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Published on: November 5, 2019
Characteristics of Neisseria meningitidis isolates causing fatal disease
Susanne Jacobsson1, Per Olcén, Margareta Löfdahl
1National Reference Laboratory for Pathogenic Neisseria, Department of Clinical Microbiology, Orebro University Hospital, Orebro, Sweden. susanne.jacobsson@orebroll.se
Abstract:
The objectives of the present study were to describe a selection of characteristics of all available fatal meningococcal isolates (n = 62) and to compare these with all the other invasive isolates (non-fatal, n = 474) collected in Sweden from 1995 to 2004 (fatality rate of 12%). The coverage of the fatal isolates by presently discussed outer membrane vesicle (OMV) vaccines was also estimated. The isolates were characterized by serogroup, serotype, genosubtype, multilocus sequence type and antibiogram. Basic epidemiological data were gathered. The results of the fatal isolates showed 55% serogroup B, 27% C, 15% Yand 3% W-135, with a fatality rate of 11% for B, 12% for C, 17% for Y and 8% for W-135. Characteristics associated with higher mortality were age, gender, serogroup Y, serotype 14 and 15 and genosubtypes P1.7,16-29,35 and P1.5-1,10-4,36-2. In contrast, non-14/non-15 serotypes, the genosubtypes P1.5-1,10-8,36-2; P1.7-2,4,37 and P1.7,16,35, as well as reduced sensitivity for penicillin G were associated with decreased mortality. The presently discussed OMV vaccines could, based solely on the complete genosubtype, theoretically cover up to 44% of the fatal serogroup B cases and up to 100% if every variable region by itself is capable to induce protective immunity.
Insights
Fatal meningococcal isolates were characterized by serogroup, serotype, and genosubtype. Serogroup Y and specific genosubtypes were linked to higher mortality, while certain other genosubtypes and penicillin G resistance were associated with decreased fatality.
Area of Science:
- Microbiology
- Epidemiology
- Vaccinology
Background:
- Neisseria meningitidis causes invasive meningococcal disease with varying fatality rates.
- Understanding isolate characteristics is crucial for disease prevention and vaccine development.
Purpose of the Study:
- To characterize fatal and non-fatal meningococcal isolates in Sweden (1995-2004).
- To identify factors associated with mortality.
- To estimate the coverage of existing outer membrane vesicle (OMV) vaccines against fatal isolates.
Main Methods:
- Analysis of 62 fatal and 474 non-fatal meningococcal isolates.
- Characterization by serogroup, serotype, genosubtype, multilocus sequence type, and antibiogram.
- Gathering of basic epidemiological data.
Main Results:
- Serogroup B predominated in fatal isolates (55%), followed by C (27%), Y (15%), and W-135 (3%).
- Higher mortality was associated with serogroup Y, specific serotypes (14, 15), and certain genosubtypes.
- Reduced penicillin G sensitivity and other specific genosubtypes correlated with decreased mortality.
Conclusions:
- Specific genosubtypes and serogroups influence meningococcal disease mortality.
- Outer membrane vesicle (OMV) vaccines show theoretical coverage potential for fatal serogroup B cases.
- Further research into genosubtype-specific immunity is warranted for vaccine improvement.
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