Abstract
An increase of invasive meningococcal disease caused by Neisseria meningitidis serogroup Y has been noted in Sweden since 2005, and to a lower extent throughout Europe. The present study describes the epidemiology of invasive N. meningitidis isolates in Sweden in the period between 2010 and 2012, with a focus on serogroup Y. We also aimed to find an optimal molecular typing scheme for both surveillance and outbreak investigations. All invasive N. meningitidis isolates in Sweden during the study period (n=208) were genetically characterised. Serogroup Y predominated with 22/57, 31/61 and 44/90 of all invasive isolates (incidence 0.23, 0.33 and 0.46 per 100,000 population) in 2010, 2011 and 2012 respectively. In each of these years, 15/22, 22/31 and 19/44 of serogroup Y isolates were genetically clonal (Y: P1.5–2,10–1,36–2: F4–1: ST-23(cc23), ‘porB allele 3–36, fHbp allele 25 and penA allele 22). Our findings further support those of others that currently recommended FetA typing could be replaced by FHbp. Moreover, in line with a previous study that we conducted, the current results indicate that highly variable multilocus variable-number tandem repeat analysis (HV-MLVA) can be used as a first-hand rapid method for small outbreak investigations.
Highlights
Neisseria meningitidis is a Gramnegative diplococcus carried asymptomatically in the pharynx by approximately 10% of the population [1].It is a potentially devastating pathogen causing meningitis and septicaemia
A total of 208 invasive N. meningitidis isolates were characterised during the study period, including 57 in
The isolates originated from clinical specimens of cerebrospinal fluid (n=44), Minimum spanning tree from multilocus sequence typing profile data for Neisseria meningitidis isolates in Sweden, 2010
Summary
Neisseria meningitidis (the meningococcus) is a Gramnegative diplococcus carried asymptomatically in the pharynx by approximately 10% of the population [1]. It is a potentially devastating pathogen causing meningitis and septicaemia. Detailed characterisation of circulating meningococcal strains is important in terms of vaccination policy decisions, outbreak management, as well as monitoring antibiotic susceptibility and vaccine coverage. The polysaccharide capsule surrounding the bacterium defines the meningococcal serogroup. The capsule is an important virulence factor and IMD is mainly restricted to encapsulated meningococci belonging to serogroups A, B, C, W, X and Y. The capsule is a polysaccharide vaccine component in available conjugate vaccines for serogroups A, C, W and Y [4]. An emergence of serogroup Y has been noted in some other European countries, the highest relative proportions are found in Scandinavia [8,9]
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