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Published on: October 24, 2010
An analysis of Neisseria meningitidis strains causing meningococcal septic arthritis in England and Wales: 2010-2020
George Gyamfi-Brobbey1, Stephen A Clark2, Helen Campbell3
1Vaccine Evaluation Unit, UK Health Security Agency, Manchester Royal Infirmary, Oxford Road, Manchester, United Kingdom.
Objectives:
To analyze clinical meningococcal strains associated with meningococcal septic arthritis cases in England and Wales, and to identify associations between patient age, the synovial joint affected and strain characteristics.
Methods:
IMD cases confirmed by the Meningococcal Reference Unit (UK Health Security Agency) between January 2010 and December 2020 were included in the analysis. Septic arthritis cases were defined as those featuring detection and/or isolation of N. meningitidis from an articular site. Capsular grouping was performed by serology on clinical isolates and/or real-time PCR on clinical samples.
Results:
We identified 162 cases of meningococcal septic arthritis, representing 2% of all invasive meningococcal disease cases during the study period. The knee and the hip were the most commonly affected joints, with the former significantly more frequent in adults and the latter seen more commonly in children and adolescents. Group B strains were between 2 and 6 times less likely to cause septic arthritis in relation to groups W, C and Y strains.
Conclusions:
Meningococcal septic arthritis remains a rare manifestation of invasive meningococcal disease. Strain and age associations identified in this study remain unexplained. Future analyzes including clinical case information may help to explain these findings.
Insights
Meningococcal septic arthritis is rare, affecting 2% of invasive meningococcal disease cases. Group B strains are less likely to cause septic arthritis compared to other groups.
Area of Science:
- Clinical microbiology
- Infectious diseases
- Rheumatology
Background:
- Invasive meningococcal disease (IMD) can lead to rare complications like septic arthritis.
- Understanding the characteristics of meningococcal strains causing septic arthritis is crucial for public health.
Observation:
- This study analyzed 162 cases of meningococcal septic arthritis in England and Wales between 2010 and 2020.
- The knee and hip were most frequently affected joints, with age-related differences observed.
- Group B meningococcal strains were less likely to cause septic arthritis than groups W, C, and Y.
Findings:
- Meningococcal septic arthritis represents a small but significant proportion of IMD cases.
- Specific joints are preferentially affected based on patient age.
- There is a notable difference in the propensity of different meningococcal serogroups to cause septic arthritis.
Implications:
- Meningococcal septic arthritis, though rare, warrants clinical awareness.
- Further research is needed to elucidate the mechanisms behind strain and age associations.
- Integrating clinical data may enhance understanding of this meningococcal complication.
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