Abstract
Background Neisseria meningitidis is a leading etiologic agent of severe invasive disease. The objective of the study was to characterise invasive meningococcal disease (IMD) epidemiology in Poland during the last decade, based on laboratory confirmed cases.MethodsThe study encompassed all invasive meningococci collected between 2002 and 2011 in the National Reference Centre for Bacterial Meningitis. The isolates were re-identified and characterised by susceptibility testing, MLST analysis, porA and fetA sequencing. A PCR technique was used for meningococcal identification directly from clinical materials.ResultsIn the period studied, 1936 cases of IMD were confirmed, including 75.6% identified by culture. Seven IMD outbreaks, affecting mostly adolescents, were reported; all were caused by serogroup C meningococci of ST-11. The highest incidence was observed among children under one year of age (15.71/100,000 in 2011). The general case fatality rate in the years 2010–2011 was 10.0%. Meningococci of serogroup B, C, Y and W-135 were responsible for 48.8%, 36.6%, 1.2% and 1.2% of cases, respectively. All isolates were susceptible to third generation cephalosporins, chloramphenicol, ciprofloxacin, and 84.2% were susceptible to penicillin. MLST analysis (2009–2011) revealed that among serogroup B isolates the most represented were clonal complexes (CC) ST-32CC, ST-18CC, ST-41/44CC, ST-213CC and ST-269CC, and among serogroup C: ST-103CC, ST-41/44CC and ST-11CC.ConclusionsThe detection of IMD in Poland has changed over time, but observed increase in the incidence of the disease was mostly attributed to changes in the surveillance system including an expanded case definition and inclusion of data from non-culture diagnostics.
Highlights
Neisseria meningitidis is a leading etiologic agent of severe invasive disease characterized by rapid onset, of which meningitis and septicaemia are the most common and important manifestations [1,2]
Meningococcal infections may appear in every age group, infants and young children are at the highest risk of invasive meningococcal disease (IMD)
IMD cases are registered through two independent surveillance systems, a written documentation-based surveillance system run by the National Institute of Public Health-National Institute of Hygiene (NIPH-NIH) and a laboratory-confirmed surveillance system run by the NRCBM
Summary
Neisseria meningitidis is a leading etiologic agent of severe invasive disease characterized by rapid onset, of which meningitis and septicaemia are the most common and important manifestations [1,2]. Meningococcal disease has a general case-fatality rate around 10%, it is lower for meningitis (approximately 5%), and higher for septicaemia (from 5 to 40%, but even up to 70% in some studies) [1,3,4,5,6]. Neisseria meningitidis is a leading etiologic agent of severe invasive disease. The objective of the study was to characterise invasive meningococcal disease (IMD) epidemiology in Poland during the last decade, based on laboratory confirmed cases
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