Changes in Serogroup and Genotype Prevalence Among Carried Meningococci in the United Kingdom During Vaccine Implementation

Ibarz-Pavón, Ana Belén; MacLennan, Jenny; Andrews, Nicholas; Gray, Stephen J.; Urwin, Rachel; Clarke, Stuart C.; Walker, A. Earl; Evans, Meirion Rhys; Kroll, J. Simon; Neal, Keith; Ala’Aldeen, Dlawer A. A.; Crook, Derrick W.; Cann, Kathryn; Harrison, Sarah M.; Cunningham, Richard; Baxter, David; Kaczmarski, Edward B.; McCarthy, Noel D.; Jolley, Keith A.; Cameron, J. Claire; Stuart, James M.; Maiden, Martin C. J.

doi:10.1093/infdis/jir466

Cited by 43 publications

(48 citation statements)

References 51 publications

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“…In general, cc22 typically show serogroup W characteristics. An over 50% incidence of cc22 in the above-mentioned serogroup has been reported by a UK study [37]. Strains of serogroup W, cc11 are characterised by a high case fatality rate [38].…”

Section: Discussionmentioning

confidence: 99%

Serogroup and Clonal Characterization of Czech Invasive Neisseria meningitidis Strains Isolated from 1971 to 2015

et al. 2016

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BackgroundThis study presents antigenic and genetic characteristics of Neisseria meningitidis strains recovered from invasive meningococcal disease (IMD) in the Czech Republic in 1971–2015.Material and MethodsA total of 1970 isolates from IMD, referred to the National Reference Laboratory for Meningococcal Infections in 1971–2015, were studied. All isolates were identified and characterized by conventional biochemical and serological tests. Most isolates (82.5%) were characterized by multilocus sequence typing method.ResultsIn the study period 1971–2015, the leading serogroup was B (52.4%), most often assigned to clonal complexes cc32, cc41/44, cc18, and cc269. A significant percentage of strains were of serogroup C (41.4%), with high clonal homogeneity due to hyperinvasive complex cc11, which played an important role in IMD in the Czech Republic in the mid-1990s. Serogroup Y isolates, mostly assigned to cc23, and isolates of clonally homogeneous serogroup W have also been recovered more often over the last years.ConclusionThe incidence of IMD and distribution of serogroups and clonal complexes of N. meningitidis in the Czech Republic varied over time, as can be seen from the long-term monitoring, including molecular surveillance data. Data from the conventional and molecular IMD surveillance are helpful in refining the antimeningococcal vaccination strategy in the Czech Republic.

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Section: Discussionmentioning

confidence: 99%

Serogroup and Clonal Characterization of Czech Invasive Neisseria meningitidis Strains Isolated from 1971 to 2015

et al. 2016

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“…There is ample evidence that pneumoocccal, Haemophilus influenzae type b (Hib) and meningococcal serogroups A and C polysaccharide-protein conjugate vaccines decrease transmission of these organisms in the population [37-41]. For example, in the U.S. Hib conjugate vaccination at 18 to 72 months of age decreased disease incidence in children <18 months of age who at the time were not being vaccinated [42].…”

Section: Discussionmentioning

confidence: 99%

A native outer membrane vesicle vaccine confers protection against meningococcal colonization in human CEACAM1 transgenic mice

Pajón¹,

Buckwalter

Johswich

et al. 2015

Vaccine

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Background The effect of protein-based meningococcal vaccines on prevention of nasopharyngeal colonization has been difficult to investigate experimentally because a reliable animal colonization model did not exist. Methods Human CEACAM1 transgenic mice, which can be colonized by meningococci, were immunized IP with one of two meningococcal native outer membrane vesicle (NOMV) vaccines prepared from mutants with attenuated endotoxin (lpxL1 knockout) and over-expressed sub-family B Factor H-binding proteins (FHbp). Animals were challenged intranasally two weeks after the third dose with wild-type strain H44/76, or were treated IP with anti-NOMV serum before and during the bacterial challenge. Results The NOMV-1 vaccine, prepared from the serogroup B H44/76 mutant, elicited ~40-fold higher serum bactericidal antibody titers against the wild-type H44/76 challenge strain than the NOMV-2 vaccine prepared from a heterologous serogroup W mutant strain with different PorA and FHbp amino acid sequence variants. Compared to aluminum hydroxide-immunized control mice, the efficacy for prevention of any H44/76 colonization was 93% (95% confidence interval, 52-99, P<0.0001) for the NOMV-1 vaccine, and 19% (−3-36, P=0.23) for NOMV-2. NOMV-2-vaccinated mice had a 5.6-fold decrease in geometric mean CFU of bacteria per animal in tracheal washes compared to control mice (P=0.007). The efficacy of passive administration of serum from NOMV-1-vaccinated mice to immunologically naïve mice against colonization was 44% (17-61; P=0.002). Conclusions Both NOMV vaccines protected against meningococcal colonization but there was greater protection by the NOMV-1 vaccine with antigens matched with the challenge strain. Meningococcal vaccines that target protein antigens have potential to decrease colonization.

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“…Although localized ST-269cc outbreaks [29], [30] and some increases in the number and proportion of ST-269cc were observed over time [32], [33], [34], reported increases have not been as dramatic as in Quebec in terms of rapidity and magnitude, neither has ST-269cc become a predominant clone. Overall prevalence of this strain in other parts of the world remains low, with the highest proportion of ST-269cc (36%) among all IMD having been reported in England and Wales between 2006 and 2010 [35].…”

Section: Discussionmentioning

confidence: 99%

The Changing Epidemiology of Meningococcal Disease in Quebec, Canada, 1991–2011: Potential Implications of Emergence of New Strains

et al. 2012

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BackgroundIn order to inform meningococcal disease prevention strategies, we analysed the epidemiology of invasive meningococcal disease (IMD) in the province of Quebec, Canada, 10 years before and 10 years after the introduction of serogroup C conjugate vaccination.MethodologyIMD cases reported to the provincial notifiable disease registry in 1991–2011 and isolates submitted for laboratory surveillance in 1997–2011 were analysed. Serogrouping, PCR testing and assignment of isolates to sequence types (ST) by using multilocus sequence typing (MLST) were performed.ResultsYearly overall IMD incidence rates ranged from 2.2–2.3/100,000 in 1991–1992 to 0.49/100,000 in 1999–2000, increasing to 1.04/100,000 in 2011. Among the 945 IMD cases identified by laboratory surveillance in 1997–2011, 68%, 20%, 8%, and 3% were due to serogroups B, C, Y, and W135, respectively. Serogroup C IMD almost disappeared following the implementation of universal childhood immunization with monovalent C conjugate vaccines in 2002. Serogroup B has been responsible for 88% of all IMD cases and 61% of all IMD deaths over the last 3 years. The number and proportion of ST-269 clonal complex has been steadily increasing among the identified clonal complexes of serogroup B IMD since its first identification in 2003, representing 65% of serogroup B IMD in 2011. This clonal complex was first introduced in adolescent and young adults, then spread to other age groups.ConclusionImportant changes in the epidemiology of IMD have been observed in Quebec during the last two decades. Serogroup C has been virtually eliminated. In recent years, most cases have been caused by the serogroup B ST-269 clonal complex. Although overall burden of IMD is low, the use of a vaccine with potential broad-spectrum coverage could further reduce the burden of disease. Acceptability, feasibility and cost-effectiveness studies coupled with ongoing clinical and molecular surveillance are necessary in guiding public policy decisions.

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Changes in Serogroup and Genotype Prevalence Among Carried Meningococci in the United Kingdom During Vaccine Implementation

Cited by 43 publications

References 51 publications

Serogroup and Clonal Characterization of Czech Invasive Neisseria meningitidis Strains Isolated from 1971 to 2015

Serogroup and Clonal Characterization of Czech Invasive Neisseria meningitidis Strains Isolated from 1971 to 2015

A native outer membrane vesicle vaccine confers protection against meningococcal colonization in human CEACAM1 transgenic mice

The Changing Epidemiology of Meningococcal Disease in Quebec, Canada, 1991–2011: Potential Implications of Emergence of New Strains

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