Multilocus sequence typing for global surveillance of meningococcal disease

Abstract

The global surveillance of bacterial pathogens is particularly important for bacteria with diverse and dynamic populations that cause periodic epidemics or pandemics. The isolate characterization methods employed for surveillance should: (1) generate unambiguous data; (2) be readily implemented in a variety of scenarios and be reproducible among laboratories; (3) be scalable and preferably available in a high throughput format; and (4) be cost effective. Multilocus sequence typing (MLST) was designed to meet these criteria and has been implemented effectively for a wide range of microorganisms. The 'Impact of meningococcal epidemiology and population biology on public health in Europe (EU-MenNet)' project had amongst its objectives: (1) to disseminate meningococcal MLST and sequence-based typing throughout Europe by establishing a centre for training and data generation, and (2) to produce a comprehensive Europe-wide picture of meningococcal disease epidemiology for the first time. Data produced from the project have shown the distribution of a relatively small number of STs, clonal complexes and PorA types that account for a large proportion of the disease-associated isolates in Europe. The project demonstrates how molecular typing can be combined with epidemiological data via the Internet for global disease surveillance.

Clonal Distribution of Disease-Associated and Healthy Carrier Isolates ofNeisseria meningitidisbetween 1983 and 2005 in Cuba

“…Furthermore, our results can be used to improve the continuous monitoring of the distribution of the circulating meningococcal strains in Cuba in the postvaccination era. This study also confirms the original concept that sequence typing methods are important for evolutionary analyses and for examining meningococcal transmission and evolution and the impacts of vaccines on meningococci (4,28).…”

Interlaboratory Standardization of the Sandwich Enzyme-Linked Immunosorbent Assay Designed for MATS, a Rapid, Reproducible Method for Estimating the Strain Coverage of Investigational Vaccines

“…These patterns of variation do not account for additional surface proteins such as the three recombinant antigens included in 4CMenB (2) because of the high rates of recombination affecting the meningococcal chromosome (4,8). Moreover, MLST and antigen genotyping do not account for expression levels or cross-reactivity to various antigen variants present on pathogenic strains (3,7,19). To determine the potential impact of 4CMenB on endemic MenB bacteria in different countries or regions, a new method was needed to account for fHbp, NadA, and NHBA diversity and expression, which varies among strains.…”

Clonal Analysis of Neisseria meningitidis Serogroup B Strains in South Africa, 2002 to 2006: Emergence of New Clone ST-4240/6688

“…In the United States, the state of Oregon continues to experience an ST-32/ET-5 outbreak, which began in 1993 (14,46). ST-269 has expanded in Europe in recent years and is responsible for a substantial portion of invasive disease (2,15,31,57). There have been reports of an increase in ST-269 following the introduction of the meningococcal C vaccine in Canada (30) and Scotland (15), with suggestions of possible capsule switching (between C and B) in Canada.…”