Characterization of invasive Neisseria meningitidis isolates recovered from children in Turkey during a period of increased serogroup B disease, 2013–2017

• Published in: Vaccine Vol. 38; no. 19; pp. 3545 - 3552
• Main Authors: Ceyhan, Mehmet, Ozsurekci, Yasemin, Lucidarme, Jay, Borrow, Ray
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 23-04-2020; Elsevier Limited
• Subjects: Adolescent; Antigens; Antigens, Bacterial - genetics; Child; Child, Preschool; Epidemics; Epidemiology; Europe; Genes; Genetic diversity; Genomes; Genotyping; Humans; Infant; Infant, Newborn; Infectious diseases; Invasive meningococcal disease; Invasive meningococcal disease (IMD); Mats; Meningitis; Meningococcal disease; Meningococcal Infections - epidemiology; Meningococcal Vaccines; Molecular epidemiology; Mortality; Multilocus Sequence Typing; Neisseria meningitidis; Neisseria meningitidis - genetics; Neisseria meningitidis, Serogroup B - genetics; Nucleotide sequence; Pediatrics; Sepsis; Sequence analysis; Serogroup; Streptococcus infections; Surveillance; Turkey; Turkey - epidemiology; University faculty; Vaccines; Europe; Turkey; China; Africa; Invasive meningococcal disease (IMD); Molecular epidemiology; Neisseria meningitidis; Turkey; Genotyping
• ISSN: 0264-410X; 1873-2518
• DOI: 10.1016/j.vaccine.2020.03.024

•MenB is now the predominant serogroup among pediatric IMD cases in Turkey.•Invasive MenB in Turkey is diverse and includes several clonal complexes.•MenW IMD persists in Turkey and includes several clonal complexes.•Predicted MenB strain coverage by MenB vaccines in Turkey is high but requires ongoing monitoring.
Diverse Neisseria meningitidis strains belonging to various serogroups and clonal complexes cause epidemic and endemic life-threatening disease worldwide. This study aimed to investigate the genetic diversity of recent invasive meningococci in Turkey with respect to multilocus sequence type (MLST) and also meningococcal serogroup B (MenB) vaccine antigens to enable assessment of potential MenB strain coverage using the genetic Meningococcal Antigen Typing System (gMATS). Fifty-four isolates, representing 37.5% of all pediatric (ages 0–18 years) invasive meningococcal disease cases in Turkey from January 2013 to December 2017, underwent genome sequence analysis. Thirty-six (66.7%) isolates were MenB, 10 (18.5%) were serogroup W (MenW), 4 (7.4%) were serogroup A (MenA), 3 (5.6%) were serogroup Y (MenY) and 1 (1.8%) was serogroup X (MenX). The MenB isolates were diverse with cc35 (19.4%), cc41/44 (19.4%) and cc32 (13.8%) as the most prevalent clonal complexes. The MenW isolates (n = 10) comprised cc11 (n = 5), ST-2754 (cc-unassigned; n = 4) and cc22 (n = 1). gMATS was indicative of high 4CMenB coverage (72.2–79.1%) of Turkish invasive MenB strains from pediatric patients. Strain coverage of several clonal complexes differed from that seen elsewhere in Europe highlighting the importance of performing local assessments and also the use of phenotypic methods, i.e. MATS, where possible. All of the isolates possessed in-frame fhbp alleles and so were potentially covered by MenB-fHbp. Continued surveillance is essential to guide recommendations for current and future vaccines as well as understanding changes in epidemiology.