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Published on: November 5, 2019
A decade of invasive meningococcal disease surveillance in Poland
Anna Skoczyńska1, Izabela Waśko, Alicja Kuch
1National Reference Centre for Bacterial Meningitis, Department of Epidemiology and Clinical Microbiology, National Medicines Institute, Warsaw, Poland.
Background:
Neisseria meningitidis is a leading etiologic agent of severe invasive disease. The objective of the study was to characterise invasive meningococcal disease (IMD) epidemiology in Poland during the last decade, based on laboratory confirmed cases.
Methods:
The study encompassed all invasive meningococci collected between 2002 and 2011 in the National Reference Centre for Bacterial Meningitis. The isolates were re-identified and characterised by susceptibility testing, MLST analysis, porA and fetA sequencing. A PCR technique was used for meningococcal identification directly from clinical materials.
Results:
In the period studied, 1936 cases of IMD were confirmed, including 75.6% identified by culture. Seven IMD outbreaks, affecting mostly adolescents, were reported; all were caused by serogroup C meningococci of ST-11. The highest incidence was observed among children under one year of age (15.71/100,000 in 2011). The general case fatality rate in the years 2010-2011 was 10.0%. Meningococci of serogroup B, C, Y and W-135 were responsible for 48.8%, 36.6%, 1.2% and 1.2% of cases, respectively. All isolates were susceptible to third generation cephalosporins, chloramphenicol, ciprofloxacin, and 84.2% were susceptible to penicillin. MLST analysis (2009-2011) revealed that among serogroup B isolates the most represented were clonal complexes (CC) ST-32CC, ST-18CC, ST-41/44CC, ST-213CC and ST-269CC, and among serogroup C: ST-103CC, ST-41/44CC and ST-11CC.
Conclusions:
The detection of IMD in Poland has changed over time, but observed increase in the incidence of the disease was mostly attributed to changes in the surveillance system including an expanded case definition and inclusion of data from non-culture diagnostics.
Insights
Invasive meningococcal disease (IMD) epidemiology in Poland showed changes over a decade, with serogroup B and C strains being most common. Increased detection is linked to improved surveillance and diagnostics.
Area of Science:
- Microbiology
- Epidemiology
- Infectious Diseases
Background:
- Neisseria meningitidis is a primary cause of severe invasive illness.
- Understanding invasive meningococcal disease (IMD) epidemiology is crucial for public health.
- This study focuses on laboratory-confirmed IMD cases in Poland.
Purpose of the Study:
- To characterize the epidemiology of invasive meningococcal disease (IMD) in Poland.
- To analyze trends in IMD over a ten-year period (2002-2011).
- To identify causative serogroups and genetic profiles of meningococcal isolates.
Main Methods:
- Analysis of 1936 laboratory-confirmed invasive meningococcal disease cases from 2002-2011.
- Bacterial isolate characterization: identification, antimicrobial susceptibility testing, Multi-Locus Sequence Typing (MLST), porA and fetA sequencing.
- Polymerase Chain Reaction (PCR) used for direct meningococcal identification from clinical samples.
Main Results:
- Serogroup B and C meningococci were predominant, causing 48.8% and 36.6% of cases, respectively.
- Highest incidence observed in children under one year; case fatality rate was 10.0% in 2010-2011.
- Seven serogroup C (ST-11) outbreaks occurred, primarily affecting adolescents. Isolates showed high susceptibility to cephalosporins and ciprofloxacin.
Conclusions:
- Changes in IMD detection over time are attributed to enhanced surveillance systems.
- Improved case definitions and inclusion of non-culture diagnostics influenced incidence reporting.
- Continued monitoring of IMD epidemiology is essential for effective control strategies.
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