15.7% but over the study period the median annual CFR remained low (4.4%). Meningococcal serogroup B (menB) dominated (78%), followed by menC (17%), menW (1%) and menY (1%). The incidence of menC IMD declined significantly in all age groups after menC vaccine introduction in 2000. MenB incidence also declined over the 20 EYs with decreasing trends in all age groups under 65, including an almost 50% decrease in infants over the final four EYs. IMD incidence in the ROI has declined, partly attributable to menC vaccination success, coupled with a spontaneous decline in menB. However, recent gradual increases in non-menB IMD and the introduction of vaccines targeting menB demand continued detailed surveillance to accurately monitor trends and to assess vaccine impact.
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24
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Aston-Deaville S, Carlsson E, Saleem M, Thistlethwaite A, Chan H, Maharjan S, Facchetti A, Feavers IM, Alistair Siebert C, Collins RF, Roseman A, Derrick JP. An assessment of the use of Hepatitis B Virus core protein virus-like particles to display heterologous antigens from Neisseria meningitidis. Vaccine 2020; 38:3201-3209. [PMID: 32178907 PMCID: PMC7113836 DOI: 10.1016/j.vaccine.2020.03.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 02/25/2020] [Accepted: 03/01/2020] [Indexed: 12/15/2022]
Abstract
Neisseria meningitidis is the causative agent of meningococcal meningitis and sepsis and remains a significant public health problem in many countries. Efforts to develop a comprehensive vaccine against serogroup B meningococci have focused on the use of surface-exposed outer membrane proteins. Here we report the use of virus-like particles derived from the core protein of Hepatitis B Virus, HBc, to incorporate antigen domains derived from Factor H binding protein (FHbp) and the adhesin NadA. The extracellular domain of NadA was inserted into the major immunodominant region of HBc, and the C-terminal domain of FHbp at the C-terminus (CFHbp), creating a single polypeptide chain 3.7-fold larger than native HBc. Remarkably, cryoelectron microscopy revealed that the construct formed assemblies that were able to incorporate both antigens with minimal structural changes to native HBc. Electron density was weak for NadA and absent for CFHbp, partly attributable to domain flexibility. Following immunization of mice, three HBc fusions (CFHbp or NadA alone, NadA + CFHbp) were able to induce production of IgG1, IgG2a and IgG2b antibodies reactive against their respective antigens at dilutions in excess of 1:18,000. However, only HBc fusions containing NadA elicited the production of antibodies with serum bactericidal activity. It is hypothesized that this improved immune response is attributable to the adoption of a more native-like folding of crucial conformational epitopes of NadA within the chimeric VLP. This work demonstrates that HBc can incorporate insertions of large antigen domains but that maintenance of their three-dimensional structure is likely to be critical in obtaining a protective response.
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Affiliation(s)
- Sebastian Aston-Deaville
- Lydia Becker Institute of Immunology and Inflammation, School of Biological Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester M13 9PL, UK
| | - Emil Carlsson
- Lydia Becker Institute of Immunology and Inflammation, School of Biological Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester M13 9PL, UK
| | - Muhammad Saleem
- Lydia Becker Institute of Immunology and Inflammation, School of Biological Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester M13 9PL, UK
| | - Angela Thistlethwaite
- Lydia Becker Institute of Immunology and Inflammation, School of Biological Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester M13 9PL, UK
| | - Hannah Chan
- National Institute for Biological Standards and Control, Blanche Lane, South Mimms, Hertfordshire EN6 3QG, UK
| | - Sunil Maharjan
- National Institute for Biological Standards and Control, Blanche Lane, South Mimms, Hertfordshire EN6 3QG, UK
| | - Alessandra Facchetti
- National Institute for Biological Standards and Control, Blanche Lane, South Mimms, Hertfordshire EN6 3QG, UK
| | - Ian M Feavers
- National Institute for Biological Standards and Control, Blanche Lane, South Mimms, Hertfordshire EN6 3QG, UK
| | - C Alistair Siebert
- Electron Bio-Imaging Centre, Diamond Light Source, Harwell Science & Innovation Campus, Didcot, Oxfordshire, UK
| | - Richard F Collins
- Lydia Becker Institute of Immunology and Inflammation, School of Biological Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester M13 9PL, UK
| | - Alan Roseman
- Lydia Becker Institute of Immunology and Inflammation, School of Biological Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester M13 9PL, UK
| | - Jeremy P Derrick
- Lydia Becker Institute of Immunology and Inflammation, School of Biological Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester M13 9PL, UK.
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25
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Azevedo AC, Franco NEC, de Carvalho Rocha MR, Andrade C, Torres MC, de Filippis I. Molecular surveillance of brazilian meningococcal isolates serogroup c in the pre and post-men-c-vaccination period: Emergence of ST-3780. INFECTION GENETICS AND EVOLUTION 2020; 78:104079. [DOI: 10.1016/j.meegid.2019.104079] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 10/16/2019] [Accepted: 10/20/2019] [Indexed: 12/15/2022]
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26
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Bennett DE, Meyler KL, Cafferkey MT, Cunney RJ. Diversity of meningococci associated with invasive meningococcal disease in the Republic of Ireland over a 19 year period, 1996-2015. PLoS One 2020; 15:e0228629. [PMID: 32053601 PMCID: PMC7018037 DOI: 10.1371/journal.pone.0228629] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 01/20/2020] [Indexed: 12/19/2022] Open
Abstract
This study examined the capsular phenotype and genotype of invasive meningococcal disease (IMD)-associated Neisseria meningitidis recovered in the Republic of Ireland (RoI) between 1996 and 2015. This time period encompasses both pre- (when IMD was hyperendemic in the RoI) and post- meningococcal serogroup C conjugate (MCC) vaccine introduction. In total, 1327 isolates representing over one-third of all laboratory-confirmed cases of IMD diagnosed each epidemiological year (EY), were characterised. Serogroups B (menB) and C (menC) predominated throughout, although their relative abundance changed; with an initial increase in the proportion of menC in the late 1990s followed by their dramatic reduction post-MCC vaccine implementation and a concomitant dominance of menB, despite an overall decline in IMD incidence. While the increase in menC was associated with expansion of specific clonal-complexes (cc), cc11 and cc8; the dominance of menB was not. There was considerable variation in menB-associated cc with declines in cc41/44 and cc32, and increases in cc269 and cc461, contributing to a significant increase in the clonal diversity of menB isolates over the study. This increase in diversity was also displayed among the serosubtyping data, with significant declines in proportions of menB isolates expressing p1.4 and p1.15 antigens. These data highlight the changing diversity of IMD-associated meningococci since 1996 in the RoI and emphasise the need for on-going surveillance particularly in view of the recent introduction of a menB vaccine.
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Affiliation(s)
- Désirée E. Bennett
- Irish Meningitis and Sepsis Reference Laboratory, Children’s Health Ireland, Dublin, Ireland
- * E-mail:
| | - Kenneth L. Meyler
- Irish Meningitis and Sepsis Reference Laboratory, Children’s Health Ireland, Dublin, Ireland
| | - Mary T. Cafferkey
- Irish Meningitis and Sepsis Reference Laboratory, Children’s Health Ireland, Dublin, Ireland
- Department of Microbiology, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Robert J. Cunney
- Irish Meningitis and Sepsis Reference Laboratory, Children’s Health Ireland, Dublin, Ireland
- Department of Microbiology, Royal College of Surgeons in Ireland, Dublin, Ireland
- Department of Clinical Microbiology, Children’s Health Ireland, Dublin, Ireland
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27
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Waśko I, Gołębiewska A, Kiedrowska M, Ronkiewicz P, Wróbel-Pawelczyk I, Kuch A, Hong E, Skoczyńska A. Genetic variability of Polish serogroup B meningococci (2010-2016) including the 4CMenB vaccine component genes. Vaccine 2020; 38:1943-1952. [PMID: 31980191 DOI: 10.1016/j.vaccine.2020.01.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 12/20/2019] [Accepted: 01/07/2020] [Indexed: 01/25/2023]
Abstract
Neisseria meningitidis serogroup B (MenB) has recently become the major cause of invasive meningococcal disease in Poland. Therefore, the purpose of this study was to characterize MenB isolates, responsible for invasive meningococcal disease in 2010-2016, by MLST and sequencing of genes encoding proteins used as 4CMenB vaccine antigens. Two methods of coverage estimation were performed: extrapolation of MATS results of Polish meningococci 2010-2011 (exMATS) and gMATS, which combines genotyping and MATS results. Among 662 isolates 20 clonal complexes (CC) were detected, of which the most frequent were CC32, CC41/44 and CC18, accounting for 31.9%, 16.5% and 12.7%, respectively. A total of 111 combinations of PorA variable regions (VR1/VR2) were found, with P1.7,16 (15.0%) and P1.22,14 (13.6%) being prevalent. Vaccine variant VR2:4 was detected in 7.3% of isolates, mainly representing CC41/44 and non-assigned CC. Eighty five fHbp alleles encoding 74 peptide subvariants were revealed. Subvariant 1.1, a component of 4CMenB, was prevalent (24.2%) and found generally in CC32. Typing of the nhba gene revealed 102 alleles encoding 87 peptides. The most frequent was peptide 3 (22.4%), whereas vaccine peptide 2 was detected in 9.8%, mostly among CC41/44. The nadA gene was detected in 34.0% of isolates and the most prevalent was peptide 1 (variant NadA-1; 71.6%), found almost exclusively in CC32 meningococci. Vaccine peptide 8 (variant NadA-2/3) was identified once. Consequently, 292 completed BAST profiles were revealed. Regarding vaccine coverage, 39.7% of isolates had at least one 4CMenB vaccine variant, but according to exMATS and gMATS the coverage was 83.3% and 86.6%, respectively. In conclusion, Polish MenB (2010-2016) was highly diverse according to MLST and gene alleles encoding 4CMenB vaccine antigens. Some correlations between clonal complexes and variants of examined proteins/BAST profiles were revealed and a high coverage of 4CMenB vaccine was estimated.
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Affiliation(s)
- Izabela Waśko
- National Reference Centre for Bacterial Meningitis, National Medicines Institute, Warsaw, Poland
| | - Agnieszka Gołębiewska
- National Reference Centre for Bacterial Meningitis, National Medicines Institute, Warsaw, Poland
| | - Marlena Kiedrowska
- National Reference Centre for Bacterial Meningitis, National Medicines Institute, Warsaw, Poland
| | - Patrycja Ronkiewicz
- National Reference Centre for Bacterial Meningitis, National Medicines Institute, Warsaw, Poland
| | - Izabela Wróbel-Pawelczyk
- National Reference Centre for Bacterial Meningitis, National Medicines Institute, Warsaw, Poland
| | - Alicja Kuch
- National Reference Centre for Bacterial Meningitis, National Medicines Institute, Warsaw, Poland
| | - Eva Hong
- Institute Pasteur, Invasive Bacterial Infections Unit, Paris, France
| | - Anna Skoczyńska
- National Reference Centre for Bacterial Meningitis, National Medicines Institute, Warsaw, Poland
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28
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Caugant DA, Brynildsrud OB. Neisseria meningitidis: using genomics to understand diversity, evolution and pathogenesis. Nat Rev Microbiol 2019; 18:84-96. [PMID: 31705134 DOI: 10.1038/s41579-019-0282-6] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/25/2019] [Indexed: 01/30/2023]
Abstract
Meningococcal disease remains an important cause of morbidity and death worldwide despite the development and increasing implementation of effective vaccines. Elimination of the disease is hampered by the enormous diversity and antigenic variability of the causative agent, Neisseria meningitidis, one of the most variable bacteria in nature. These features are attained mainly through high rates of horizontal gene transfer and alteration of protein expression through phase variation. The recent availability of whole-genome sequencing (WGS) of large-scale collections of N. meningitidis isolates from various origins, databases to facilitate storage and sharing of WGS data and the concomitant development of effective bioinformatics tools have led to a much more thorough understanding of the diversity of the species, its evolution and population structure and how virulent traits may emerge. Implementation of WGS is already contributing to enhanced epidemiological surveillance and is essential to ascertain the impact of vaccination strategies. This Review summarizes the recent advances provided by WGS studies in our understanding of the biology of N. meningitidis and the epidemiology of meningococcal disease.
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Affiliation(s)
- Dominique A Caugant
- Division for Infection Control and Environmental Health, Norwegian Institute of Public Health, Oslo, Norway. .,Department of Community Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
| | - Ola B Brynildsrud
- Division for Infection Control and Environmental Health, Norwegian Institute of Public Health, Oslo, Norway.,Department of Food Safety and Infection Biology, Faculty of Veterinary Science, Norwegian University of Life Science, Oslo, Norway
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29
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Bai X, Borrow R, Bukovski S, Caugant DA, Culic D, Delic S, Dinleyici EC, Eloshvili M, Erdősi T, Galajeva J, Křížová P, Lucidarme J, Mironov K, Nurmatov Z, Pana M, Rahimov E, Savrasova L, Skoczyńska A, Smith V, Taha MK, Titov L, Vázquez J, Yeraliyeva L. Prevention and control of meningococcal disease: Updates from the Global Meningococcal Initiative in Eastern Europe. J Infect 2019; 79:528-541. [PMID: 31682877 DOI: 10.1016/j.jinf.2019.10.018] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 10/23/2019] [Accepted: 10/26/2019] [Indexed: 12/20/2022]
Abstract
The Global Meningococcal Initiative (GMI) aims to prevent invasive meningococcal disease (IMD) worldwide through education, research and cooperation. In March 2019, a GMI meeting was held with a multidisciplinary group of experts and representatives from countries within Eastern Europe. Across the countries represented, IMD surveillance is largely in place, with incidence declining in recent decades and now generally at <1 case per 100,000 persons per year. Predominating serogroups are B and C, followed by A, and cases attributable to serogroups W, X and Y are emerging. Available vaccines differ between countries, are generally not included in immunization programs and provided to high-risk groups only. Available vaccines include both conjugate and polysaccharide vaccines; however, current data and GMI recommendations advocate the use of conjugate vaccines, where possible, due to the ability to interrupt the acquisition of carriage. Ongoing carriage studies are expected to inform vaccine effectiveness and immunization schedules. Additionally, IMD prevention and control should be guided by monitoring outbreak progression and the emergence and international spread of strains and antibiotic resistance through use of genomic analyses and implementation of World Health Organization initiatives. Protection of high-risk groups (such as those with complement deficiencies, laboratory workers, migrants and refugees) is recommended.
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Affiliation(s)
- Xilian Bai
- Meningococcal Reference Unit, Public Health England, Manchester Royal Infirmary, Manchester M13 9WZ, UK.
| | - Ray Borrow
- Meningococcal Reference Unit, Public Health England, Manchester Royal Infirmary, Manchester M13 9WZ, UK.
| | - Suzana Bukovski
- University Hospital for Infectious Diseases, Zagreb, Croatia.
| | | | - Davor Culic
- Institute for Public Health, Sombor, Serbia.
| | | | | | - Medeia Eloshvili
- National Center for Disease Control & Public Health, Tbilisi, Georgia.
| | - Tímea Erdősi
- National Public Health Center, Budapest, Hungary.
| | | | - Pavla Křížová
- National Institute of Public Health, Prague, Czechia.
| | - Jay Lucidarme
- Meningococcal Reference Unit, Public Health England, Manchester Royal Infirmary, Manchester M13 9WZ, UK.
| | | | - Zuridin Nurmatov
- Scientific and Production Association "Preventive Medicine", Bishkek, Kyrgyzstan.
| | - Marina Pana
- Cantacuzino National Medico Military Institute for Research Development, Bucharest, Romania
| | | | - Larisa Savrasova
- The Centre for Disease Prevention and Control of Latvia, Riga, Latvia.
| | - Anna Skoczyńska
- National Reference Centre for Bacterial Meningitis, National Medicines Institute, Warsaw, Poland.
| | - Vinny Smith
- Meningitis Research Foundation, Bristol, UK.
| | - Muhamed-Kheir Taha
- National Reference Centre for Meningococci, Institute Pasteur, Paris, France.
| | - Leonid Titov
- Republican Research & Practical Center for Epidemiology & Microbiology, Minsk, Belarus.
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30
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Bratcher HB, Rodrigues CMC, Finn A, Wootton M, Cameron JC, Smith A, Heath P, Ladhani S, Snape MD, Pollard AJ, Cunningham R, Borrow R, Trotter C, Gray SJ, Maiden MCJ, MacLennan JM. UKMenCar4: A cross-sectional survey of asymptomatic meningococcal carriage amongst UK adolescents at a period of low invasive meningococcal disease incidence. Wellcome Open Res 2019; 4:118. [PMID: 31544158 PMCID: PMC6749934 DOI: 10.12688/wellcomeopenres.15362.2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/23/2019] [Indexed: 01/02/2023] Open
Abstract
Carriage of
Neisseria meningitidis, the meningococcus, is a prerequisite for invasive meningococcal disease (IMD), a potentially devastating infection that disproportionately afflicts infants and children. Humans are the sole known reservoir for the meningococcus, and it is carried asymptomatically in the nasopharynx of ~10% of the population. Rates of carriage are dependent on age of the host and social and behavioural factors. In the UK, meningococcal carriage has been studied through large, multi-centre carriage surveys of adolescents in 1999, 2000, and 2001, demonstrating carriage can be affected by immunisation with the capsular group C meningococcal conjugate vaccine, inducing population immunity against carriage. Fifteen years after these surveys were carried out, invasive meningococcal disease incidence had declined from a peak in 1999. The UKMenCar4 study was conducted in 2014/15 to investigate rates of carriage amongst the adolescent population during a period of low disease incidence. The protocols and methodology used to perform UKMenCar4, a large carriage survey, are described here.
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Affiliation(s)
- Holly B Bratcher
- Peter Medawar Building for Pathogen Research, Department of Zoology, University of Oxford, Oxford, OX1 3SY, UK
| | - Charlene M C Rodrigues
- Peter Medawar Building for Pathogen Research, Department of Zoology, University of Oxford, Oxford, OX1 3SY, UK
| | - Adam Finn
- School of Cellular and Molecular Medicine, University of Bristol, Bristol, BS2 8AE, UK
| | - Mandy Wootton
- Division of Public Health Wales, Cardiff, CF10 3NW, UK
| | - J Claire Cameron
- NHS National Services Scotland, Health Protection Scotland, Glasgow, G2 6QE, UK
| | - Andrew Smith
- University of Glasgow Dental School, Glasgow, G2 3JZ, UK.,Scottish Microbiology Reference Laboratory, NHS Greater Glasgow & Clyde, Glasgow, G2 6QE, UK
| | - Paul Heath
- Paediatric Infectious Diseases Research Group, St George's, University of London, London, SW17 0QT, UK
| | - Shamez Ladhani
- Paediatric Infectious Diseases Research Group, St George's, University of London, London, SW17 0QT, UK.,Immunisation Department, Public Health England, London, UK
| | - Matthew D Snape
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford Biomedical Research Centre, Oxford, OX3 7LE, UK
| | - Andrew J Pollard
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford Biomedical Research Centre, Oxford, OX3 7LE, UK
| | - Richard Cunningham
- Microbiology Department, University Hospitals Plymouth NHS Trust, Plymouth, PL6 8DH, UK
| | - Raymond Borrow
- Meningococcal Reference Unit, Public Health England, Manchester Royal Infirmary, Manchester, M13 9WL, UK
| | - Caroline Trotter
- Disease Dynamics Unit, Department of Veterinary Medicine, University of Cambridge, Cambridge, CB3 0ES, UK
| | - Stephen J Gray
- Meningococcal Reference Unit, Public Health England, Manchester Royal Infirmary, Manchester, M13 9WL, UK
| | - Martin C J Maiden
- Peter Medawar Building for Pathogen Research, Department of Zoology, University of Oxford, Oxford, OX1 3SY, UK
| | - Jenny M MacLennan
- Peter Medawar Building for Pathogen Research, Department of Zoology, University of Oxford, Oxford, OX1 3SY, UK
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31
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Bratcher HB, Rodrigues CMC, Finn A, Wootton M, Cameron JC, Smith A, Heath P, Ladhani S, Snape MD, Pollard AJ, Cunningham R, Borrow R, Trotter C, Gray SJ, Maiden MCJ, MacLennan JM. UKMenCar4: A cross-sectional survey of asymptomatic meningococcal carriage amongst UK adolescents at a period of low invasive meningococcal disease incidence. Wellcome Open Res 2019; 4:118. [PMID: 31544158 DOI: 10.12688/wellcomeopenres.15362.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/26/2019] [Indexed: 11/20/2022] Open
Abstract
Carriage of Neisseria meningitidis, the meningococcus, is a prerequisite for invasive meningococcal disease (IMD), a potentially devastating infection that disproportionately afflicts infants and children. Humans are the sole known reservoir for the meningococcus, and it is carried asymptomatically in the nasopharynx of ~10% of the population. Rates of carriage are dependent on age of the host and social and behavioural factors. In the UK, meningococcal carriage has been studied through large, multi-centre carriage surveys of adolescents in 1999, 2000, and 2001, demonstrating carriage can be affected by immunisation with the capsular group C meningococcal conjugate vaccine, inducing population immunity against carriage. Fifteen years after these surveys were carried out, invasive meningococcal disease incidence had declined from a peak in 1999. The UKMenCar4 study was conducted in 2014/15 to investigate rates of carriage amongst the adolescent population during a period of low disease incidence. The protocols and methodology used to perform UKMenCar4, a large carriage survey, are described here.
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Affiliation(s)
- Holly B Bratcher
- Peter Medawar Building for Pathogen Research, Department of Zoology, University of Oxford, Oxford, OX1 3SY, UK
| | - Charlene M C Rodrigues
- Peter Medawar Building for Pathogen Research, Department of Zoology, University of Oxford, Oxford, OX1 3SY, UK
| | - Adam Finn
- School of Cellular and Molecular Medicine, University of Bristol, Bristol, BS2 8AE, UK
| | - Mandy Wootton
- Division of Public Health Wales, Cardiff, CF10 3NW, UK
| | - J Claire Cameron
- NHS National Services Scotland, Health Protection Scotland, Glasgow, G2 6QE, UK
| | - Andrew Smith
- University of Glasgow Dental School, Glasgow, G2 3JZ, UK.,Scottish Microbiology Reference Laboratory, NHS Greater Glasgow & Clyde, Glasgow, G2 6QE, UK
| | - Paul Heath
- Paediatric Infectious Diseases Research Group, St George's, University of London, London, SW17 0QT, UK
| | - Shamez Ladhani
- Paediatric Infectious Diseases Research Group, St George's, University of London, London, SW17 0QT, UK.,Immunisation Department, Public Health England, London, UK
| | - Matthew D Snape
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford Biomedical Research Centre, Oxford, OX3 7LE, UK
| | - Andrew J Pollard
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford Biomedical Research Centre, Oxford, OX3 7LE, UK
| | - Richard Cunningham
- Microbiology Department, University Hospitals Plymouth NHS Trust, Plymouth, PL6 8DH, UK
| | - Raymond Borrow
- Meningococcal Reference Unit, Public Health England, Manchester Royal Infirmary, Manchester, M13 9WL, UK
| | - Caroline Trotter
- Disease Dynamics Unit, Department of Veterinary Medicine, University of Cambridge, Cambridge, CB3 0ES, UK
| | - Stephen J Gray
- Meningococcal Reference Unit, Public Health England, Manchester Royal Infirmary, Manchester, M13 9WL, UK
| | - Martin C J Maiden
- Peter Medawar Building for Pathogen Research, Department of Zoology, University of Oxford, Oxford, OX1 3SY, UK
| | - Jenny M MacLennan
- Peter Medawar Building for Pathogen Research, Department of Zoology, University of Oxford, Oxford, OX1 3SY, UK
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Bratcher HB, Brehony C, Heuberger S, Pieridou-Bagatzouni D, Křížová P, Hoffmann S, Toropainen M, Taha MK, Claus H, Tzanakaki G, Erdôsi T, Galajeva J, van der Ende A, Skoczyńska A, Pana M, Vaculíková A, Paragi M, Maiden MC, Caugant DA. Establishment of the European meningococcal strain collection genome library (EMSC-GL) for the 2011 to 2012 epidemiological year. ACTA ACUST UNITED AC 2019; 23. [PMID: 29790460 PMCID: PMC6152424 DOI: 10.2807/1560-7917.es.2018.23.20.17-00474] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Invasive meningococcal disease surveillance in Europe combines isolate characterisation and epidemiological data to support public health intervention. A representative European Meningococcal Strain Collection (EMSC) of IMD isolates was obtained, and whole genome sequenced to characterise 799 EMSC isolates from the epidemiological year July 2011-June 2012. To establish a genome library (GL), the isolate information was deposited in the pubMLST.org/neisseria database. Genomes were curated and annotated at 2,429 meningococcal loci, including those defining clonal complex, capsule, antigens, and antimicrobial resistance. Most genomes contained genes encoding B (n = 525; 65.7%) or C (n = 163; 20.4%) capsules; isolates were genetically highly diverse, with >20 genomic lineages, five of which comprising 60.7% (n = 485) of isolates. There were >350 antigenic fine-types: 307 were present once, the most frequent (P1.7-2,4:F5-1) comprised 8% (n = 64) of isolates. Each genome was characterised for Bexsero Antigen Sequence Typing (BAST): 25.5% (n = 204) of isolates contained alleles encoding the fHbp and/or the PorA VR1 vaccine component, but most genomes (n = 513; 64.2%) did not contain the NadA component. EMSC-GL will support an integrated surveillance of disease-associated genotypes in Europe, enabling the monitoring of hyperinvasive lineages, outbreak identification, and supporting vaccine programme implementation.
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Affiliation(s)
- Holly B Bratcher
- University of Oxford, Department of Zoology, Oxford, United Kingdom
| | - Carina Brehony
- Clinical Science Institute, National University of Ireland, Galway, Republic of Ireland.,University of Oxford, Department of Zoology, Oxford, United Kingdom
| | | | | | - Pavla Křížová
- National Institute of Public Health, Prague, Czech Republic
| | | | | | | | | | | | - Tímea Erdôsi
- National Center for Epidemiology, Budapest, Hungary
| | | | | | | | - Marina Pana
- National Institute of Research and Development for Microbiology and Immunology, Bucharest, Romania
| | - Alena Vaculíková
- Public Health Authority of the Slovak Republic, Bratislava, Slovakia
| | - Metka Paragi
- National Institute of Public Health, Ljubljana, Slovenia
| | - Martin Cj Maiden
- University of Oxford, Department of Zoology, Oxford, United Kingdom
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Krizova P, Honskus M. Genomic surveillance of invasive meningococcal disease in the Czech Republic, 2015-2017. PLoS One 2019; 14:e0219477. [PMID: 31295279 PMCID: PMC6622526 DOI: 10.1371/journal.pone.0219477] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 06/25/2019] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION The study presents the results of the genomic surveillance of invasive meningococcal disease (IMD) in the Czech Republic for the period of 2015-2017. MATERIAL AND METHODS The study set includes all available IMD isolates recovered in the Czech Republic and referred to the National Reference Laboratory for Meningococcal Infections in 2015-2017, a total of 89 Neissseria meningitidis isolates-from 2015 (n = 20), 2016 (n = 27), and from 2017 (n = 42). All isolates were studied by whole genome sequencing (WGS). RESULTS Serogroup B (MenB) was the most common, followed by serogroups C, W, and Y. Altogether 17 clonal complexes were identified, the most common of which was hypervirulent complex cc11, followed by complexes cc32, cc41/44, cc269, and cc865. Over the three study years, hypervirulent cc11 (MenC) showed an upward trend. The WGS method showed two clearly differentiated clusters of N. meningitidis C: P1.5,2:F3-3:ST-11 (cc11). The first cluster is represented by nine isolates, all of which are from 2017. The second cluster consisted of five isolates from 2016 and eight isolates from 2017. Their genetic discordance is illustrated by the changing nadA allele and subsequently by the variance in BAST type. Clonal complex cc269 (MenB) also increased over the time frame. WGS identified the presence of MenB vaccine antigen genes in all B and non-B isolates of N. meningitidis. Altogether 49 different Bexsero antigen sequence types (BAST) were identified and 10 combinations of these have not been previously described in the PubMLST database. CONCLUSIONS The genomic surveillance of IMD in the Czech Republic provides data needed to update immunisation guidelines for this disease. WGS showed a higher discrimination power and provided more accurate data on molecular characteristics and genetic relationships among invasive N. meningitidis isolates.
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Affiliation(s)
- Pavla Krizova
- National Reference Laboratory for Meningococcal Infections, Centre for Epidemiology and Microbiology, National Institute of Public Health, Prague, Czech Republic
- * E-mail:
| | - Michal Honskus
- National Reference Laboratory for Meningococcal Infections, Centre for Epidemiology and Microbiology, National Institute of Public Health, Prague, Czech Republic
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34
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Tran TX, Le TT, Trieu LP, Austin CM, Van Quyen D, Nguyen HM. Whole-genome sequencing and characterization of an antibiotic resistant Neisseria meningitidis B isolate from a military unit in Vietnam. Ann Clin Microbiol Antimicrob 2019; 18:16. [PMID: 31060558 PMCID: PMC6501280 DOI: 10.1186/s12941-019-0315-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 04/27/2019] [Indexed: 12/30/2022] Open
Abstract
Background Invasive meningococcal disease (IMD) persists in military units in Vietnam despite the availability of antibiotics and vaccines. A hindrance to reducing the incidence of IMD in Vietnam is a lack of molecular data from isolates of the causative agent, Neisseria meningitidis from this country. Here, we characterized key genetic and epidemiological features of an invasive N. meningitidis isolate from a military unit in Vietnam using whole-genome sequencing. Methods Neisseria meningitidis was isolated from a conscript admitted for meningitis and tested against seven antibiotics. DNA from the isolate was extracted and sequenced using the Illumina HiSeq platform. Denovo assembly and scaffolding were performed to construct a draft genome assembly, from which genes were predicted and functionally annotated. Genome analysis included epidemiological characterization, genomic composition and identification of antibiotic resistance genes. Results Susceptibility testing of the isolate showed high levels of resistance to chloramphenicol and diminished susceptibility to ampicillin and rifampicin. A draft genome of ~ 2.1 Mb was assembled, containing 2451 protein coding sequences, 49 tRNAs and 3 rRNAs. Fifteen coding sequences sharing ≥ 84% identity with known antibiotic resistance genes were identified. Genome analysis revealed abundant repetitive DNAs and two prophages. Epidemiological typing revealed newly described sequence type, antigenic finetype and Bexsero® Antigen Sequence Typing (BAST). The BAST profile showed no coverage by either Bexsero® or Trumenba®. Conclusions Our results present the first genome assembly of an invasive N. meningitidis isolate from a military unit in Vietnam. This study illustrates the usefulness of whole genome sequencing (WGS) analysis for epidemiological and antibiotic resistance studies and surveillance of IMD in Vietnam.
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Affiliation(s)
- Thach Xuan Tran
- Laboratory of Molecular Microbiology, Institute of Biotechnology, Vietnam Academy of Science and Technology, 18 Hoang Quoc Viet Street, Cau Giay District, Hanoi, Vietnam
| | - Trang Thu Le
- Laboratory of Molecular Microbiology, Institute of Biotechnology, Vietnam Academy of Science and Technology, 18 Hoang Quoc Viet Street, Cau Giay District, Hanoi, Vietnam
| | - Long Phi Trieu
- Laboratory of Microbiology, Military Institute of Preventive Medicine, 21 Trung Liet Street, Dong Da District, Hanoi, Vietnam
| | - Christopher M Austin
- Centre for Integrative Ecology, School of Life and Environmental Sciences, Deakin University, 75 Pigdons Rd, Waurn Ponds, Geelong, VIC, 3216, Australia
| | - Dong Van Quyen
- Laboratory of Molecular Microbiology, Institute of Biotechnology, Vietnam Academy of Science and Technology, 18 Hoang Quoc Viet Street, Cau Giay District, Hanoi, Vietnam. .,Pharmacological, Medical and Agronomical Biotechnology (PMAB) Department, University of Science and Technology of Hanoi, 18 Hoang Quoc Viet Street, Cau Giay District, Hanoi, Vietnam.
| | - Huong Minh Nguyen
- Laboratory of Molecular Microbiology, Institute of Biotechnology, Vietnam Academy of Science and Technology, 18 Hoang Quoc Viet Street, Cau Giay District, Hanoi, Vietnam.
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35
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Masignani V, Pizza M, Moxon ER. The Development of a Vaccine Against Meningococcus B Using Reverse Vaccinology. Front Immunol 2019; 10:751. [PMID: 31040844 PMCID: PMC6477034 DOI: 10.3389/fimmu.2019.00751] [Citation(s) in RCA: 83] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Accepted: 03/20/2019] [Indexed: 12/04/2022] Open
Abstract
The discovery of vaccine antigens through whole genome sequencing (WGS) contrasts with the classical hypothesis-driven laboratory-based analysis of microbes to identify components to elicit protective immunity. This radical change in scientific direction and action in vaccine research is captured in the term reverse vaccinology. The complete genome sequence of an isolate of Neisseria meningitidis serogroup B (MenB) was systematically analyzed to identify proteins predicted to be secreted or exported to the outer membrane. This identified hundreds of genes coding for potential surface-exposed antigens. These were amplified, cloned in expression vectors and used to immunize mice. Antisera against 350 recombinant antigens were obtained and analyzed in a panel of immunological assays from which 28 were selected as potentially protective based on the -antibody dependent, complement mediated- serum bactericidal activity assay. Testing of these candidate vaccine antigens, using a large globally representative strain collection of Neisseria species isolated from cases of disease and carriage, indicated that no single component would be sufficient to induce broad coverage and that a “universal” vaccine should contain multiple antigens. The final choice of antigens to be included was based on cross-protective ability, assayed by serum bactericidal activity and maximum coverage of the extensive antigenic variability of MenB strains. The resulting multivalent vaccine formulation selected consisted of three recombinant antigens (Neisserial Heparin Binding Antigen or NHBA, Factor H binding protein or fHbp and Neisseria Adhesin A or NadA). To improve immunogenicity and potential strain coverage, an outer membrane vesicle component obtained from the epidemic New Zealand strain (OMVNz) was added to the formulation to create a four component vaccine, called 4CMenB. A series of phase 2 and 3 clinical trials were conducted to evaluate safety and tolerability and to estimate the vaccine effectiveness of human immune responses at different ages and how these were affected by various factors including concomitant vaccine use and lot-to-lot consistency. 4CMenB was approved in Europe in 2013 and introduced in the National Immunization Program in the UK starting from September 2015 when the vaccine was offered to all newborns using a 2, 4, and 12 months schedule., The effectiveness against invasive MenB disease measured at 11 months after the study start and 5 months after the second vaccination was 83% and there have been no safety concerns.
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Affiliation(s)
| | | | - E Richard Moxon
- Department of Pediatrics, Oxford University, Oxford, United Kingdom
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36
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Rodrigues CMC, Chan H, Vipond C, Jolley K, Harrison OB, Wheeler J, Whiting G, Feavers IM, Maiden MCJ. Typing complex meningococcal vaccines to understand diversity and population structure of key vaccine antigens. Wellcome Open Res 2019; 3:151. [PMID: 30687793 DOI: 10.12688/wellcomeopenres.14859.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/13/2018] [Indexed: 11/20/2022] Open
Abstract
Background: Protein-conjugate capsular polysaccharide vaccines can potentially control invasive meningococcal disease (IMD) caused by five (A, C, W, X, Y) of the six IMD-associated serogroups. Concerns raised by immunological similarity of the serogroup B capsule to human neural cell carbohydrates, meant that 'serogroup B substitute' vaccines target more variable subcapsular protein antigens. A successful approach using outer membrane vesicles (OMVs) as major vaccine components had limited strain coverage. In 4CMenB (Bexsero ®), recombinant proteins have been added to ameliorate this problem. Methods: Scalable, portable, genomic techniques were used to investigate the Bexsero ® OMV protein diversity in meningococcal populations. Shotgun proteomics identified 461 proteins in the OMV, defining a complex proteome. Amino acid sequences for the 24 proteins most likely to be involved in cross-protective immune responses were catalogued within the PubMLST.org/neisseria database using a novel OMV peptide Typing (OMVT) scheme. Results: Among these proteins there was variation in the extent of diversity and association with meningococcal lineages, identified as clonal complexes (ccs), ranging from the most conserved peptides (FbpA, NEISp0578, and putative periplasmic protein, NEISp1063) to the most diverse (TbpA, NEISp1690). There were 1752 unique OMVTs identified amongst 2492/3506 isolates examined by whole-genome sequencing (WGS). These OMVTs were grouped into clusters (sharing ≥18 identical OMVT peptides), with 45.3% of isolates assigned to one of 27 OMVT clusters. OMVTs and OMVT clusters were strongly associated with cc, genogroup, and Bexsero ® antigen variants, demonstrating that combinations of OMV proteins exist in discrete, non-overlapping combinations associated with genogroup and Bexsero ® Antigen Sequence Type. This highly structured population of IMD-associated meningococci is consistent with strain structure models invoking host immune and/or metabolic selection. Conclusions: The OMVT scheme facilitates region-specific WGS investigation of meningococcal diversity and is an open-access, portable tool with applications for vaccine development, especially in the choice of antigen combinations, assessment and implementation.
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Affiliation(s)
| | - Hannah Chan
- Division of Bacteriology, National Institute for Biological Standards and Control, Potters Bar, EN6 3QG, UK
| | - Caroline Vipond
- Division of Bacteriology, National Institute for Biological Standards and Control, Potters Bar, EN6 3QG, UK
| | - Keith Jolley
- Department of Zoology, University of Oxford, Oxford, OX1 3SY, UK
| | - Odile B Harrison
- Department of Zoology, University of Oxford, Oxford, OX1 3SY, UK
| | - Jun Wheeler
- Division of Bacteriology, National Institute for Biological Standards and Control, Potters Bar, EN6 3QG, UK
| | - Gail Whiting
- Division of Bacteriology, National Institute for Biological Standards and Control, Potters Bar, EN6 3QG, UK
| | - Ian M Feavers
- Division of Bacteriology, National Institute for Biological Standards and Control, Potters Bar, EN6 3QG, UK
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37
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Rodrigues CMC, Chan H, Vipond C, Jolley K, Harrison OB, Wheeler J, Whiting G, Feavers IM, Maiden MCJ. Typing complex meningococcal vaccines to understand diversity and population structure of key vaccine antigens. Wellcome Open Res 2019; 3:151. [PMID: 30687793 PMCID: PMC6338130 DOI: 10.12688/wellcomeopenres.14859.2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/07/2019] [Indexed: 01/09/2023] Open
Abstract
Background: Protein-conjugate capsular polysaccharide vaccines can potentially control invasive meningococcal disease (IMD) caused by five (A, C, W, X, Y) of the six IMD-associated serogroups. Concerns raised by immunological similarity of the serogroup B capsule to human neural cell carbohydrates, meant that ‘serogroup B substitute’ vaccines target more variable subcapsular protein antigens. A successful approach using outer membrane vesicles (OMVs) as major vaccine components had limited strain coverage. In 4CMenB (Bexsero
®), recombinant proteins have been added to ameliorate this problem. Methods: Scalable, portable, genomic techniques were used to investigate the Bexsero
® OMV protein diversity in meningococcal populations. Shotgun proteomics identified 461 proteins in the OMV, defining a complex proteome. Amino acid sequences for the 24 proteins most likely to be involved in cross-protective immune responses were catalogued within the
PubMLST.org/neisseria database using a novel OMV peptide Typing (OMVT) scheme. Results: Among these proteins there was variation in the extent of diversity and association with meningococcal lineages, identified as clonal complexes (ccs), ranging from the most conserved peptides (FbpA, NEISp0578, and putative periplasmic protein, NEISp1063) to the most diverse (TbpA, NEISp1690). There were 1752 unique OMVTs identified amongst 2492/3506 isolates examined by whole-genome sequencing (WGS). These OMVTs were grouped into clusters (sharing ≥18 identical OMVT peptides), with 45.3% of isolates assigned to one of 27 OMVT clusters. OMVTs and OMVT clusters were strongly associated with cc, genogroup, and Bexsero
® antigen variants, demonstrating that combinations of OMV proteins exist in discrete, non-overlapping combinations associated with genogroup and Bexsero
® Antigen Sequence Type. This highly structured population of IMD-associated meningococci is consistent with strain structure models invoking host immune and/or metabolic selection. Conclusions:The OMVT scheme facilitates region-specific WGS investigation of meningococcal diversity and is an open-access, portable tool with applications for vaccine development, especially in the choice of antigen combinations, assessment and implementation.
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Affiliation(s)
| | - Hannah Chan
- Division of Bacteriology, National Institute for Biological Standards and Control, Potters Bar, EN6 3QG, UK
| | - Caroline Vipond
- Division of Bacteriology, National Institute for Biological Standards and Control, Potters Bar, EN6 3QG, UK
| | - Keith Jolley
- Department of Zoology, University of Oxford, Oxford, OX1 3SY, UK
| | - Odile B Harrison
- Department of Zoology, University of Oxford, Oxford, OX1 3SY, UK
| | - Jun Wheeler
- Division of Bacteriology, National Institute for Biological Standards and Control, Potters Bar, EN6 3QG, UK
| | - Gail Whiting
- Division of Bacteriology, National Institute for Biological Standards and Control, Potters Bar, EN6 3QG, UK
| | - Ian M Feavers
- Division of Bacteriology, National Institute for Biological Standards and Control, Potters Bar, EN6 3QG, UK
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38
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Rodrigues CMC, Lucidarme J, Borrow R, Smith A, Cameron JC, Moxon ER, Maiden MCJ. Genomic Surveillance of 4CMenB Vaccine Antigenic Variants among Disease-Causing Neisseria meningitidis Isolates, United Kingdom, 2010-2016. Emerg Infect Dis 2019; 24:673-682. [PMID: 29553330 PMCID: PMC5875271 DOI: 10.3201/eid2404.171480] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
In September 2015, 4CMenB meningococcal vaccine was introduced into the United Kingdom infant immunization program without phase 3 trial information. Understanding the effect of this program requires enhanced surveillance of invasive meningococcal disease (IMD) Neisseria meningitidis isolates and comparison with prevaccination isolates. Bexsero Antigen Sequence Types (BASTs) were used to analyze whole-genome sequences of 3,073 prevaccine IMD N. meningitidis isolates obtained during 2010−2016. Isolates exhibited 803 BASTs among 31 clonal complexes. Frequencies of antigen peptide variants were factor H binding protein 1, 13.4%; Neisserial heparin-binding antigen 2, 13.8%; Neisseria adhesin A 8, 0.8%; and Porin A-VR2:P1.4,10.9%. In 2015−16, serogroup B isolates showed the highest proportion (35.7%) of exact matches to >1 Bexsero components. Serogroup W isolates showed the highest proportion (93.9%) of putatively cross-reactive variants of Bexsero antigens. Results highlighted the likely role of cross-reactive antigens. BAST surveillance of meningococcal whole-genome sequence data is rapid, scalable, and portable and enables international comparisons of isolates.
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39
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Muzzi A, Brozzi A, Serino L, Bodini M, Abad R, Caugant D, Comanducci M, Lemos AP, Gorla MC, Křížová P, Mikula C, Mulhall R, Nissen M, Nohynek H, Simões MJ, Skoczyńska A, Stefanelli P, Taha MK, Toropainen M, Tzanakaki G, Vadivelu-Pechai K, Watson P, Vazquez JA, Rajam G, Rappuoli R, Borrow R, Medini D. Genetic Meningococcal Antigen Typing System (gMATS): A genotyping tool that predicts 4CMenB strain coverage worldwide. Vaccine 2019; 37:991-1000. [PMID: 30661831 DOI: 10.1016/j.vaccine.2018.12.061] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 12/17/2018] [Accepted: 12/20/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND The Meningococcal Antigen Typing System (MATS) was developed to identify meningococcus group B strains with a high likelihood of being covered by the 4CMenB vaccine, but is limited by the requirement for viable isolates from culture-confirmed cases. We examined if antigen genotyping could complement MATS in predicting strain coverage by the 4CMenB vaccine. METHODS From a panel of 3912 MATS-typed invasive meningococcal disease isolates collected in England and Wales in 2007-2008, 2014-2015 and 2015-2016, and in 16 other countries in 2000-2015, 3481 isolates were also characterized by antigen genotyping. Individual associations between antigen genotypes and MATS coverage for each 4CMenB component were used to define a genetic MATS (gMATS). gMATS estimates were compared with England and Wales human complement serum bactericidal assay (hSBA) data and vaccine effectiveness (VE) data from England. RESULTS Overall, 81% of the strain panel had genetically predictable MATS coverage, with 92% accuracy and highly concordant results across national panels (Lin's accuracy coefficient, 0.98; root-mean-square deviation, 6%). England and Wales strain coverage estimates were 72-73% by genotyping (66-73% by MATS), underestimating hSBA values after four vaccine doses (88%) and VE after two doses (83%). The gMATS predicted strain coverage in other countries was 58-88%. CONCLUSIONS gMATS can replace MATS in predicting 4CMenB strain coverage in four out of five cases, without requiring a cultivable isolate, and is open to further improvement. Both methods underestimated VE in England. Strain coverage predictions in other countries matched or exceeded England and Wales estimates.
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Affiliation(s)
| | | | | | | | - Raquel Abad
- National Centre for Microbiology, Institute of Health Carlos III, Madrid, Spain.
| | | | | | | | | | - Pavla Křížová
- National Institute of Public Health, Prague, Czech Republic.
| | - Claudia Mikula
- Austrian Agency for Health and Food Safety, Institute for Medical Microbiology and Hygiene, Graz, Austria.
| | - Robert Mulhall
- Irish Meningitis and Sepsis Reference Laboratory (IMSRL), Dublin, Ireland.
| | - Michael Nissen
- Queensland Paediatric Infectious Diseases Laboratory, Children's Health Research Centre, University of Queensland, Lady Cilento Children's Hospital South Brisbane, Queensland, Australia.
| | - Hanna Nohynek
- National Institute for Health and Welfare (THL), Helsinki, Finland.
| | | | | | - Paola Stefanelli
- Department of Infectious Parasitic and Immune-mediated Diseases, Istituto Superiore di Sanità, Rome, Italy.
| | | | - Maija Toropainen
- National Institute for Health and Welfare (THL), Helsinki, Finland.
| | - Georgina Tzanakaki
- National Meningitis Reference Laboratory, National School of Public Health, Athens, Greece.
| | | | | | - Julio A Vazquez
- National Centre for Microbiology, Institute of Health Carlos III, Madrid, Spain.
| | | | | | - Ray Borrow
- Meningococcal Reference Unit, Public Health England, Manchester Royal Infirmary, Manchester, UK.
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Maiden MCJ. The Impact of Nucleotide Sequence Analysis on Meningococcal Vaccine Development and Assessment. Front Immunol 2019; 9:3151. [PMID: 30697213 PMCID: PMC6340965 DOI: 10.3389/fimmu.2018.03151] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Accepted: 12/20/2018] [Indexed: 12/21/2022] Open
Abstract
Since it became available as a routine tool in biology, the determination and analysis of nucleotide sequences has been applied to the design of vaccines and the investigation of their effectiveness. As vaccination is primarily concerned with the interaction of biological molecules with the immune system, the utility of sequence data is not immediately obvious and, indeed, nucleotide sequence data are most effective when used to complement more conventional immunological approaches. Here, the impact of sequencing on the field of vaccinology will be illustrated with reference to the development and implementation of vaccines against Neisseria meningitidis (the meningococcus) over the 30-year period from the late-1980s to the late-2010s. Nucleotide sequence-based studies have been important in the fight against this aggressive pathogen largely because of its high genetic and antigenic diversity, properties that were only fully appreciated because of sequence-based studies. Five aspects will be considered, the use of sequence data to: (i) discover vaccine antigens; (ii) assess the diversity and distribution of vaccine antigens; (iii) determine the evolutionary and population biology of the organism and their implications for immunization; and (iv) develop molecular approaches to investigate pre- and post-vaccine pathogen populations to assess vaccine impact. One of the great advantages of nucleotide sequence data has been its scalability, which has meant that increasingly large data sets have been available, which has proved invaluable in the investigation of an organism as diverse and enigmatic as the meningococcus.
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Kesanopoulos K, Bratcher HB, Hong E, Xirogianni A, Papandreou A, Taha MK, Maiden MCJ, Tzanakaki G. Characterization of meningococcal carriage isolates from Greece by whole genome sequencing: Implications for 4CMenB vaccine implementation. PLoS One 2018; 13:e0209919. [PMID: 30592763 PMCID: PMC6310245 DOI: 10.1371/journal.pone.0209919] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Accepted: 12/13/2018] [Indexed: 12/21/2022] Open
Abstract
Herd protection, resulting from the interruption of transmission and asymptomatic carriage, is an important element of the effectiveness of vaccines against the meningococcus. Whilst this has been well established for conjugate polysaccharide vaccines directed against the meningococcal capsule, two uncertainties surround the potential herd protection provided by the novel protein-based vaccines that are used in place of serogroup B (MenB) polysaccharide vaccines (i) the strain coverage of such vaccines against carried meningococci, which are highly diverse; and (ii) the generation of a protective immune response in the mucosa. These considerations are essential for realistic estimates of cost-effectiveness of new MenB vaccines. Here the first of these questions is addressed by the whole genome sequence (WGS) analysis of meningococci isolated from healthy military recruits and university students in Greece. The study included a total of 71 MenB isolates obtained from 1420 oropharyngeal single swab samples collected from military recruits and university students on voluntary basis, aged 18-26 years. In addition to WGS analysis to identify genetic lineage and vaccine antigen genes, including the Bexsero Antigen Sequence Type (BAST), the isolates were examined with the serological Meningococcal antigen Typing System (MATS) assay. Comparison of these data demonstrated that the carried meningococcal population was highly diverse with 38% of the carriage isolates showed expression of antigens matching those included in the 4CMenB vaccine. Our data may suggest a limited potential herd immunity to be expected and be driven by an impact on a subset of carriage isolates.
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Affiliation(s)
- Konstantinos Kesanopoulos
- National Meningitis Reference Laboratory (NMRL), Dept of Public Health, National School of Public Health, Athens, Greece
| | - Holly B. Bratcher
- Department of Zoology, Peter Medawar Building, University of Oxford, Oxford, United Kingdom
| | - Eva Hong
- Institute Pasteur, Invasive Bacterial Infections Unit, Paris, France
| | - Athanasia Xirogianni
- National Meningitis Reference Laboratory (NMRL), Dept of Public Health, National School of Public Health, Athens, Greece
| | - Anastasia Papandreou
- National Meningitis Reference Laboratory (NMRL), Dept of Public Health, National School of Public Health, Athens, Greece
| | | | - Martin C. J. Maiden
- Department of Zoology, Peter Medawar Building, University of Oxford, Oxford, United Kingdom
| | - Georgina Tzanakaki
- National Meningitis Reference Laboratory (NMRL), Dept of Public Health, National School of Public Health, Athens, Greece
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Jolley KA, Bray JE, Maiden MCJ. Open-access bacterial population genomics: BIGSdb software, the PubMLST.org website and their applications. Wellcome Open Res 2018; 3:124. [PMID: 30345391 PMCID: PMC6192448 DOI: 10.12688/wellcomeopenres.14826.1] [Citation(s) in RCA: 1551] [Impact Index Per Article: 258.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/18/2018] [Indexed: 12/29/2022] Open
Abstract
The
PubMLST.org website hosts a collection of open-access, curated databases that integrate population sequence data with provenance and phenotype information for over 100 different microbial species and genera. Although the PubMLST website was conceived as part of the development of the first multi-locus sequence typing (MLST) scheme in 1998 the software it uses, the Bacterial Isolate Genome Sequence database (BIGSdb, published in 2010), enables PubMLST to include all levels of sequence data, from single gene sequences up to and including complete, finished genomes. Here we describe developments in the BIGSdb software made from publication to June 2018 and show how the platform realises microbial population genomics for a wide range of applications. The system is based on the gene-by-gene analysis of microbial genomes, with each deposited sequence annotated and curated to identify the genes present and systematically catalogue their variation. Originally intended as a means of characterising isolates with typing schemes, the synthesis of sequences and records of genetic variation with provenance and phenotype data permits highly scalable (whole genome sequence data for tens of thousands of isolates) means of addressing a wide range of functional questions, including: the prediction of antimicrobial resistance; likely cross-reactivity with vaccine antigens; and the functional activities of different variants that lead to key phenotypes. There are no limitations to the number of sequences, genetic loci, allelic variants or schemes (combinations of loci) that can be included, enabling each database to represent an expanding catalogue of the genetic variation of the population in question. In addition to providing web-accessible analyses and links to third-party analysis and visualisation tools, the BIGSdb software includes a RESTful application programming interface (API) that enables access to all the underlying data for third-party applications and data analysis pipelines.
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Affiliation(s)
- Keith A Jolley
- Department of Zoology, University of Oxford, Oxford, OX1 3PS, UK
| | - James E Bray
- Department of Zoology, University of Oxford, Oxford, OX1 3PS, UK
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Honskus M, Okonji Z, Musilek M, Kozakova J, Krizova P. Whole genome sequencing of Neisseria meningitidis W isolates from the Czech Republic recovered in 1984-2017. PLoS One 2018; 13:e0199652. [PMID: 30212468 PMCID: PMC6136696 DOI: 10.1371/journal.pone.0199652] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2018] [Accepted: 08/23/2018] [Indexed: 11/18/2022] Open
Abstract
Introduction The study presents the analysis of whole genome sequence (WGS) data for Neisseria meningitidis serogroup W isolates recovered in the Czech Republic in 1984–2017 and their comparison with WGS data from other countries. Material and methods Thirty-one Czech N. meningitidis W isolates, 22 from invasive meningococcal disease (IMD) and nine from healthy carriers were analysed. The 33-year study period was divided into three periods: 1984–1999, 2000–2009, and 2010–2017. Results Most study isolates from IMD and healthy carriers were assigned to clonal complex cc22 (n = 10) in all study periods. The second leading clonal complex was cc865 (n = 8) presented by IMD (n = 7) and carriage (n = 1) isolates that emerged in the last study period, 2010–2017. The third clonal complex was cc11 (n = 4) including IMD isolates from the first (1984–1999) and third (2010–2017) study periods. The following clonal complex was cc174 (n = 3) presented by IMD isolates from the first two study periods, i.e. 1984–1999 and 2000–2009. One isolate of each cc41/44 and cc1136 originated from healthy carriers from the second study period, 2000–2009. The comparison of WGS data for N. meningitidis W isolates recovered in the Czech Republic in the study period 1984–2017 and for isolates from other countries recovered in the same period showed that clonal complex cc865, ST-3342 is unique to the Czech Republic since 2010. Moreover, the comparison shows that cc11 in the Czech Republic does not comprise novel hypervirulent lineages reported from both European and non-European countries. All 31 study isolates were assigned to Bexsero® Antigen Sequence Types (BAST), and seven of them were of newly described BASTs. Conclusions WGS analysis contributed considerably to a more detailed molecular characterization of N. meningitidis W isolates recovered in the Czech Republic over a 33-year period and allowed for a spatial and temporal comparison of these characteristics between isolates from the Czech Republic and other countries. The most interesting finding of this study is that eight of 31 Czech isolates of N. meningitidis W belong to clonal complex cc865, which is uncommon for serogroup W. In addition, the WGS data precised the base for the update of the recommendation for vaccination in the Czech Republic.
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Affiliation(s)
- Michal Honskus
- National Reference Laboratory for Meningococcal Infections, Centre for Epidemiology and Microbiology, National Institute of Public Health, Prague, Czech Republic
| | - Zuzana Okonji
- National Reference Laboratory for Meningococcal Infections, Centre for Epidemiology and Microbiology, National Institute of Public Health, Prague, Czech Republic
| | - Martin Musilek
- National Reference Laboratory for Meningococcal Infections, Centre for Epidemiology and Microbiology, National Institute of Public Health, Prague, Czech Republic
| | - Jana Kozakova
- National Reference Laboratory for Meningococcal Infections, Centre for Epidemiology and Microbiology, National Institute of Public Health, Prague, Czech Republic
| | - Pavla Krizova
- National Reference Laboratory for Meningococcal Infections, Centre for Epidemiology and Microbiology, National Institute of Public Health, Prague, Czech Republic
- * E-mail:
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Stein-Zamir C, Shoob H, Abramson N, Block C, Keller N, Jaffe J, Valinsky L. Invasive meningococcal disease epidemiology and characterization of Neisseria meningitidis serogroups, sequence types, and clones; implication for use of meningococcal vaccines. Hum Vaccin Immunother 2018; 15:242-248. [PMID: 30156954 DOI: 10.1080/21645515.2018.1507261] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND AND AIMS Neisseria meningitidis (N. meningitidis) is a Gram-negative bacterium that can cause life-threatening invasive infections referred to as invasive meningococcal disease (IMD). In the last decade the incidence of IMD in Israel is about 1/100,000 population annually. We aimed to describe the epidemiology of IMD in Israel combining epidemiological data and characterization of N. meningitidis isolates. METHODS Invasive infection caused by N. meningitidis is a notifiable disease in Israel. Data were collected by epidemiological investigations and control measures were employed. Laboratory work-up included serogrouping, N. meningitides molecular characterization and whole-genome sequencing. RESULTS During 1998-2017, 1349 cases of IMD were notified in Israel (mean annual incidence rate 0.94/100,000). The peak incidence rates were observed in infants under 1 year of age (10.9/100,000). Case fatality rate was 9.7%. The majority of the N. meningitidis isolates were of serogroup B (67.9%). During 2007-2017, three clonal complexes (CC) 32, 41/44 and 23 (hyper-invasive clonal complexes) were the leading CC (61%). CC32 was the leading CC causing meningococcemia and mortality. In 2017, 35 isolates were tested for 4CMenB antigens variants; of the serogroup B isolates tested 46.7% showed a match to one or more antigens (fHbp or PorA:VR1), most were ST32 (CC32). CONCLUSIONS Preliminary analysis based on limited number of samples suggests that the 4CMenB coverage would be about half the strains; further research is necessary. Integration of clinical, epidemiological and laboratory data is essential to support decision-making on the introduction of the novel MENB vaccines in Israel.
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Affiliation(s)
- Chen Stein-Zamir
- a Ministry of Health , Jerusalem District Health Office , Jerusalem , Israel.,b The Hebrew University of Jerusalem, Faculty of Medicine , The Hebrew University and Hadassah Braun School of Public and Community Medicine , Jerusalem , Israel
| | - Hanna Shoob
- a Ministry of Health , Jerusalem District Health Office , Jerusalem , Israel
| | - Nitza Abramson
- a Ministry of Health , Jerusalem District Health Office , Jerusalem , Israel
| | - Colin Block
- c Department of Clinical Microbiology and Infectious Diseases , Hadassah-Hebrew University Medical Centre , Jerusalem , Israel
| | - Natan Keller
- d Ministry of Health , National Reference Center for Meningococci, Microbiology Laboratory, Sheba Medical Center , Ramat-Gan , Israel
| | - Joseph Jaffe
- e Ministry of Health , Government Central Laboratories , Jerusalem , Israel
| | - Lea Valinsky
- e Ministry of Health , Government Central Laboratories , Jerusalem , Israel
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Potential Coverage of the 4CMenB Vaccine against Invasive Serogroup B Neisseria meningitidis Isolated from 2009 to 2013 in the Republic of Ireland. mSphere 2018; 3:3/4/e00196-18. [PMID: 30135218 PMCID: PMC6106058 DOI: 10.1128/msphere.00196-18] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
The meningococcal antigen typing system (MATS) is an enzyme-linked immunosorbent assay (ELISA) that measures both the levels of expression and the immune reactivity of the three recombinant 4CMenB antigens. Together with PorA variable-region sequence data, this system provides an estimation of how susceptible MenB isolates are to killing by 4CMenB vaccine-induced antibodies. Assays based on subcapsular antigen phenotype analyses, such as MATS, are important in situations where conventional vaccine coverage estimations are not possible. Subcapsular antigens are typically highly diverse across strains, and vaccine coverage estimations would require unfeasibly large efficacy trials and screening of an exhaustive strain panel for antibody functional activity. Here, MATS was applied to all invasive meningococcal serogroup B (MenB) strains isolated over four consecutive epidemiological years (n = 105) and predicted reasonably high 4CMenB vaccine coverage in the Republic of Ireland. Neisseria meningitidis is a common cause of bacterial meningitis in children and young adults worldwide. The 4CMenB vaccine (Bexsero), developed to combat meningococcal serogroup B (MenB) disease, contains subcapsular antigens that may induce immunity against strains of N. meningitidis, regardless of serogroup. Owing to differential levels of expression and peptide diversity in vaccine antigens across meningococcal strains, the meningococcal antigen typing system (MATS) was developed to estimate the potential MenB strain coverage of 4CMenB. Prior to introducing the 4CMenB vaccine into routine use, we sought to estimate the potential 4CMenB coverage against invasive MenB strains isolated in the Republic of Ireland (RoI) over four consecutive epidemiological years. MATS was applied to a panel of 105 invasive MenB strains isolated during July 2009 to June 2013. Sequence data characterizing the multilocus sequence typing (MLST) alleles and the major 4CMenB target peptides were extracted from isolate genome sequence data, hosted in the Bacterial Isolate Sequencing database (BIGSdb). MATS data indicated that 4CMenB may induce protective immunity against 69.5% (95% confidence interval [CI95%], 64.8% to 84.8%) of circulating MenB strains. Estimated coverage was highest against the most prevalent disease-causing lineage, cc41/44, where the most frequently observed sequence types, ST-154 and ST-41 (21% of isolates, collectively), were typically covered by three antigens. No significant temporal trends were observed. Overall, these data provide a baseline of strain coverage prior to the introduction of 4CMenB and indicate that a decrease in invasive meningococcal disease (IMD) is predicted following the introduction of 4CMenB into the routine infant immunization schedule in the RoI. IMPORTANCE The meningococcal antigen typing system (MATS) is an enzyme-linked immunosorbent assay (ELISA) that measures both the levels of expression and the immune reactivity of the three recombinant 4CMenB antigens. Together with PorA variable-region sequence data, this system provides an estimation of how susceptible MenB isolates are to killing by 4CMenB vaccine-induced antibodies. Assays based on subcapsular antigen phenotype analyses, such as MATS, are important in situations where conventional vaccine coverage estimations are not possible. Subcapsular antigens are typically highly diverse across strains, and vaccine coverage estimations would require unfeasibly large efficacy trials and screening of an exhaustive strain panel for antibody functional activity. Here, MATS was applied to all invasive meningococcal serogroup B (MenB) strains isolated over four consecutive epidemiological years (n = 105) and predicted reasonably high 4CMenB vaccine coverage in the Republic of Ireland.
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Invasive meningococcal disease in Shanghai, China from 1950 to 2016: implications for serogroup B vaccine implementation. Sci Rep 2018; 8:12334. [PMID: 30120257 PMCID: PMC6098053 DOI: 10.1038/s41598-018-30048-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Accepted: 07/23/2018] [Indexed: 11/24/2022] Open
Abstract
Serogroup B invasive meningococcal disease (IMD) is increasing in China, but little is known about the causative meningococci. Here, IMD and carriage isolates in Shanghai characterised and the applicability of different vaccines assessed. Seven IMD epidemic periods have been observed in Shanghai since 1950, with 460 isolates collected including 169 from IMD and 291 from carriage. Analyses were divided according to the period of meningococcal polysaccharide vaccine (MPV) introduction: (i) pre-MPV-A, 1965–1980; (ii) post-MPV-A, 1981–2008; and (iii) post-MPV-A + C, 2009–2016. Over this period, IMD incidence decreased from 55.4/100,000 to 0.71 then to 0.02, corresponding to successive changes in meningococcal type from serogroup A ST-5 complex (MenA:cc5) to MenC:cc4821, and finally MenB:cc4821. MenB IMD became predominant (63.2%) in the post-MPV-A + C period, and 50% of cases were caused by cc4821, with the highest incidence in infants (0.45/100,000) and a case-fatality rate of 9.5%. IMD was positively correlated with population carriage rates. Using the Bexsero Antigen Sequence Type (BAST) system, fewer than 25% of MenB isolates in the post-MPV-A + C period contained exact or predicted cross reactive matches to the vaccines Bexsero, Trumenba, or an outer membrane vesicle (OMV)-based vaccine, NonaMen. A unique IMD epidemiology was seen in China, changing periodically from epidemic to hyperepidemic and low-level endemic disease. At the time of writing, MenB IMD dominated IMD in Shanghai, with isolates potentially beyond coverage with licenced OMV- and protein-based MenB vaccines.
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Harrison OB, Schoen C, Retchless AC, Wang X, Jolley KA, Bray JE, Maiden MCJ. Neisseria genomics: current status and future perspectives. Pathog Dis 2018; 75:3861976. [PMID: 28591853 PMCID: PMC5827584 DOI: 10.1093/femspd/ftx060] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Accepted: 06/05/2017] [Indexed: 12/17/2022] Open
Abstract
High-throughput whole genome sequencing has unlocked a multitude of possibilities enabling members of the Neisseria genus to be examined with unprecedented detail, including the human pathogens Neisseria meningitidis and Neisseria gonorrhoeae. To maximise the potential benefit of this for public health, it is becoming increasingly important to ensure that this plethora of data are adequately stored, disseminated and made readily accessible. Investigations facilitating cross-species comparisons as well as the analysis of global datasets will allow differences among and within species and across geographic locations and different times to be identified, improving our understanding of the distinct phenotypes observed. Recent advances in high-throughput platforms that measure the transcriptome, proteome and/or epigenome are also becoming increasingly employed to explore the complexities of Neisseria biology. An integrated approach to the analysis of these is essential to fully understand the impact these may have in the Neisseria genus. This article reviews the current status of some of the tools available for next generation sequence analysis at the dawn of the ‘post-genomic’ era.
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Affiliation(s)
| | - Christoph Schoen
- Institute for Hygiene and Microbiology, University of Würzburg, Würzburg 97080, Germany
| | - Adam C Retchless
- Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Xin Wang
- Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Keith A Jolley
- Department of Zoology, University of Oxford, Oxford OX1 3SY, UK
| | - James E Bray
- Department of Zoology, University of Oxford, Oxford OX1 3SY, UK
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Rodrigues CMC, Maiden MCJ. A world without bacterial meningitis: how genomic epidemiology can inform vaccination strategy. F1000Res 2018; 7:401. [PMID: 29636909 PMCID: PMC5871810 DOI: 10.12688/f1000research.13793.1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/21/2018] [Indexed: 11/20/2022] Open
Abstract
Bacterial meningitis remains an important cause of global morbidity and mortality. Although effective vaccinations exist and are being increasingly used worldwide, bacterial diversity threatens their impact and the ultimate goal of eliminating the disease. Through genomic epidemiology, we can appreciate bacterial population structure and its consequences for transmission dynamics, virulence, antimicrobial resistance, and development of new vaccines. Here, we review what we have learned through genomic epidemiological studies, following the rapid implementation of whole genome sequencing that can help to optimise preventative strategies for bacterial meningitis.
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Affiliation(s)
- Charlene M C Rodrigues
- Department of Zoology, University of Oxford, Peter Medawar Building for Pathogen Research, Oxford, UK
| | - Martin C J Maiden
- Department of Zoology, University of Oxford, Peter Medawar Building for Pathogen Research, Oxford, UK
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Andreae CA, Sessions RB, Virji M, Hill DJ. Bioinformatic analysis of meningococcal Msf and Opc to inform vaccine antigen design. PLoS One 2018; 13:e0193940. [PMID: 29547646 PMCID: PMC5856348 DOI: 10.1371/journal.pone.0193940] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Accepted: 02/21/2018] [Indexed: 11/19/2022] Open
Abstract
Neisseria meningitidis is an antigenically and genetically variable Gram-negative bacterium and a causative agent of meningococcal meningitis and septicaemia. Meningococci encode many outer membrane proteins, including Opa, Opc, Msf, fHbp and NadA, identified as being involved in colonisation of the host and evasion of the immune response. Although vaccines are available for the prevention of some types of meningococcal disease, none currently offer universal protection. We have used sequences within the Neisseria PubMLST database to determine the variability of msf and opc in 6,500 isolates. In-silico analysis revealed that although opc is highly conserved, it is not present in all isolates, with most isolates in clonal complex ST-11 lacking a functional opc. In comparison, msf is found in all meningococcal isolates, and displays diversity in the N-terminal domain. We identified 20 distinct Msf sequence variants (Msf SV), associated with differences in number of residues within the putative Vn binding motifs. Moreover, we showed distinct correlations with certain Msf SVs and isolates associated with either hyperinvasive lineages or those clonal complexes associated with a carriage state. We have demonstrated differences in Vn binding between three Msf SVs and generated a cross reactive Msf polyclonal antibody. Our study has highlighted the importance of using large datasets to inform vaccine development and provide further information on the antigenic diversity exhibited by N. meningitidis.
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Affiliation(s)
- Clio A. Andreae
- School of Cellular and Molecular Medicine, University of Bristol, Bristol, United Kingdom
| | | | - Mumtaz Virji
- School of Cellular and Molecular Medicine, University of Bristol, Bristol, United Kingdom
| | - Darryl. J. Hill
- School of Cellular and Molecular Medicine, University of Bristol, Bristol, United Kingdom
- * E-mail:
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O'Lorcain P, Bennett D, Morgan S, Cunney R, Cotter S, Cafferkey M, O'Flanagan D. A retrospective assessment of the completeness and timeliness of meningococcal disease notifications in the Republic of Ireland over a 16-year period, 1999–2015. Public Health 2018; 156:44-51. [DOI: 10.1016/j.puhe.2017.11.027] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Revised: 11/06/2017] [Accepted: 11/25/2017] [Indexed: 11/29/2022]
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