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Coronell-Rodriguez W, Caceres DC, Cintra O, Guzman-Holst A. Epidemiology of Invasive Meningococcal Disease in Colombia: A Retrospective Surveillance Database Analysis. Infect Dis Ther 2023; 12:2709-2724. [PMID: 37966702 PMCID: PMC10746648 DOI: 10.1007/s40121-023-00886-y] [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: 08/19/2023] [Accepted: 10/19/2023] [Indexed: 11/16/2023] Open
Abstract
INTRODUCTION Invasive meningococcal disease (IMD), caused by Neisseria meningitidis, is associated with high morbidity and mortality. The aim of the current study was to describe the historical and recent epidemiology of IMD in Colombia. METHODS This retrospective surveillance database analysis examined all available data on IMD in Colombia. Data were extracted from publicly available disease event reports and laboratory surveillance reports or obtained directly from hospitals in Cartagena. RESULTS During 2015-2021, the overall incidence of IMD was 0.04-0.18 per 100,000 based on laboratory surveillance reports. IMD incidence was highest among infants aged < 1 year (0.52-1.47 per 100,000), as was IMD mortality (0.00-0.65 per 100,000). Serogroup B was the dominant serogroup responsible for IMD in Colombia during 1988-2014, but, since 2015, serogroup C has been dominant in all age groups, followed by serogroups B and Y. During 2010-2021 combined, the majority of IMD cases were reported in Bogotá (31.9%) and Antioquia (21.7%). Of 42 IMD cases in the city of Cartagena, 54.8% occurred in people who lived in the poorest neighborhoods, and these patients had the highest IMD lethality (52.2%) and the shortest median hospitalization duration (3 days). CONCLUSION The overall incidence of IMD in Colombia was low but was highest among infants aged < 1 year. IMD cases tended to be concentrated in the more densely populated areas and in poorer neighborhoods. As the majority of IMD cases in Colombia since 2015 have been serogroup C, followed by B or Y, vaccination to protect against these serogroups could potentially be beneficial and help to achieve the World Health Organization's and Pan American Health Organization's roadmaps to defeat meningitis by 2030.
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Alarcon ZK, Prada D, Gabastou JM, Sanabria O, Duarte C, Moreno J. Population structure of Neisseria meningitidis ST-9493 identified in Colombian isolates. ENFERMEDADES INFECCIOSAS Y MICROBIOLOGIA CLINICA (ENGLISH ED.) 2023; 41:290-293. [PMID: 36681574 DOI: 10.1016/j.eimce.2022.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 01/26/2022] [Indexed: 01/21/2023]
Abstract
INTRODUCTION Neisseria meningitidis is associated with invasive infections causing high mortality rates. The objective of this study was to describe the population structure of Colombian invasive isolates with ST-9493, a potentially emerging clonal group in the country. METHODS The complete genomes of 34 invasive isolates of serogroup B with ST-9493 and its variants at one or two loci were sequenced by Illumina to describe the phenotypic and genotypic characteristics of these isolates. RESULTS The relationship of a clonal group associated with ST-136 CC41/44 was phylogenetically established, identifying two main clades composed of isolates from an outbreak or endemic. The most frequent alleles and peptides included porA 17, porB 44, fHbp 2.24, NHBA 10, and the FetA F5-17 variant. Most of the isolates were susceptible to the antibiotics evaluated. CONCLUSION This study shows that meningococcal isolates with ST-9493 are an autochthonous clonal group with population dynamics and the capacity to cause endemic and epidemic meningococcal disease in Colombia.
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Affiliation(s)
| | - Diego Prada
- Grupo de Microbiología, Instituto Nacional de Salud (INS), Bogotá, Colombia
| | | | - Olga Sanabria
- Grupo de Microbiología, Instituto Nacional de Salud (INS), Bogotá, Colombia
| | - Carolina Duarte
- Grupo de Microbiología, Instituto Nacional de Salud (INS), Bogotá, Colombia
| | - Jaime Moreno
- Grupo de Microbiología, Instituto Nacional de Salud (INS), Bogotá, Colombia.
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Alarcon ZK, Prada D, Gabastou JM, Sanabria O, Duarte C, Moreno J. Population structure of Neisseria meningitidis ST-9493 identified in Colombian isolates. Enferm Infecc Microbiol Clin 2022. [DOI: 10.1016/j.eimc.2022.01.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Whaley MJ, Vuong JT, Topaz N, Chang HY, Thomas JD, Jenkins LT, Hu F, Schmink S, Steward-Clark E, Mathis M, Rodriguez-Rivera LD, Retchless AC, Joseph SJ, Chen A, Acosta AM, McNamara L, Soeters HM, Mbaeyi S, Marjuki H, Wang X. Genomic Insights on Variation Underlying Capsule Expression in Meningococcal Carriage Isolates From University Students, United States, 2015-2016. Front Microbiol 2022; 13:815044. [PMID: 35250931 PMCID: PMC8893959 DOI: 10.3389/fmicb.2022.815044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Accepted: 01/11/2022] [Indexed: 11/16/2022] Open
Abstract
In January and February 2015, Neisseria meningitidis serogroup B (NmB) outbreaks occurred at two universities in the United States, and mass vaccination campaigns using MenB vaccines were initiated as part of a public health response. Meningococcal carriage evaluations were conducted concurrently with vaccination campaigns at these two universities and at a third university, where no NmB outbreak occurred. Meningococcal isolates (N = 1,514) obtained from these evaluations were characterized for capsule biosynthesis by whole-genome sequencing (WGS). Functional capsule polysaccharide synthesis (cps) loci belonging to one of seven capsule genogroups (B, C, E, W, X, Y, and Z) were identified in 122 isolates (8.1%). Approximately half [732 (48.4%)] of isolates could not be genogrouped because of the lack of any serogroup-specific genes. The remaining 660 isolates (43.5%) contained serogroup-specific genes for genogroup B, C, E, W, X, Y, or Z, but had mutations in the cps loci. Identified mutations included frameshift or point mutations resulting in premature stop codons, missing or fragmented genes, or disruptions due to insertion elements. Despite these mutations, 49/660 isolates expressed capsule as observed with slide agglutination, whereas 45/122 isolates with functional cps loci did not express capsule. Neither the variable capsule expression nor the genetic variation in the cps locus was limited to a certain clonal complex, except for capsule null isolates (predominantly clonal complex 198). Most of the meningococcal carriage isolates collected from student populations at three US universities were non-groupable as a result of either being capsule null or containing mutations within the capsule locus. Several mutations inhibiting expression of the genes involved with the synthesis and transport of the capsule may be reversible, allowing the bacteria to switch between an encapsulated and non-encapsulated state. These findings are particularly important as carriage is an important component of the transmission cycle of the pathogen, and understanding the impact of genetic variations on the synthesis of capsule, a meningococcal vaccine target and an important virulence factor, may ultimately inform strategies for control and prevention of disease caused by this pathogen.
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Affiliation(s)
- Melissa J. Whaley
- Meningitis and Vaccine Preventable Diseases Branch, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Coordinating Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Jeni T. Vuong
- Meningitis and Vaccine Preventable Diseases Branch, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Coordinating Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Nadav Topaz
- CDC Foundation Field Employee assigned to the Meningitis and Vaccine Preventable Diseases Branch, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - How-Yi Chang
- IHRC Inc., Contractor to Meningitis and Vaccine Preventable Diseases Branch, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Jennifer Dolan Thomas
- Meningitis and Vaccine Preventable Diseases Branch, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Coordinating Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Laurel T. Jenkins
- IHRC Inc., Contractor to Meningitis and Vaccine Preventable Diseases Branch, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Fang Hu
- IHRC Inc., Contractor to Meningitis and Vaccine Preventable Diseases Branch, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Susanna Schmink
- Meningitis and Vaccine Preventable Diseases Branch, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Coordinating Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Evelene Steward-Clark
- Meningitis and Vaccine Preventable Diseases Branch, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Coordinating Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Marsenia Mathis
- IHRC Inc., Contractor to Meningitis and Vaccine Preventable Diseases Branch, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Lorraine D. Rodriguez-Rivera
- IHRC Inc., Contractor to Meningitis and Vaccine Preventable Diseases Branch, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Adam C. Retchless
- Meningitis and Vaccine Preventable Diseases Branch, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Coordinating Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Sandeep J. Joseph
- IHRC Inc., Contractor to Meningitis and Vaccine Preventable Diseases Branch, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Alexander Chen
- Meningitis and Vaccine Preventable Diseases Branch, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Coordinating Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Anna M. Acosta
- Meningitis and Vaccine Preventable Diseases Branch, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Coordinating Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Lucy McNamara
- Meningitis and Vaccine Preventable Diseases Branch, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Coordinating Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Heidi M. Soeters
- Meningitis and Vaccine Preventable Diseases Branch, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Coordinating Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Sarah Mbaeyi
- Meningitis and Vaccine Preventable Diseases Branch, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Coordinating Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Henju Marjuki
- Meningitis and Vaccine Preventable Diseases Branch, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Coordinating Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Xin Wang
- Meningitis and Vaccine Preventable Diseases Branch, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Coordinating Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
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Lemos APSD, Gorla MCO, de Moraes C, Willemann MC, Sacchi CT, Fukasawa LO, Camargo CH, Barreto G, Rodrigues DS, Gonçalves MG, Higa FT, Salgado MM, de Moraes JC. Emergence of Neisseria meningitidis W South American sublineage strain variant in Brazil: disease and carriage. J Med Microbiol 2022; 71. [PMID: 35144719 DOI: 10.1099/jmm.0.001484] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Introduction. Invasive meningococcal disease is a major health problem, impacting morbidity and mortality worldwide. Exploratory genomics has revealed insights into adaptation, transmissibility and virulence to elucidate endemic, outbreaks or epidemics caused by Neisseria meningitidis serogroup W (MenW) strains.Gap Statement. Limited information on the genomics of Neisseria meningitis serogroup W ST11/cc11 is available from emerging countries, especially in contemporary isolates.Aim. To (i) describe the antigenic diversity and distribution of genetic lineages of N. meningitidis serogroup W circulating in Brazil; (ii) study the carriage prevalence of hypervirulent clones in adolescents students and (iii) analyse the potential risk factors for meningococcal carriage.Methodology. Using whole-genome sequencing, we analysed the genomic diversity of 92 invasive N. meningitidis serogroup W isolates circulating in Brazil from 2016 to 2019. A cross-sectional survey of meningococcal carriage was conducted in 2019, in the city of Florianópolis, Brazil, among a representative sample of 538 students.Results. A predominance (58.5 %, 41/82) of ST11/cc11 presenting PorB2-144, PorA VR1-5, VR2-2, FetA 1-1, and a novel fHbp peptide 1241 was found on invasive N. meningitidis W isolates, on the other hand, a high diversity of clonal complexes was found among carriage isolates. The overall carriage rate was 7.5 % (40/538). A total of 28 of 538 swab samples collected were culture positive for N. meningitidis, including four serogroup/genogroup B isolates (14.8 %;4/27), 1 serogroup/genogroup Y isolate (3.7 %;1/27), 22 (81.5 %; 22/27) non-groupable isolates. No MenW isolate was identified among carriages isolates.Conclusion. This report describes the emergence of the new MenW ST11/cc11 South America sublineage variant, named here, 2016 strain, carrying a novel fHbp peptide 1241, but its emergence, was not associated with an increased MenW carriage prevalence. Continuous surveillance is necessary to ascertain the role of this sublineage diversification and how its emergence can impact transmission.
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Affiliation(s)
| | | | - Camile de Moraes
- Coordenação Geral de Emergências em Saúde Pública, Brasília, Distrito Federal, Brazil
| | | | | | | | | | - Gisele Barreto
- Vigilância Epidemiológica de Santa Catarina, Santa Catarina, Brazil
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Fahimzad A, Khatmi M, Shiva F, Mortazavi SE, Shirvani F, Gorji FA. Evaluation of pharyngeal carriage of Neisseria meningitidis in tehran, Iran. New Microbes New Infect 2022; 45:100953. [PMID: 35145699 PMCID: PMC8819400 DOI: 10.1016/j.nmni.2022.100953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 12/22/2021] [Indexed: 11/25/2022] Open
Abstract
Meningitis and meningococcal septicemia are potentially life-threatening illnesses; young people in educational institutions have been repeatedly exposed to outbreaks of meningococcal infections. Since invasive meningococcal disease is preceded by pharyngeal carriage of Neisseria meningitidis, ascertaining the prevalence of meningococcal carriage in this population is of utmost importance. The aim of this study was to determine the rate of meningococcal carriage in students of Shahid Beheshti University of Medical Sciences. This cross-sectional study was conducted on pharyngeal swab specimens of 251 healthy asymptomatic students from November 2019 for one year. A questionnaire was used to find correlation between isolation of Neisseria spp. and the place of residence, number of roommates, antibiotic use in the last month, and smoking. One sample from each student was used for culture on general and selective culture media for Neisseria spp. Polymerase chain reaction was used for the final diagnosis of Neisseria meningitidis. Participants in the study included 222 medical students (88.4%), 23 nursing students (9.2%) and 6 radiology students (2.4%). Mean (IQR1) age of students was 23 years, 134 students were female, (53.4%); 234 students were single, (93.2%). 92 students (36.7%) lived in dormitories. Neisseria were isolated from 18 specimens (7.2%), of which 11 (4.4%) were pigmented bacteria. PCR assay did not detect Neisseria meningitidis in any of the samples. This study showed that meningococcal bacteria were not detected in any of the oropharyngeal specimens from students participating in the study during the one-year study period.
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Gentile A, Della Latta MP, Bloch M, Martorelli L, Wisner B, Sorhouet Pereira C, Regueira M, Juarez MDV, Umido V, Efron A. Oropharyngeal meningococcal carriage in children and adolescents, a single center study in Buenos Aires, Argentina. PLoS One 2021; 16:e0247991. [PMID: 33780457 PMCID: PMC8006983 DOI: 10.1371/journal.pone.0247991] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 02/18/2021] [Indexed: 11/18/2022] Open
Abstract
Background Neisseria meningitidis (Nm) pharyngeal carriage is a necessary condition for invasive disease. We present the first carriage study in children in Buenos Aires, Argentina, considering 2017 as a transition year. Aims: to assess the rate of Nm carriage, to determine genogroup, clonal complex and outer membrane protein distribution, to determine carriage risk factors by age. Methods Cross-sectional study including children 1–17 yrs, at Ricardo Gutiérrez Children’s Hospital in Buenos Aires 2017. Oro-pharyngeal swabs were taken and cultured within a short time after collection. Genogroup was determined by PCR and clonal complex by MLST. Categorical variables were analyzed. Results A total of 1,751 children were included. Group 1: 943 children 1–9 yrs, 38 Nm were isolated; overall carriage 4.0%. Genogroup distribution: B 26.3%, W 5.3%, Y 2.6%, Z 5.3%, other groups 7.9% and capsule null (cnl) 52.6%. Participating in extracurricular activities was the only independent predictor of Nm carriage. Group 2: 808 children 10–17 yrs, 76 Nm were isolated; overall carriage 9.4%. Genogroup distribution: B 19.7%, C 5.3%, W 7.9%, Y 9.2%, Z 5.3%, other groups 7.9% and cnl 44.7%. Independent predictors of carriage: attending pubs/night clubs and passive smoking (adjusted OR: 0.55, 95%CI = 0.32–0.93; p = 0.025). Conclusions Overall carriage was higher in 10–17 yrs. The isolates presenting the cnl locus were prevalent in both age groups and genogroup B was the second most frequent.
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Affiliation(s)
- Angela Gentile
- Epidemiology Division, Dr Ricardo Gutiérrez Children’s Hospital, Buenos Aires, Argentina
- * E-mail:
| | | | - Mercedes Bloch
- Epidemiology Division, Dr Ricardo Gutiérrez Children’s Hospital, Buenos Aires, Argentina
| | - Luisina Martorelli
- Clinical Microbiology Service, INEI-ANLIS Dr. Carlos G. Malbrán, Buenos Aires, Argentina
| | - Barbara Wisner
- Clinical Microbiology Service, INEI-ANLIS Dr. Carlos G. Malbrán, Buenos Aires, Argentina
| | | | - Mabel Regueira
- Clinical Microbiology Service, INEI-ANLIS Dr. Carlos G. Malbrán, Buenos Aires, Argentina
| | - Maria del Valle Juarez
- Epidemiology Division, Dr Ricardo Gutiérrez Children’s Hospital, Buenos Aires, Argentina
| | - Veronica Umido
- Epidemiology Division, Dr Ricardo Gutiérrez Children’s Hospital, Buenos Aires, Argentina
| | - Adriana Efron
- Clinical Microbiology Service, INEI-ANLIS Dr. Carlos G. Malbrán, Buenos Aires, Argentina
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Juscamayta-López E, Valdivia F, Morales S, Donaires LF, Fiestas-Solórzano V, Oré M, Pachas P, León-Janampa N, Gavilán R. Emergence of ciprofloxacin-resistant Neisseria meningitidis B from asymptomatic carriers during an outbreak in Peru, 2017. J Med Microbiol 2020; 70. [PMID: 33196407 DOI: 10.1099/jmm.0.001245] [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: 11/18/2022] Open
Abstract
Asymptomatic carriers are a likely source of transmission of Neisseria meningitidis to close contacts who are placed at a higher risk for invasive meningococcal disease (IMD). Although N. meningitidis ciprofloxacin-resistance is rare, there have been an increase in the reports of resistant isolates mainly in patients diagnosed with IMD, and little is known about the N. meningitidis ciprofloxacin-resistance in the carrier populations. We performed a pharyngeal carriage study during a 2017 military setting outbreak in Peru, caused by a ciprofloxacin-resistant N. meningitidis B. The isolates analysed came from two hospitalized cases and six asymptomatic carriers. Whole-genome sequence-based analysis was performed and showed that strains carrying the Thr91Ile mutation, in the gene encoding for subunit A of DNA gyrase (gyrA), were responsible for the fluoroquinolone resistance (MICs ≥0.256 µg ml-1) and were closely related to highly virulent strains from France, Norway and the UK. Phylogenetic analysis of the gyrA gene revealed that likely these Peruvian isolates acquired resistance through horizontal gene transfer from Neisseria lactamica. Our study provides evidence for the emergence and propagation of ciprofloxacin-resistant N. meningitidis B from asymptomatic carriers, and recommends the introduction of serogroup B vaccines for high-risk populations.
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Affiliation(s)
| | - Faviola Valdivia
- Centro Nacional de Salud Pública, Instituto Nacional de Salud, Lima, Peru
| | - Sara Morales
- Centro Nacional de Salud Pública, Instituto Nacional de Salud, Lima, Peru
| | | | | | - Marianela Oré
- Epidemiología, Comando de Salud del Ejército, Lima, Peru
| | - Paul Pachas
- Centro Nacional de Salud Pública, Instituto Nacional de Salud, Lima, Peru
| | - Nancy León-Janampa
- Centro Nacional de Salud Pública, Instituto Nacional de Salud, Lima, Peru
| | - Ronnie Gavilán
- Centro Nacional de Salud Pública, Instituto Nacional de Salud, Lima, Peru
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Abstract
Teenagers are important carriers of Neisseria meningitidis, which is a leading cause of invasive meningococcal disease. In China, the carriage rate and risk factors among teenagers are unclear. The present study presents a retrospective analysis of epidemiological data for N. meningitidis carriage from 2013 to 2017 in Suizhou city, China. The carriage rates were 3.26%, 2.22%, 3.33%, 3.53% and 9.88% for 2013, 2014, 2015, 2016 and 2017, respectively. From 2014 to 2017, the carriage rate in the 15- to 19-year-old age group (teenagers) was the highest and significantly higher than that in remain age groups. Subsequently, a larger scale survey (December 2017) for carriage rate and relative risk factors (population density, time spent in the classroom, gender and antibiotics use) were investigated on the teenagers (15- to 19-year-old age) at the same school. The carriage rate was still high at 33.48% (223/663) and varied greatly from 6.56% to 52.94% in a different class. Population density of the classroom was found to be a significant risk factor for carriage, and 1.4 persons/m2 is recommended as the maximum classroom density. Further, higher male gender ratio and more time spent in the classroom were also significantly associated with higher carriage. Finally, antibiotic use was associated with a significantly lower carriage rate. All the results imply that attention should be paid to the teenagers and various measures can be taken to reduce the N. meningitidis carriage, to prevent and control the outbreak of IMD.
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Moreno J, Alarcon Z, Parra E, Duarte C, Sanabria O, Prada D, Gabastou JM. Molecular characterization of Neisseria meningitidis isolates recovered from patients with invasive meningococcal disease in Colombia from 2013 to 2016. PLoS One 2020; 15:e0234475. [PMID: 32663215 PMCID: PMC7360035 DOI: 10.1371/journal.pone.0234475] [Citation(s) in RCA: 8] [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: 12/06/2019] [Accepted: 05/26/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Neisseria meningitidis is a significant cause of morbidity and mortality worldwide. Meningococcal isolates have a highly dynamic population structure and can be phenotypically and genetically differentiated into serogroups and clonal complexes. The aim of this study was to describe the phenotypic and genotypic characteristics of invasive isolates recovered in Colombia from 2013 to 2016. METHODOLOGY A total of 193 invasive isolates were analyzed. Phenotypic and genotypic characteristics were determined by serotyping, antimicrobial susceptibility testing, pulsed-field gel electrophoresis (PFGE) and whole-genome sequencing. RESULTS Based on the results, meningococcal serogroups C, B and Y were responsible for 47.9%, 41.7%, and 9.4% of cases, respectively, and the distribution of serogroups B and C changed over time. Fifteen clonal groups and 14 clonal complexes (cc) were identified by PFGE and genome sequencing. The main clonal group included serogroup B isolates with sequence type (ST)-9493 and its four single-locus variants, which has only been identified in Colombian isolates. The clonal population structure demonstrates that the isolates in this study mainly belong to four clonal complexes: ST-11 cc, ST-32 cc, ST-35 cc and ST-41/44 cc. Thirty-eight penA alleles were identified, but no correlation between MICs and specific sequences was observed. CONCLUSION This study shows that most meningococcal isolates recovered from patients with invasive meningococcal disease in Colombia are strains associated with distinct globally disseminated hyperinvasive clones.
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Affiliation(s)
- Jaime Moreno
- Grupo de Microbiología, Instituto Nacional de Salud (INS), Bogotá, Colombia
- * E-mail:
| | - Zonia Alarcon
- Grupo de Microbiología, Instituto Nacional de Salud (INS), Bogotá, Colombia
| | - Eliana Parra
- Grupo de Microbiología, Instituto Nacional de Salud (INS), Bogotá, Colombia
| | - Carolina Duarte
- Grupo de Microbiología, Instituto Nacional de Salud (INS), Bogotá, Colombia
| | - Olga Sanabria
- Grupo de Microbiología, Instituto Nacional de Salud (INS), Bogotá, Colombia
| | - Diego Prada
- Grupo de Microbiología, Instituto Nacional de Salud (INS), Bogotá, Colombia
| | - Jean Marc Gabastou
- Panamerican Health Organization/World Health Organization (PAHO/WHO), Washington, DC, United States of America
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Serra L, Presa J, Christensen H, Trotter C. Carriage of Neisseria Meningitidis in Low and Middle Income Countries of the Americas and Asia: A Review of the Literature. Infect Dis Ther 2020; 9:209-240. [PMID: 32242281 PMCID: PMC7237586 DOI: 10.1007/s40121-020-00291-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION Meningococcal colonization, or carriage, can progress to invasive meningococcal disease, a serious public health concern, with rapid progression of disease and severe consequences if left untreated. Information on meningococcal carriage and epidemiology in low/middle income American and Asian countries remains sparse. These data are crucial to ensure that appropriate preventive strategies such as vaccination can be implemented in these regions. The goal of this study was to summarize the Neisseria meningitidis carriage literature in low and middle income countries of the Americas and Asia. METHODS Target countries were categorized as low and middle income according to the International Monetary Fund classification of low income/developing economies and middle income/emerging market economies, respectively. A PubMed search identified English-language publications that examined carriage in these countries. Studies reporting the epidemiology of N. meningitidis carriage or assessing risk factors for carriage were included. RESULTS Fourteen studies from the Americas [Brazil (n = 7), Chile (n = 3), and Colombia, Cuba, Mexico, and Paraguay (n = 1 each)] and nine from Asia [China (n = 2), India (n = 3), and Malaysia, Nepal, Philippines, and Thailand (n = 1 each)] were identified; an additional Cuban study from the authors' files was also included. Studies were not identified in many target countries, and substantial diversity was observed among study methodologies, populations, and time periods, thereby limiting comparison between studies. The carriage rate in the Americas ranged from 1.6% to 9.9% and from 1.4% to 14.2% in Asia. Consistent risk factors for carriage were not identified. CONCLUSIONS There is a lack of comprehensive and contemporary information on meningococcal carriage in low and medium income countries of the Americas and Asia. Future carriage studies should incorporate larger representative populations, a wider age range, and additional countries to improve our understanding of meningococcal epidemiology and disease control.
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Affiliation(s)
- Lidia Serra
- Pfizer Vaccine Medical Development, Scientific and Clinical Affairs, Collegeville, PA, USA.
| | - Jessica Presa
- Pfizer Vaccines, Medical and Scientific Affairs, Collegeville, PA, USA
| | - Hannah Christensen
- Bristol Medical School, Population Health Sciences, University of Bristol, Clifton, UK
| | - Caroline Trotter
- Department of Veterinary Medicine, University of Cambridge, Cambridge, UK
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Ferreira VM, Ferreira ÍE, Chang HY, Nunes AMPB, Topaz N, Pimentel ER, Moura ARSS, Ribeiro GS, Feitosa CA, Reis MG, Wang X, Campos LC. Meningococcal carriage in young adults six years after meningococcal C conjugate (MCC) vaccine catch-up campaign in Salvador, Brazil. Vaccine 2020; 38:2995-3002. [PMID: 32115294 DOI: 10.1016/j.vaccine.2020.02.050] [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: 10/11/2019] [Revised: 02/16/2020] [Accepted: 02/17/2020] [Indexed: 11/29/2022]
Abstract
Meningococcal carriage studies are important to improve the knowledge of disease epidemiology as well as to support appropriate vaccination strategies. We conducted a cross-sectional study to determine the prevalence and genotypic characteristics of meningococci collected from young adults in Salvador, Brazil six years after a meningococcal C conjugate vaccine catch-up campaign. From August through November 2016, oropharyngeal swabs were collected from 407 students aged 1824 years attending a private college in Salvador, Brazil. Neisseria meningitidis was identified by standard microbiology methods and real time PCR. Genetic characteristics of meningococci were assessed by rt-PCR and/or whole genome sequencing. We also investigated potential factors associated with carriage. N. meningitidis was detectable in 50 students, 39 by both culture and rt-PCR, 7 by culture alone and 4 by rt-PCR alone, resulting in an overall meningococcal carriage prevalence of 12.3% (50/407). Carriage was independently associated with male sex (adjusted PR: 1.97; 95% CI: 1.12-3.46; p = 0.018) and attending bars or parties at least once per month (aPR: 3.31; 95% CI: 1.49-7.38; p = 0.003). Molecular tests identified 92% (46/50) N. meningitidis as non-groupable, of which 63% (29/46) had the capsule null genotype; 14 NG isolates contained disrupted capsule backbones and belonged to the following genogroups: 7 B, 3 Z, 3 E and 1 W. One isolate belonged to genogroup C tested only by PCR; 3 isolates contained a complete B capsule backbones, 2 of which were determined to be NG by slide agglutination serogrouping. While most meningococcal carriage isolates were non-groupable, there was a high degree of genetic diversity present in the collection, as evidenced by 25 unique STs being detected. The carriage prevalence of meningococcal serogroup C was low among young adults. Continuous vaccination is important to maintain reduced meningococcal carriage and transmission, inducing herd protection.
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Affiliation(s)
- Viviane Matos Ferreira
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Bahia, Brazil; Escola Bahiana de Medicina e Saúde Pública, Salvador, Bahia, Brazil
| | | | - How-Yi Chang
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Nadav Topaz
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | | | - Guilherme Sousa Ribeiro
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Bahia, Brazil; Faculdade de Medicina, Universidade Federal da Bahia, Salvador, Bahia, Brazil
| | | | - Mitermayer Galvão Reis
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Bahia, Brazil; Faculdade de Medicina, Universidade Federal da Bahia, Salvador, Bahia, Brazil; Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, United States
| | - Xin Wang
- Centers for Disease Control and Prevention, Atlanta, GA, USA
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13
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Epidemiological burden of meningococcal disease in Latin America: A systematic literature review. Int J Infect Dis 2019; 85:37-48. [DOI: 10.1016/j.ijid.2019.05.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 05/01/2019] [Accepted: 05/02/2019] [Indexed: 12/17/2022] Open
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Peterson ME, Li Y, Shanks H, Mile R, Nair H, Kyaw MH. Serogroup-specific meningococcal carriage by age group: a systematic review and meta-analysis. BMJ Open 2019; 9:e024343. [PMID: 31005910 PMCID: PMC6500331 DOI: 10.1136/bmjopen-2018-024343] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 12/03/2018] [Accepted: 02/26/2019] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVE Neisseria meningitidis carriage prevalence has known variation across the lifespan, but it is unclear whether carriage varies among meningococcal capsular groups. Therefore, we aimed to characterise group-specific meningococcal carriage by age group and world region from 2007 to 2016. DESIGN Systematic review and meta-analysis. DATA SOURCES MEDLINE, Embase, Global Health Database, WHO Global Health Library, Web of Science, Current Contents Connects, China National Knowledge Infrastructure and Wanfang were systematically searched. Database searches were conducted through July 2018 and Google Scholar forward searches of included studies were conducted through August 2018. References of included studies and relevant conference abstracts were also searched to identify additional articles for inclusion. ELIGIBILITY CRITERIA Studies were eligible for inclusion if they reported capsular group-specific meningococcal carriage in a healthy population of a specified age group and geographical region. For this review, only studies conducted between 2007 and 2016 were included. DATA EXTRACTION AND SYNTHESIS Data were independently extracted by two authors into Microsoft Access. Studies were assessed for risk of bias using the Joanna Briggs Institute Critical Appraisal Checklist for Studies Reporting Prevalence Data. Studies eligible for inclusion in quantitative analyses by pre-specified age groups were pooled using random effects meta-analyses. Results are reported by capsular group, age group and WHO region. Where meta-analyses were not appropriate, study results were discussed narratively. RESULTS 7511 articles were identified and 65 were eligible for inclusion. Adolescents and young adults were the focus of many studies (n=24), especially in the Americas and Europe. Studies from China and Africa, typically, included data from a wider age range. The overall carriage prevalence varied markedly by age group and region. Based on the available data, 21 studies were included in meta-analyses reporting serogroup carriage for: all ages in Africa, 18-24-year olds in the Americas, and 11-17 and 18-24-year olds in Europe. Capsular groups W, X, Y and 'other' (non-ABCWXY, including non-groupable) were the most prevalent in Africa, and 5-17-year olds had higher carriage prevalence than other age groups. 'Other' serogroups (11.5%, 95% CI 1.6% to 16.1%) were the most common among 18-24-year olds from the Americas. In Europe, 18-24-year old were carriers more frequently than 11-17-year olds, and groups B (5.0%, 95% CI 3.0% to 7.5%), Y (3.9%, 95% CI 1.3% to 7.8%) and 'other' (6.4%, 95% CI 3.1% to 10.8%) were the most commonly carried in the older age group. CONCLUSIONS Of the age groups included in the analysis, carriage patterns by age were similar across capsular groups within a region but differed between regions. Data gaps remain for age- and capsular group-specific carriage in many regions, especially in the Eastern Mediterranean and South-East Asia. As such, clear and robust conclusions about the variation of capsular group-specific carriage by age group and WHO region were unable to be determined. PROSPERO REGISTRATION NUMBER CRD42017074671.
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Affiliation(s)
- Meagan E Peterson
- Centre for Global Health Research, University of Edinburgh School of Molecular Genetic and Population Health Sciences, Edinburgh, UK
| | - You Li
- Centre for Global Health Research, University of Edinburgh School of Molecular Genetic and Population Health Sciences, Edinburgh, UK
| | - Heather Shanks
- Centre for Global Health Research, University of Edinburgh School of Molecular Genetic and Population Health Sciences, Edinburgh, UK
| | - Rebecca Mile
- Centre for Global Health Research, University of Edinburgh School of Molecular Genetic and Population Health Sciences, Edinburgh, UK
| | - Harish Nair
- University of Edinburgh School of Molecular Genetic and Population Health Sciences, Edinburgh, UK
| | - Moe H Kyaw
- Sanofi Pasteur, Inc., Swiftwater, Pennsylvania, USA
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León ME, Kawabata A, Nagai M, Rojas L, Chamorro G. [Genotypes of Neisseria meningitidis isolates in patients with meningococcal meningitis in Paraguay, 1996-2015Genótipos de Neisseria meningitidis isolados de pacientes com doença meningocócica no Paraguai, 1996-2015]. Rev Panam Salud Publica 2019; 43:e10. [PMID: 31093234 PMCID: PMC6393723 DOI: 10.26633/rpsp.2019.10] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Accepted: 07/04/2018] [Indexed: 11/26/2022] Open
Abstract
Objetivo Describir las características fenotípicas y genotípicas de cepas de Neisseria meningitidis aisladas de enfermedad meningocócica en Paraguay entre 1996 y 2015. Métodos Se estudiaron por métodos microbiológicos convencionales y técnicas moleculares 114 aislamientos de N. meningitidis y 12 muestras clínicas sin aislamiento confirmadas por reacción en cadena de la polimerasa (PCR) que fueron remitidas por los diferentes centros centinelas y centros colaboradores de Paraguay. Resultados El grupo de edad más afectado fue el de menores de 1 año (19,0%), seguido por el de 1 a 5 años (17,5%). Un mayor porcentaje de las cepas se aisló de casos de meningitis (81,7%) y el serogrupo B se encontró en 60,3% de los casos. Los fenotipos más frecuentes fueron B:4:P1.14 (16,0%), B:15:P1.5, C:NT:NST y W:NT:P1.2 (10,5%), respectivamente. Los complejos clonales prevalentes fueron ST-11/ET37 complex 29,6% (8/27) con predominio del serogrupo W (6/8), ST-35 complex 18,5% (5/27) en el serogrupo B (4/4), y ST-32/ET5 complex 14,8% (4/16) en el serogrupo B (5/5). Conclusiones En Paraguay la enfermedad meningocócica es relativamente infrecuente. Los análisis de distribución de serogrupo muestran que el más frecuente es el B y en los últimos dos años aumentaron los casos de enfermedad meningocócica por C y W. Los complejos clonales encontrados se correlacionan con los hallados en la región del Cono Sur. Debido al alto nivel de virulencia de N. meningitidis, su vigilancia debe constituir una prioridad estratégica de los sistemas de salud pública nacionales y regionales para prevenir brotes epidémicos y apoyar la toma de decisiones en salud pública.
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Affiliation(s)
- María Eugenia León
- Laboratorio Central de Salud Pública, Ministerio de Salud Pública y Bienestar Social, Asunción, Paraguay
| | - Aníbal Kawabata
- Laboratorio Central de Salud Pública, Ministerio de Salud Pública y Bienestar Social, Asunción, Paraguay
| | - Minako Nagai
- Laboratorio Central de Salud Pública, Ministerio de Salud Pública y Bienestar Social, Asunción, Paraguay
| | - Liliana Rojas
- Laboratorio Central de Salud Pública, Ministerio de Salud Pública y Bienestar Social, Asunción, Paraguay
| | - Gustavo Chamorro
- Laboratorio Central de Salud Pública, Ministerio de Salud Pública y Bienestar Social, Asunción, Paraguay
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16
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Miglietta A, Innocenti F, Pezzotti P, Riccobono E, Moriondo M, Pecile P, Nieddu F, Rossolini GM, Azzari C, Balocchini E, Rezza G, Voller F, Stefanelli P. Carriage rates and risk factors during an outbreak of invasive meningococcal disease due to Neisseria meningitidis serogroup C ST-11 (cc11) in Tuscany, Italy: a cross-sectional study. BMC Infect Dis 2019; 19:29. [PMID: 30621624 PMCID: PMC6323866 DOI: 10.1186/s12879-018-3598-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Accepted: 12/07/2018] [Indexed: 12/17/2022] Open
Abstract
Background During 2015–2016 an outbreak of invasive meningococcal disease due to N. meningitidis serogroup C ST-11 (cc11) occurred in Tuscany, Italy. The outbreak affected mainly the age group 20–30 years, men who have sex with men, and the area located between the cities of Firenze, Prato and Empoli, with discos and gay-venues associated-clusters. A cross-sectional-survey was conducted to assess the prevalence and risk factors for meningococcal-carriage, in order to address public health interventions. Methods A convenience sample of people aged 11–45 years provided oropharyngeal swab specimens and completed questionnaires on risk factors for meningococcal carriage during a 3 months study-period, conducted either in the outbreak-area and in a control-area not affected by the outbreak (cities of Grosseto and Siena). Isolates were tested by culture plus polymerase chain reaction. Serogroup C meningococcal isolates were further characterized using multilocus sequence typing. Univariate and multivariate analyses were performed to estimate adjusted odds ratios (AORs) for meningococcal carriage. Results A total of 2285 oropharyngeal samples were collected. Overall, meningococcal carriage prevalence was 4.8% (n = 110), with nonencapsulated meningococci most prevalent (2.3%; n = 52). Among encapsulated meningococci, serogroup B was the most prevalent (1.8%; n = 41), followed by serogroup Y (0.5%; n = 11) and serogroup C (0.2%; n = 4); one carrier of serogroup E and one of serogroup Z, were also found (0.04%). Three individuals from the city of Empoli were found to carry the outbreak strain, C:ST-11 (cc11); this city also had the highest serogroup C carriage prevalence (0.5%). At the multivariate analyses, risk factors for meningococcal carriage were: illicit-drugs consumption (AOR 6.30; p < 0.01), active smoking (AOR 2.78; p = 0.01), disco/clubs/parties attendance (AOR 2.06; p = 0.04), being aged 20–30 years (AOR 3.08; p < 0.01), and have had same-sex intercourses (AOR 6.69; p < 0.01). Conclusions A low prevalence of meningococcal serogroup C carriage in an area affected by an outbreak due to the hypervirulent N. meningitidis serogroup C ST-11 (cc11) strain was found. The city of Empoli had the highest attack-rate during the outbreak and also the highest meningococcal serogroup C carriage-prevalence due to the outbreak-strain. Multivariate analyses underlined a convergence of risk factors, which partially confirmed those observed among meningococcal outbreak-cases, and that should be considered in targeted immunization campaigns. Electronic supplementary material The online version of this article (10.1186/s12879-018-3598-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Alessandro Miglietta
- Department of Infectious Diseases, Istituto Superiore di Sanità, Viale Regina Elena, 299, 00161, Rome, Italy. .,Regional Health Agency of Tuscany, Epidemiologic Observatory, Via Pietro Dazzi, 1, Flroence, Italy. .,Units of Epidemiology and Preventive Medicine, Central Tuscany Health Authority, Via di San Salvi , 12 - Palazzina 16 -, 50135, Florence, Italy.
| | - Francesco Innocenti
- Regional Health Agency of Tuscany, Epidemiologic Observatory, Via Pietro Dazzi, 1, Flroence, Italy
| | - Patrizio Pezzotti
- Department of Infectious Diseases, Istituto Superiore di Sanità, Viale Regina Elena, 299, 00161, Rome, Italy
| | - Eleonora Riccobono
- Clinical Microbiology and Virology Unit, Careggi University Hospital, Largo Brambilla, 3, 50134, Florence, Italy
| | - Maria Moriondo
- Laboratory of Immunology and Infectious Diseases, Anna Meyer Children's University Hospital, University of Florence, Viale Gaetano Pieraccini, 24, 50139, Florence, Italy
| | - Patrizia Pecile
- Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla, 3, 50134, Florence, Italy
| | - Francesco Nieddu
- Laboratory of Immunology and Infectious Diseases, Anna Meyer Children's University Hospital, University of Florence, Viale Gaetano Pieraccini, 24, 50139, Florence, Italy
| | - Gian Maria Rossolini
- Clinical Microbiology and Virology Unit, Careggi University Hospital, Largo Brambilla, 3, 50134, Florence, Italy.,Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla, 3, 50134, Florence, Italy
| | - Chiara Azzari
- Laboratory of Immunology and Infectious Diseases, Anna Meyer Children's University Hospital, University of Florence, Viale Gaetano Pieraccini, 24, 50139, Florence, Italy
| | | | - Emanuela Balocchini
- Living Environment, Food and Veterinary Prevention and Safety Office, Tuscany Region, Via Taddeo Alderotti, 26/N, 50139, Florence, Italy
| | - Giovanni Rezza
- Department of Infectious Diseases, Istituto Superiore di Sanità, Viale Regina Elena, 299, 00161, Rome, Italy
| | - Fabio Voller
- Regional Health Agency of Tuscany, Epidemiologic Observatory, Via Pietro Dazzi, 1, Flroence, Italy
| | - Paola Stefanelli
- Department of Infectious Diseases, Istituto Superiore di Sanità, Viale Regina Elena, 299, 00161, Rome, Italy
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17
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Sadeghi M, Ahmadrajabi R, Dehesh T, Saffari F. Prevalence of meningococcal carriage among male university students living in dormitories in Kerman, southeast of Iran. Pathog Glob Health 2018; 112:329-333. [PMID: 30156971 DOI: 10.1080/20477724.2018.1514138] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Neisseria meningitidis is an important causative agent of bacterial meningitis. The nasopharynx is the only known reservoir of this organism. Although the relationship between carriage and invasive disease is not completely understood, asymptomatic meningococcal carriers are considered as the most important sources for causing strains of disease. Living in closed and overcrowded places such as university dormitories can increase the carriage rate and meningococcal disease. This cross-sectional study was conducted to determine the prevalence of N. meningitidis carriers among male students living in three dormitories affiliated with Kerman University of Medical Sciences (Kerman, Iran). Nasopharyngeal swab was taken from all participants recruited in the study. Conventional microbiological tests were performed for isolation and detection of the organism. The amplification of crgA gene was used to confirm the identity of isolates. Molecular serogrouping was used to detect the six most frequent serotypes. The overall carriage rate was 6.8% (23/335). The capsular type of these isolates was in determinate (56.5%) or of serogroup C (43.5%). Multivariate logistic regression analysis revealed that cigarette smoking was significantly associated with meningococcal carriage (OR = 5.02; p = 0.01). Additionally, using univariate regression analysis, a significant association was found between water pipe smoking and carriage (p = 0.018). The rate of meningococcal carriage among male students in the studied population was lower as compared to other high-risk group (freshmen conscripts) in Iran. University students should be aware of the consequences of cigarette and water pipe smoking as risk factors in meningococcal carriage.
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Affiliation(s)
- Mohammad Sadeghi
- a Department of Microbiology and Virology, School of Medicine , Kerman University of Medical Sciences , Kerman , Iran
| | - Roya Ahmadrajabi
- a Department of Microbiology and Virology, School of Medicine , Kerman University of Medical Sciences , Kerman , Iran
| | - Tania Dehesh
- b Department of Epidemiology and Biostatistics, School of Public Health , Kerman University of Medical Sciences , Kerman , Iran
| | - Fereshteh Saffari
- a Department of Microbiology and Virology, School of Medicine , Kerman University of Medical Sciences , Kerman , Iran
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18
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Moura ARSS, Kretz CB, Ferreira IE, Nunes AMPB, de Moraes JC, Reis MG, McBride AJA, Wang X, Campos LC. Molecular characterization of Neisseria meningitidis isolates recovered from 11-19-year-old meningococcal carriers in Salvador, Brazil. PLoS One 2017; 12:e0185038. [PMID: 28931058 PMCID: PMC5607198 DOI: 10.1371/journal.pone.0185038] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2017] [Accepted: 09/04/2017] [Indexed: 11/18/2022] Open
Abstract
Characterization of meningococci isolated from the pharynx is essential towards understanding the dynamics of meningococcal carriage and disease. Meningococcal isolates, collected from adolescents resident in Salvador, Brazil during 2014, were characterized by multilocus sequence typing, genotyping or whole-genome sequencing. Most were nongroupable (61.0%), followed by genogroups B (11.9%) and Y (8.5%). We identified 34 different sequence types (STs), eight were new STs, distributed among 14 clonal complexes (cc), cc1136 represented 20.3% of the nongroupable isolates. The porA and fetA genotypes included P1.18,25-37 (11.9%), P1.18-1,3 (10.2%); F5-5 (23.7%), F4-66 (16.9%) and F1-7 (13.6%). The porB class 3 protein and the fHbp subfamily A (variants 2 and 3) genotypes were found in 93.0 and 71.0% of the isolates, respectively. NHBA was present in all isolates, and while most lacked NadA (94.9%), we detected the hyperinvasive lineages B:P1.19,15:F5-1:ST-639 (cc32); C:P1.22,14-6:F3-9:ST-3780 (cc103) and W:P1.5,2:F1-1:ST-11 (cc11). This is the first report on the genetic diversity and vaccine antigen prevalence among N. meningitidis carriage isolates in the Northeast of Brazil. This study highlights the need for ongoing characterization of meningococcal isolates following the introduction of vaccines and for determining public health intervention strategies.
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Affiliation(s)
| | - Cécilia Batmalle Kretz
- Meningitis and Vaccine Preventable Diseases Branch, Division of Bacterial Diseases, Centers for Disease Control and Prevention, Atlanta, United States of America
| | - Italo Eustáquio Ferreira
- Laboratório de Patologia e Biologia Molecular, Instituto Gonçalo Moniz, FIOCRUZ-BA, Salvador, Bahia, Brazil
| | | | | | - Mitermayer Galvão Reis
- Laboratório de Patologia e Biologia Molecular, Instituto Gonçalo Moniz, FIOCRUZ-BA, Salvador, Bahia, Brazil
| | - Alan John Alexander McBride
- Laboratório de Patologia e Biologia Molecular, Instituto Gonçalo Moniz, FIOCRUZ-BA, Salvador, Bahia, Brazil
- Núcleo de Biotecnologia, Centro de Desenvolvimento Tecnológico, Universidade Federal de Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Xin Wang
- Meningitis and Vaccine Preventable Diseases Branch, Division of Bacterial Diseases, Centers for Disease Control and Prevention, Atlanta, United States of America
| | - Leila Carvalho Campos
- Laboratório de Patologia e Biologia Molecular, Instituto Gonçalo Moniz, FIOCRUZ-BA, Salvador, Bahia, Brazil
- * E-mail:
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19
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Tekin RT, Dinleyici EC, Ceyhan M, Karbuz A, Salman N, Sutçu M, Kurugol Z, Balliel Y, Celik M, Hacimustafaoglu M, Kuyucu N, Kondolot M, Sensoy G, Metin O, Kara SS, Dinleyici M, Kılıç O, Bayhan C, Gurbuz V, Aycan E, Memedova A, Karli A, Bozlu G, Celebi S. The prevalence, serogroup distribution and risk factors of meningococcal carriage in adolescents and young adults in Turkey. Hum Vaccin Immunother 2017; 13:1182-1189. [PMID: 28140784 PMCID: PMC5443366 DOI: 10.1080/21645515.2016.1268304] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Revised: 11/18/2016] [Accepted: 11/29/2016] [Indexed: 12/19/2022] Open
Abstract
The serogroup epidemiology of invasive meningococcal disease (IMD), which varies considerably by geographic region and immunization schedule, changes continuously. Meningococcal carriage data are crucial for assessing IMD epidemiology and designing f potential vaccination strategies. Meningococcal seroepidemiology in Turkey differs from that in other countries: serogroups W and B are the predominant strains for IMD during childhood, whereas no serogroup C cases were identified over the last 10 y and no adolescent peak for IMD was found. There is a lack of data on meningococcal carriage that represents the whole population. The aims of this multicenter study (12 cities in Turkey) were to evaluate the prevalence of Neisseria meningitidis carriage, the serogroup distribution and the related risk factors (educational status, living in a dormitory or student house, being a household contact with Hajj pilgrims, smoking, completion of military service, attending bars/clubs) in 1518 adolescents and young adults aged 10-24 y. The presence of N. meningitidis DNA was tested, and a serogroup analysis was performed using polymerase chain reaction. The overall meningococcal carriage rate was 6.3% (n = 96) in the study population. A serogroup distribution of the 96 N. meningitidis strains isolated from the nasopharyngeal specimens revealed serogroup A in 5 specimens (5.2%), serogroup B in 9 specimens (9.4%), serogroup W in 64 specimens (66.6%), and serogroup Y in 4 specimens (4.2%); 14 were classified as non-grouped (14.4%). No serogroup C cases were detected. The nasopharyngeal meningococcal carriage rate was 5% in the 10-14 age group, 6.4% in the 15-17 age-group, and 4.7% in the 18-20 age group; the highest carriage rate was found in the 21-24 age group (9.1%), which was significantly higher than those of the other age groups (p < 0.05). The highest carriage rate was found in 17-year-old adolescents (11%). The carriage rate was higher among the participants who had had close contact with Hajj/Umrah pilgrims (p < 0.01) or a history of upper respiratory tract infections over the past 3 months (p < 0.05). The nasopharyngeal carriage rate was 6.3% among adolescents and young adults in Turkey and was similar to the recent rates observed in the same age groups in other countries. The most prevalent serogroup was W, and no serogroup C cases were found. In conclusion, the present study found that meningococcal carriage reaches its peak level by age 17, the highest carriage rate was found in 21 - to 24 - year-olds and the majority of the carriage cases were due to serogroup W. Adolescents and young adult carriers seem to be a potential reservoir for the disease, and further immunization strategies, including adolescent immunization, may play a role in the control of IMD.
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Affiliation(s)
- Rahmi Tuna Tekin
- Eskisehir Osmangazi University Faculty of Medicine, Department of Pediatrics, Eskisehir, Turkey
| | - Ener Cagri Dinleyici
- Eskisehir Osmangazi University Faculty of Medicine, Department of Pediatrics, Eskisehir, Turkey
| | - Mehmet Ceyhan
- Hacettepe University Faculty of Medicine, Pediatric Infectious Disease Unit, Ankara, Turkey
| | - Adem Karbuz
- Okmeydanı Training and Research Hospital, Pediatric Infectious Disease Unit, Istanbul, Turkey
| | - Nuran Salman
- Istanbul University Istanbul Faculty of Medicine, Pediatric Infectious Disease Unit, Istanbul, Turkey
| | - Murat Sutçu
- Istanbul University Istanbul Faculty of Medicine, Pediatric Infectious Disease Unit, Istanbul, Turkey
| | - Zafer Kurugol
- Ege University Faculty of Medicine, Pediatric Infectious Disease Unit, Izmir, Turkey
| | - Yasemin Balliel
- Muratpasa 1st Caybasi Family Practice Center, Antalya, Turkey
| | - Melda Celik
- Sanlıurfa Children Hospital, Sanliurfa, Turkey
| | | | - Necdet Kuyucu
- Mersin University Faculty of Medicine, Pediatric Infectious Disease Unit, Mersin, Turkey
| | - Meda Kondolot
- Erciyes University Faculty of Medicine, Department of Social Pediatrics, Kayseri, Turkey
| | - Gülnar Sensoy
- Konya Training and Research Hospital, Pediatric Infectious Disease Unit, Konya, Turkey
| | - Ozge Metin
- Ondokuz Mayıs University Faculty of Medicine, Pediatric Infectious Disease Unit, Samsun, Turkey
| | - Soner Sertan Kara
- Erzurum Training and Research Hospital, Pediatric Infectious Disease Unit, Erzurum, Turkey
| | - Meltem Dinleyici
- Eskisehir Osmangazi University Faculty of Medicine, Department of Pediatrics, Eskisehir, Turkey
| | - Omer Kılıç
- Eskisehir Osmangazi University Faculty of Medicine, Department of Pediatrics, Eskisehir, Turkey
| | - Cihangul Bayhan
- Hacettepe University Faculty of Medicine, Pediatric Infectious Disease Unit, Ankara, Turkey
| | - Venhar Gurbuz
- Hacettepe University Faculty of Medicine, Pediatric Infectious Disease Unit, Ankara, Turkey
| | - Emre Aycan
- Hacettepe University Faculty of Medicine, Pediatric Infectious Disease Unit, Ankara, Turkey
| | - Aygun Memedova
- Ege University Faculty of Medicine, Pediatric Infectious Disease Unit, Izmir, Turkey
| | - Arzu Karli
- Konya Training and Research Hospital, Pediatric Infectious Disease Unit, Konya, Turkey
| | - Gulçin Bozlu
- Mersin University Faculty of Medicine, Pediatric Infectious Disease Unit, Mersin, Turkey
| | - Solmaz Celebi
- Uludag University Faculty of Medicine, Pediatric Infectious Disease Unit, Bursa, Turkey
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Meningococcal Carriage in Military Recruits and University Students during the Pre MenB Vaccination Era in Greece (2014-2015). PLoS One 2016; 11:e0167404. [PMID: 27907129 PMCID: PMC5131982 DOI: 10.1371/journal.pone.0167404] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Accepted: 11/14/2016] [Indexed: 12/17/2022] Open
Abstract
Purpose The aim of the study was to estimate the meningococcal carriage rate and to identify the genotypic characteristics of the strains isolated from healthy military recruits and university students in order to provide data that might increase our understanding on the epidemiology of meningococcus and obtain information which helps to evaluate the potential effects on control programs such as vaccination., Methods A total of 1420 oropharyngeal single swab samples were collected from military recruits and university students on voluntary basis, aged 18–26 years. New York City Medium was used for culture and the suspected N. meningitidis colonies were identified by Gram stain, oxidase and rapid carbohydrate utilization tests. Further characterisation was carried out by molecular methods (multiplex PCR, MLST, WGS). Results The overall carriage rate was of 12.7%; 15% and 10.4% for recruits and university students respectively. MenB (39.4%) was the most prevalent followed by MenY (12.8%) and MenW (4.4%). Among the initial 76 Non Groupable (NG) isolates, Whole Genome Sequence Analysis (WGS) revealed that 8.3% belonged to MenE, 3.3% to MenX and 1.1% to MenZ, while, 53 strains (29.4%) were finally identified as capsule null. Genetic diversity was found among the MenB isolates, with 41/44 cc and 35 cc predominating. Conclusion Meningococcal carriage rate in both groups was lower compared to our previous studies (25% and 18% respectively) with predominance of MenB isolates. These findings, help to further our understanding on the epidemiology of meningococcal disease in Greece. Although the prevalence of carriage seems to have declined compared to our earlier studies, the predominant MenB clonal complexes (including 41/44cc and 35cc) are associated with invasive meningococcal disease.
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Nunes AMPB, Ribeiro GS, Ferreira ÍE, Moura ARSS, Felzemburgh RDM, de Lemos APS, Reis MG, de Moraes JC, Campos LC. Meningococcal Carriage among Adolescents after Mass Meningococcal C Conjugate Vaccination Campaigns in Salvador, Brazil. PLoS One 2016; 11:e0166475. [PMID: 27861618 PMCID: PMC5115742 DOI: 10.1371/journal.pone.0166475] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Accepted: 10/28/2016] [Indexed: 11/21/2022] Open
Abstract
Neisseria meningitidis is a commensal bacterium of the human nasopharynx. In rare cases, it penetrates the mucosa, entering the blood stream and causing various forms of disease. Meningococcal conjugate vaccines can prevent invasive disease not only by direct effect in vaccinated individuals but also by herd protection, preventing acquisition of carriage, which interrupts transmission and leads to protection of unvaccinated persons. In 2010 in Salvador, Brazil, an outbreak of group C meningococcal disease led to a mass meningococcal serogroup C conjugate vaccination drive, targeting those <5 and 10–24 years of age. The present study aimed to estimate the prevalence of and identify factors associated with N. meningitidis carriage among adolescents from Salvador, Brazil, in the post-vaccination period. In spring 2014, we performed a cross-sectional study involving 1,200 public school students aged 11–19 years old. Oropharyngeal swabs were collected to identify N. meningitidis. Of the 59 colonized participants, 36 (61.0%) carried non-groupable N. meningitidis, while genogroup B (11.9%), Y (8.5%), E (6.8%), Z (5.1%), C (3.4%), and W (3.4%) were also detected. The overall prevalence of N. meningitidis carriage was 4.9% (95% confidence interval [CI], 3.6–6.1%); the prevalence of N. meningitidis genogroup C was 0.17% (95% CI, 0.0–0.40%). There was no difference by age. Factors associated with carriage were having only one, shared, bedroom in the household (PR, 2.02; 95% CI, 0.99–4.12, p = 0.05); the mother being the only smoker in the home (PR, 2.48; 95% CI, 1.16–5.29; p = 0.01); and going to pubs/parties more than 5 times/month (PR, 2.61; 95% CI, 1.38–4.92; p = 0.02). Our findings show that the N. meningitidis carriage rate in adolescents from Salvador, Bahia, is low and is potentially influenced by the low prevalence of N. meningitidis genogroup C. However, continued surveillance is important to identify changes in the dynamics of N. meningitidis, including the emergence of diseases due to a non-C serogroup.
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Affiliation(s)
| | - Guilherme Sousa Ribeiro
- Instituto Gonçalo Moniz, FIOCRUZ-BA, 40296–710, Salvador, Brazil
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, 40110–040, Salvador, Brazil
| | | | | | | | | | | | - José Cassio de Moraes
- Faculdade de Ciências Médicas da Santa Casa de São Paulo, 01221–020, São Paulo, Brazil
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Rizek CF, Luiz AM, Assis GRD, Costa SF, Levin AS, Lopes MH. COMPARISON OF METHODS TO IDENTIFY Neisseria meningitidis IN ASYMPTOMATIC CARRIERS. Rev Inst Med Trop Sao Paulo 2016; 58:60. [PMID: 27680165 PMCID: PMC5048631 DOI: 10.1590/s1678-9946201658060] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Accepted: 03/11/2016] [Indexed: 01/17/2023] Open
Abstract
Neisseria meningitidis is a cause of several life-threatening
diseases and can be a normal commensal in the upper respiratory tract of healthy
carriers. The carrier rate is not well established especially because there is no
standard method for the isolation of N. meningitidis. Therefore, the
aim of this study was to compare identification methods for the carrier state. Two
swabs were collected from 190 volunteers: one was cultured and the other had DNA
extracted directly from the sample. The Polymerase Chain Reaction (PCR) was performed
to determine species and serogroups and compared the results between the methods. PCR
for species determination used two pairs of primers and when there was only one
amplicon, it was sequenced. The culture technique was positive in 23 (12.1%) subjects
while the direct extraction method was positive in 132 (69.5%), p
< 0.001. Among the 135 subjects with positive N. meningitides
tests, 88 (65.2%) were serogroup C; 3 (2.2%) serogroup B; 5 (3.7%) were positive for
both serogroup B and C, and 39 (28.9%) did not belong to any of the tested
serogroups. In this study, PCR from DNA extracted directly from swabs identified more
N. meningitidis asymptomatic carriers than the culture technique.
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Affiliation(s)
- Camila F Rizek
- University of São Paulo, School of Medicine, Department of Infectious Diseases, Laboratory of Bacteriology (LIM-54). São Paulo, SP, Brazil. E-mails: ; ; ;
| | - André Machado Luiz
- University of São Paulo, School of Medicine, Department of Infectious Diseases, São Paulo, SP, Brazil. E-mails: ;
| | - Gracilene Ramos de Assis
- University of São Paulo, School of Medicine, Department of Infectious Diseases, Laboratory of Bacteriology (LIM-54). São Paulo, SP, Brazil. E-mails: ; ; ;
| | - Silvia Figueiredo Costa
- University of São Paulo, School of Medicine, Department of Infectious Diseases, Laboratory of Bacteriology (LIM-54). São Paulo, SP, Brazil. E-mails: ; ; ;
| | - Anna Sara Levin
- University of São Paulo, School of Medicine, Department of Infectious Diseases, Laboratory of Bacteriology (LIM-54). São Paulo, SP, Brazil. E-mails: ; ; ;
| | - Marta Heloisa Lopes
- University of São Paulo, School of Medicine, Department of Infectious Diseases, São Paulo, SP, Brazil. E-mails: ;
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Meningococcal carriage in children and young adults in the Philippines: a single group, cross-sectional study. Epidemiol Infect 2016; 145:126-132. [PMID: 27655066 PMCID: PMC9507336 DOI: 10.1017/s0950268816002119] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
This cross-sectional prevalence study investigates meningococcal carriage for the first time in a Southeast Asian population. Posterior pharyngeal swabs were collected between August 2013 and March 2014 from 937 healthy Filipinos aged 5-24 years attending school or university in Manila. Of these, 35 were found to be carriers giving an overall carriage prevalence of 3·7% [95% confidence interval (CI) 2·6-5·2]. Carriage was associated with age (P < 0·001) and was highest (9·0%, 95% CI 5·5-13·8) in subjects aged 10-14 years, but was comparatively low (<3%) in all other age groups considered. This suggests that an immunization programme in the Philippines designed to reduce carriage acquisition and induce herd immunity may require a vaccine dose before the age of 10 years. Serogroup B was most commonly carried (65·7%, 95% CI 47·8-80·9), with a small number of carriers for serogroups C, Y and W also present. Two individuals (5·7%, 95% CI 0·7-19·2) who were simultaneously carrying multiple serogroups were identified. This exploratory study provides valuable insight into the asymptomatic carriage of Neisseria meningitidis in a healthy subset of the Filipino population and illustrates the importance of generating local carriage data.
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Correction: Characterization of Carriage Isolates of Neisseria meningitidis in the Adolescents and Young Adults Population of Bogota (Colombia). PLoS One 2015; 10:e0139983. [PMID: 26437321 PMCID: PMC4593576 DOI: 10.1371/journal.pone.0139983] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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