Neisseria meningitidis disease-associated clones in Amazonas State, Brazil

Background: The aim of this study is to describe the molecular epidemiology of Neisseria meningitidis invasive disease before the introduction of serogroup C conjugate vaccine in Amazonas State in 2010. Methods: Meningococcal disease reported cases were investigated in Amazonas State during the peri...

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Published in:	Infectious diseases (London, England) Vol. 50; no. 9; pp. 697 - 704
Main Authors:	Silva, Luciete A., Coronato, Beatriz, Schlackman, Jessica, Marsh, Jane W., Ezeonwuka, Chinelo, Fernandes, Andréia C. L., Souza, Victor C., da Silva, Lirna S., de Amorim, Elaine F. Q., Naveca, Felipe G., de Albuquerque, Bernardino C., Amaral, Alcirene, Souza, Ana L. S., Carvalho-Costa, Filipe A., Mustapha, Mustapha M., Harrison, Lee H., Barroso, David E.
Format:	Journal Article
Language:	English
Published:	England Taylor & Francis 02-09-2018
Subjects:	Amazonas Anti-Bacterial Agents - pharmacology Antigens, Bacterial - genetics Brazil - epidemiology DNA, Bacterial - genetics Genes, Bacterial - genetics Genotype Humans Meningococcal disease Meningococcal Infections - epidemiology Meningococcal Infections - microbiology Microbial Sensitivity Tests Microbial Viability - drug effects MLST clones Molecular Epidemiology Multilocus Sequence Typing Neisseria meningitidis Neisseria meningitidis - classification Neisseria meningitidis - genetics Neisseria meningitidis - immunology Neisseria meningitidis - isolation & purification Serogroup Serogroup C conjugate vaccine MLST clones Serogroup C conjugate vaccine Neisseria meningitidis Amazonas Meningococcal disease
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Summary:	Background: The aim of this study is to describe the molecular epidemiology of Neisseria meningitidis invasive disease before the introduction of serogroup C conjugate vaccine in Amazonas State in 2010. Methods: Meningococcal disease reported cases were investigated in Amazonas State during the period 2000-2010. N. meningitidis isolates (n = 196) recovered from patients were genotyped by multilocus sequence typing (MLST) and sequencing of porB, porA, fetA, fHbp and penA. Antimicrobial susceptibility was determined using E-test. Results: In the study period, 948 cases were reported; the incidence was 2.8 for the entire state and 4.8 per 100,000 in the capital of Manaus. Most meningococcal disease was caused by N. meningitidis belonging to ST-32 (72%; 141/196) or ST-103 (21%; 41/196) clonal complexes. Capsular switching (B→C) was suggested within clonal complex (cc) 32. There were 6 (3%; 6/196) strains with intermediate susceptibility to penicillin and a single strain was resistant to rifampicin. Since 2007, serogroup C strains belonging to the cc103 have predominated and case-fatality has increased. Conclusion: We demonstrate a high rate of meningococcal disease in Amazonas State, where, like other parts of Brazil, serogroup C replaced serogroup B during 2000s. These data serve as a baseline to measure impact of serogroup C conjugate vaccine introduction in 2010. This study emphasizes the need for enhanced surveillance to monitor changes in meningococcal disease trends following the introduction of meningococcal vaccines.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	2374-4235 2374-4243
DOI:	10.1080/23744235.2018.1459829