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Australian Meningococcal Surveillance Programme annual report, 2017
Monica M Lahra1, Rodney P Enriquez2, C R Robert George2
1The National Neisseria Network, Australia; Neisseria Reference Laboratory and World Health Organisation Collaborating Centre for STD, Sydney; New South Wales Health Pathology, Microbiology, The Prince of Wales Hospital, Randwick, NSW Australia;School of Medical Sciences, Faculty of Medicine, The University of New South Wales, 2053 Australia.
Abstract:
In 2017, there were 374 laboratory-confirmed cases of invasive meningococcal disease (IMD) analysed by the Australian National Neisseria Network. This was the highest number of laboratory-confirmed cases since 2003. Probable and confirmed cases of IMD are notifiable in Australia; there were 379 IMD cases notified to the National Notifiable Diseases Surveillance System in 2017, the highest number reported since 2005. Meningococcal sero-grouping was determined for 98% (367/374) of laboratory-confirmed IMD cases. Serogroup B infections accounted for 137 cases (37%). The number of serogroup W infections (141 cases, 38%) in 2017 was the highest since the Australian Meningococcal Surveillance Programme (AMSP) began. In addition, the number and proportion of serogroup Y infections (75 cases, 20%) was also the highest recorded by the AMSP. Molecular typing results were available for 315 of the 374 IMD cases (83%). Of the serogroup W IMD strains that were able to be genotyped, 97% (125/129) had the PorA antigen encoding gene type P1.5,2 and of these, 59% (74/125) were sequence type 11, the same type as the hypervirulent serogroup W strain that has been circulating in the UK and South America since 2009. The primary IMD age peak was observed in adults aged 45 years or more, whilst secondary disease peaks were observed in those aged less than 5 years. Serogroup B infections predominated in the age group 15-19 years. Serogroup W infections predominated in those aged 65 years or more. Serogroup Y infections were predominately seen in adults aged 45 years or more. Of the IMD isolates tested for antimicrobial susceptibility, 5.1% (14/276) were resistant to penicillin; decreased susceptibility to penicillin was observed in a further 89% (247/276) of isolates. All isolates tested were susceptible to ceftriaxone; two isolates were less susceptible to ciprofloxacin; and one isolate was resistant to rifampicin.
Insights
Invasive meningococcal disease (IMD) cases in Australia reached a 14-year high in 2017, with serogroup W and Y infections at record levels. Serogroup B remained prevalent in younger individuals, while W and Y strains showed distinct age distributions.
Area of Science:
- Public Health and Epidemiology
- Infectious Diseases
- Microbiology
Background:
- Invasive meningococcal disease (IMD) is a significant public health concern in Australia.
- Surveillance data is crucial for understanding trends and guiding public health interventions.
- 2017 marked a notable increase in reported IMD cases.
Purpose of the Study:
- To analyze the epidemiological and microbiological characteristics of laboratory-confirmed IMD cases in Australia in 2017.
- To identify trends in serogroup distribution, age-specific incidence, and antimicrobial resistance patterns.
- To compare findings with historical data and circulating international strains.
Main Methods:
- Analysis of 374 laboratory-confirmed IMD cases reported to the Australian National Neisseria Network in 2017.
- Serogroup determination for 98% of cases.
- Molecular typing (genotyping) of strains, including PorA and sequence typing for serogroup W isolates.
- Antimicrobial susceptibility testing for penicillin, ceftriaxone, ciprofloxacin, and rifampicin.
Main Results:
- A total of 374 laboratory-confirmed IMD cases were reported, the highest since 2003.
- Serogroup B (37%) and W (38%) were the most common, with serogroup W reaching record high numbers.
- Serogroup Y also showed a record high proportion (20%).
- Serogroup W strains predominantly belonged to sequence type 11, consistent with hypervirulent international strains.
- Primary IMD peak was in adults aged 45+, with secondary peaks in children <5 years.
- Serogroup B predominated in 15-19 year olds, W in those aged 65+, and Y in adults aged 45+.
- 5.1% of isolates were resistant to penicillin, with decreased susceptibility in 89%; all isolates were susceptible to ceftriaxone.
Conclusions:
- 2017 saw a significant increase in IMD cases in Australia, driven by serogroups W and Y.
- The genetic characteristics of serogroup W strains suggest ongoing transmission of hypervirulent clones.
- Age distribution varied by serogroup, highlighting the need for targeted prevention strategies.
- Emerging antimicrobial resistance, particularly to penicillin, warrants continued monitoring.
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