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Australian Meningococcal Surveillance Programme annual report, 2015
Monica M Lahra1,2, Rodney P Enriquez1,
1Neisseria Reference Laboratory and World Health Organisation Collaborating Centre for STD, Sydney. Department of Microbiology, South Eastern Area Laboratory Services, The Prince of Wales Hospital, Randwick, New South Wales.
Communicable Diseases Intelligence Quarterly Report
|January 4, 2017
Summary
Invasive meningococcal disease (IMD) cases increased in Australia in 2015, with a significant rise in serogroup W and Y strains, particularly among adults. Serogroup B remained common in younger populations, while antibiotic resistance was generally low.
Area of Science:
- Epidemiology
- Infectious Diseases
- Microbiology
Background:
- Invasive meningococcal disease (IMD) is a notifiable condition in Australia.
- Surveillance data from 1994 to 2015 showed historical lows in IMD cases in 2013 and 2014.
- Understanding current trends in IMD epidemiology and serogroup distribution is crucial for public health interventions.
Purpose of the Study:
- To analyze the epidemiological and microbiological characteristics of invasive meningococcal disease (IMD) cases in Australia in 2015.
- To identify shifts in serogroup prevalence and molecular characteristics of circulating strains.
- To assess antimicrobial susceptibility patterns of IMD isolates.
Main Methods:
- Laboratory-confirmed IMD cases were analyzed by the Australian National Neisseria Network.
- Meningococcal serogrouping and molecular typing (including porA genotyping and ST determination) were performed.
- Antimicrobial susceptibility testing was conducted on IMD isolates.
Main Results:
- A total of 174 laboratory-confirmed IMD cases were reported in 2015, an increase from previous years.
- Serogroup B remained the most common (64.2%), but at its lowest reported proportion since 2003. Serogroup C cases were also at a record low (1.2%).
- A significant increase in serogroup W (21.4%) and Y (13.1%) cases was observed, reaching the highest levels since 1994. The majority of serogroup W strains were ST-11 (81%), matching hypervirulent strains found internationally.
- The primary age peak shifted to adults aged 45 years and over, with secondary peaks in young children and adolescents. Serogroups W and Y predominated in older adults, while serogroup B was more common in other age groups.
- All isolates were susceptible to ceftriaxone and ciprofloxacin. Resistance to rifampicin was rare (one isolate), and penicillin resistance was observed in 4 isolates, with decreased susceptibility in 86%.
Conclusions:
- The 2015 IMD data indicate a resurgence of the disease in Australia, driven by serogroups W and Y, particularly in adults.
- The emergence of the ST-11 serogroup W strain highlights the potential for rapid changes in circulating meningococcal genotypes.
- While overall antibiotic susceptibility remains high, monitoring for antimicrobial resistance, especially to penicillin, is warranted.
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