Abstract
Determination of the major serogroups is an important step for establishing a vaccine programme and management strategy targeting Neisseria meningitidis. From April 2010 to November 2016, a total of 25 N. meningitidis isolates were collected in South Korea, in collaboration with the Korean Society of Clinical Microbiology. Among isolates, 19 isolates were recovered from blood and/or cerebrospinal fluid (CSF) in 46 patients who suffered from invasive meningococcal disease (IMD), and six isolates were found in sputum or the throat. The most common serogroup was serogroup B (overall, 36%, n = 9/25; IMD, 37%, n = 7/19), which was isolated in every year of the research period except for 2011. There were five serogroup W isolates recovered from patients in military service. W was no longer isolated after initiation of a vaccine programme for military trainees, but serogroup B caused meningitis in an army recruit training centre in 2015. In MLST analysis, 14 sequence types were found, and all isolates belonging to W showed the same molecular epidemiologic characteristics (W:P1.5-1, 2-2:F3-9:ST-8912). All isolates showed susceptibility to ceftriaxone, meropenem, ciprofloxacin, minocycline, and rifampin; however, the susceptibility rates to penicillin and ampicillin for isolates with W and C capsules were 22% and 30%, respectively.
Highlights
Neisseria meningitidis isolates can cause asymptomatic colonization or severe invasive infections
From April 2010 to November 2016, a total of 46 invasive meningococcal disease (IMD) patients who could represent all cases of IMD in Korea were reported to the Korea Centers for Disease Control and Prevention (CDC), and 19 isolates were recovered from blood and/or cerebrospinal fluid (CSF) among 46 IMD patients
In the United States, the CDC reported that the prevalence of meningitis and bacteremia due to N. meningitidis was 0.16 cases/100,000 individuals; in 2015, 12.5% of these infected patients died[3]
Summary
Neisseria meningitidis isolates can cause asymptomatic colonization or severe invasive infections. Invasive meningococcal disease (IMD) may develop as acute sepsis or meningitis[1], and meningococcal meningitis combined with septic shock is responsible for a higher mortality (adjusted odds ratio, 23.3) than simple meningitis[2]. Infants and children are the main targets of N. meningitidis infection, outbreaks in adolescents and young adults can occur as well. Meningitis combined with meningococcal septic shock can result in death in approximately 30% of patients, with an increasing death rate associated with age (adjusted odds ratio of 1.02 per 1-year increase in age)[5]. Rapid progression and high mortality can make it difficult to properly manage patients in certain circumstances, vaccines have been developed to overcome this serious infection. The most important virulence factor causing invasive infection is the polysaccharide capsule, and this structure is the main target of vaccines. We aimed to investigate the sero/genogroups, PorA subtypes, FetA subtypes, multilocus sequence types (MLSTs), and antimicrobial susceptibility of N. meningitidis using isolates collected across South Korea
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