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Muzzi A, Lu MC, Mori E, Biolchi A, Fu T, Serino L. Prediction by genetic MATS of 4CMenB vaccine strain coverage of invasive meningococcal serogroup B isolates circulating in Taiwan between 2003 and 2020. mSphere 2024; 9:e0022024. [PMID: 38752729 DOI: 10.1128/msphere.00220-24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Accepted: 04/01/2024] [Indexed: 06/26/2024] Open
Abstract
Neisseria meningitidis serogroup B (NmB) strains have diverse antigens, necessitating methods for predicting meningococcal serogroup B (MenB) vaccine strain coverage. The genetic Meningococcal Antigen Typing System (gMATS), a correlate of MATS estimates, predicts strain coverage by the 4-component MenB (4CMenB) vaccine in cultivable and non-cultivable NmB isolates. In Taiwan, 134 invasive, disease-causing NmB isolates were collected in 2003-2020 (23.1%, 4.5%, 5.2%, 29.8%, and 37.3% from individuals aged ≤11 months, 12-23 months, 2-4 years, 5-29 years, and ≥30 years, respectively). NmB isolates were characterized by whole-genome sequencing and vaccine antigen genotyping, and 4CMenB strain coverage was predicted using gMATS. Analysis of phylogenetic relationships with 502 global NmB genomes showed that most isolates belonged to three global hyperinvasive clonal complexes: ST-4821 (27.6%), ST-32 (23.9%), and ST-41/44 (14.9%). Predicted strain coverage by gMATS was 62.7%, with 27.6% isolates covered, 2.2% not covered, and 66.4% unpredictable by gMATS. Age group coverage point estimates ranged from 42.9% (2-4 years) to 66.1% (≤11 months). Antigen coverage estimates and percentages predicted as covered/not covered were highly variable, with higher estimates for isolates with one or more gMATS-positive antigens than for isolates positive for one 4CMenB antigen. In conclusion, this first study on NmB strain coverage by 4CMenB in Taiwan shows 62.7% coverage by gMATS, with predictable coverage for 29.8% of isolates. These could be underestimated since the gMATS calculation does not consider synergistic mechanisms associated with simultaneous antibody binding to multiple targets elicited by multicomponent vaccines or the contributions of minor outer membrane vesicle vaccine components.IMPORTANCEMeningococcal diseases, caused by the bacterium Neisseria meningitidis (meningococcus), include meningitis and septicemia. Although rare, invasive meningococcal disease is often severe and can be fatal. Nearly all cases are caused by six meningococcal serogroups (types), including meningococcal serogroup B. Vaccines are available against meningococcal serogroup B, but the antigens targeted by these vaccines have highly variable genetic features and expression levels, so the effectiveness of vaccination may vary depending on the strains circulating in particular countries. It is therefore important to test meningococcal serogroup B strains isolated from specific populations to estimate the percentage of bacterial strains that a vaccine can protect against (vaccine strain coverage). Meningococcal isolates were collected in Taiwan between 2003 and 2020, of which 134 were identified as serogroup B. We did further investigations on these isolates, including using a method (called gMATS) to predict vaccine strain coverage by the 4-component meningococcal serogroup B vaccine (4CMenB).
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Affiliation(s)
| | - Min-Chi Lu
- School of Medicine, China Medical University, Taichung, Taiwan
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Huyen DT, Reboud J, Quyen DT, Cooper JM, Velavan TP, Trung NT, Song LH. An isothermal CRISPR- based lateral flow assay for detection of Neisseria meningitidis. Ann Clin Microbiol Antimicrob 2024; 23:28. [PMID: 38555443 PMCID: PMC10981803 DOI: 10.1186/s12941-024-00688-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Accepted: 03/21/2024] [Indexed: 04/02/2024] Open
Abstract
BACKGROUND Neisseria meningitidis can cause life-threatening meningococcal meningitis and meningococcemia. Old standard microbiological results from CSF/blood cultures are time consuming. This study aimed to combine the sensitivity of loop-mediated isothermal nucleic acid amplification (LAMP) with the specificity of CRISPR/Cas12a cleavage to demonstrate a reliable diagnostic assay for rapid detection of N. meningitidis. METHODS A total of n = 139 samples were collected from patients with suspected meningococcal disease and were used for evaluation. The extracted DNA was subjected to qualitative real-time PCR, targeting capsular transporter gene (ctrA) of N. meningitidis. LAMP-specific primer pairs, also targeting the ctrA, were designed and the LAMP products were subjected to CRISPR/Cas12 cleavage reaction. the readout was on a lateral flow strip. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of LAMP-CRISPR/Cas was compared with real-time PCR assays. The limit of detection (LOD) was established with serial dilutions of the target N. meningitidis DNA and calculated by Probit regression analysis. RESULTS Six LAMP assay-specific primers were developed targeting the ctrA gene of N. meningitidis, which is conserved in all meningococcal serogroups. The LAMP primers did not amplify DNA from other bacterial DNA tested, showing 100% specificity. The use of 0.4 M betaine increased the sensitivity and stability of the reaction. LAMP-CRISPR/Cas detected meningococcal serogroups (B, C, W). The assay showed no cross-reactivity and was specific for N. meningitidis. The LOD was 74 (95% CI: 47-311) N. meningitidis copies. The LAMP-CRISPR/Cas performed well compared to the gold standard. In the 139 samples from suspected patients, the sensitivity and specificity of the test were 91% and 99% respectively. CONCLUSION This developed and optimized method can complement for the available gold standard for the timely diagnosis of meningococcal meningitis and meningococcemia.
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Affiliation(s)
- Dao Thi Huyen
- Vietnamese - German Center for Medical Research (VG-CARE), 108 Military Central Hospital, Nr 1, Tran Hung Dao Street, Hai Ba Trung Dist., Hanoi, 10000, Vietnam
| | - Julien Reboud
- James Watt School of Engineering, University of Glasgow, Glasgow, G12 8QQ, UK
| | - Dao Thanh Quyen
- Vietnamese - German Center for Medical Research (VG-CARE), 108 Military Central Hospital, Nr 1, Tran Hung Dao Street, Hai Ba Trung Dist., Hanoi, 10000, Vietnam
- Department of Molecular Biology, 108 Military Central Hospital, Hanoi, 10000, Vietnam
| | - Jonathan M Cooper
- James Watt School of Engineering, University of Glasgow, Glasgow, G12 8QQ, UK
| | - Thirumalaisamy P Velavan
- Vietnamese - German Center for Medical Research (VG-CARE), 108 Military Central Hospital, Nr 1, Tran Hung Dao Street, Hai Ba Trung Dist., Hanoi, 10000, Vietnam
- Institute of Tropical Medicine, University of Tübingen, 72074, Tübingen, Germany
| | - Ngo Tat Trung
- Vietnamese - German Center for Medical Research (VG-CARE), 108 Military Central Hospital, Nr 1, Tran Hung Dao Street, Hai Ba Trung Dist., Hanoi, 10000, Vietnam.
- Centre for Genetics Consultation and Cancer Screening, 108 Military Central Hospital, Hanoi, 10000, Vietnam.
| | - Le Huu Song
- Vietnamese - German Center for Medical Research (VG-CARE), 108 Military Central Hospital, Nr 1, Tran Hung Dao Street, Hai Ba Trung Dist., Hanoi, 10000, Vietnam.
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Thisyakorn U, Carlos J, Chotpitayasunondh T, Dien TM, Gonzales MLAM, Huong NTL, Ismail Z, Nordin MM, Ong-Lim ALT, Tantawichien T, Terumalay SD, Vu TD, Cintra O, Oladehin O. Invasive meningococcal disease in Malaysia, Philippines, Thailand, and Vietnam: An Asia-Pacific expert group perspective on current epidemiology and vaccination policies. Hum Vaccin Immunother 2022; 18:2110759. [PMID: 36084311 DOI: 10.1080/21645515.2022.2110759] [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: 12/15/2022] Open
Abstract
Invasive meningococcal disease (IMD) imposes a significant burden on the global community due to its high case fatality rate (4-20%) and the risk of long-term sequelae for one in five survivors. An expert group meeting was held to discuss the epidemiology of IMD and immunization policies in Malaysia, Philippines, Thailand, and Vietnam. Most of these countries do not include meningococcal immunization in their routine vaccination programs, except for high-risk groups such as immunocompromised people and pilgrims. It is difficult to estimate the epidemiology of IMD in the highly diverse Asia-Pacific region, but available evidence indicate serogroup B is increasingly dominant. Disease surveillance systems differ by country. IMD is not a notifiable disease in some of them. Without an adequate surveillance system in the region, the risk and the burden of IMD might well be underestimated. With the availability of new combined meningococcal vaccines and the World Health Organization roadmap to defeat bacterial meningitis by 2030, a better understanding of the epidemiology of IMD in the Asia-Pacific region is needed.
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Affiliation(s)
- Usa Thisyakorn
- Tropical Medicine Cluster, Chulalongkorn University, Bangkok, Thailand
| | - Josefina Carlos
- University of the East Ramon Magsaysay Memorial Medical Center, Quezon City, Philippines
| | | | - Tran M Dien
- Vietnam National Children's Hospital, Hanoï, Vietnam
| | | | | | | | - Musa M Nordin
- KPJ Damansara Specialist Hospital, Selangor, Malaysia
| | - Anna Lisa T Ong-Lim
- University of the Philippines - Philippine General Hospital, Manila, Philippines
| | - Terapong Tantawichien
- Division of Infectious Diseases, Department of Medicine, Chulalongkorn University, Bangkok, Thailand
| | | | - Thiem D Vu
- National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
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Ciruela P, Vilaró M, Carmona G, Jané M, Soldevila N, Garcia T, Hernández S, Ruiz L, Domínguez A. Estimation of the incidence of invasive meningococcal disease using a capture-recapture model based on two independent surveillance systems in Catalonia, Spain. BMJ Open 2022; 12:e058003. [PMID: 35728904 PMCID: PMC9214402 DOI: 10.1136/bmjopen-2021-058003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES Invasive meningococcal disease (IMD) is an urgent notifiable disease and its early notification is essential to prevent cases. The objective of the study was to assess the sensitivity of two independent surveillance systems and to estimate the incidence of IMD. DESIGN We used capture-recapture model based on two independent surveillance systems, the statutory disease reporting (SDR) system and the microbiological reporting system (MRS) of the Public Health Agency of Catalonia, between 2011 and 2015. The capture-recapture analysis and 95% CIs were calculated using the Chapman formula. Multivariate vector generalised linear model was performed for adjusted estimation. MEASURES The variables collected were age, sex, year of report, size of municipality (<10 000 and ≥10 000), clinical form, death, serogroup, country of birth and type of reporting centre (private and public). RESULTS The sensitivity of the two combined surveillance systems was 88.5% (85.0-92.0). SDR had greater sensitivity than the MRS (67.9%; 62.7-73.1 vs 64.7%; 59.4-70.0). In 2014-2015, the sensitivity of both systems was higher (80.6%; 73.2-87.9 vs 73.4%; 65.2-81.6) than in 2011-2013 (59.3%; 52.6-66.0 vs 58.3%; 51.6-65.1). In private centres, the sensitivity was higher for SDR than for MRS (100%; 100-100 vs 4.8%; -4.4-13.9). The adjusted estimate of IMD cases was lower than that obtained using the Chapman formula (279; 266-296 vs 313; 295-330). The estimated adjusted incidence of IMD was 0.7/100 000 persons-year. CONCLUSIONS The sensitivity of enhanced surveillance through the combination of two complementary sources was higher than for the sources individually. Factors associated with under-reporting in different systems should be analysed to improve IMD surveillance.
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Affiliation(s)
- Pilar Ciruela
- Public Health Agency of Catalonia (ASPCAT), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Marta Vilaró
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Departament de Medicina, Universitat de Barcelona, Barcelona, Spain
| | - Gloria Carmona
- Public Health Agency of Catalonia (ASPCAT), Barcelona, Spain
| | - Mireia Jané
- Public Health Agency of Catalonia (ASPCAT), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Departament de Medicina, Universitat de Barcelona, Barcelona, Spain
| | - Núria Soldevila
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Departament de Medicina, Universitat de Barcelona, Barcelona, Spain
| | - Tomás Garcia
- Public Health Agency of Catalonia (ASPCAT), Barcelona, Spain
| | - Sergi Hernández
- Public Health Agency of Catalonia (ASPCAT), Barcelona, Spain
| | - Laura Ruiz
- Public Health Agency of Catalonia (ASPCAT), Barcelona, Spain
| | - Angela Domínguez
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Departament de Medicina, Universitat de Barcelona, Barcelona, Spain
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