Serogroup C meningococcal disease outbreak associated with 
discotheque attendance during carnival

Hauri, Anja M.; Ehrhard, Ingrid; Frank, Uwe; Ammer, Julia; Fell, Gerhard; Hamouda, Osamah; Petersen, Luis

doi:10.1017/s0950268899003416

Cited by 19 publications

(12 citation statements)

References 18 publications

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“…Epidemiologically related isolates gave similar results. For example, 28 ET-37 complex strains belonging to clone ET-15, which were isolated in the Czech Republic or Bavaria between 1993 and 1998 (18,23,24), were positive for all probes used. The genomic loci 37/1-7 (putative R-M system) and 37/1-26 (puta -FIG.…”

Section: Resultsmentioning

confidence: 99%

Genetic Isolation of Meningococci of the Electrophoretic Type 37 Complex

et al. 2001

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Neisseria meningitidis (the meningococcus) is a naturally competent bacterial species in which intra-and interspecific horizontal gene transfer is a major source of genetic diversity. In strains of the electrophoretic type 37 (ET-37) complex and of the A4 cluster, we identified genomic DNA coding for a novel restrictionmodification system and for the tail of a previously unidentified prophage. Furthermore, a novel 7.2-kb DNA segment restricted to clones of the ET-37 complex and the A4 cluster was isolated and shown to occur both as a plasmid (pJS-B) and as a chromosomal integration. Neither the genomic loci nor pJS-B was present in ET-5 complex, lineage 3, or serogroup A meningococci. The differential distribution of the DNA segments described herein, as well as of opcA, porB, nmeAI, nmeBI, and nmeDI described previously, supports the concept of genetic isolation of hypervirulent lineages responsible for most cases of serogroup C disease worldwide.The species Neisseria meningitidis is composed of a large variety of clones and clonal groupings (reviewed in reference 1). The majority of clones colonizing the nasopharynx of humans should be regarded as avirulent (7), and only a few hypervirulent clonal groupings are responsible for the majority of disease in humans. In Europe, serogroup B disease is caused mainly by the electrophoretic type 5 (ET-5) complex and lineage 3 whereas serogroup C disease is caused by the ET-37 complex and the A4 cluster (reviewed in reference 1). Horizontal gene transfer within the naturally competent species and with commensal neisseriae has resulted in genetic variability (2,(11)(12)(13)27), but it has been demonstrated that hypervirulent lineages of both serogroups B and C can be readily distinguished by the presence or absence of several genomic loci; e.g., the ET-5 complex and lineage 3 are characterized by a class 3 porB gene, whereas a class 2 gene is found in the ET-37 complex and the A4 cluster (9, 43). Isotype I of the tbpB gene is restricted to meningococci of the ET-37 complex, while other hypervirulent lineages harbour isotype II (31). Furthermore, the latter lack the gene encoding the adhesin OpcA (32,44).We recently demonstrated a differential distribution of three novel restriction-modification (R-M) systems, nmeAI, nmeBI, and nmeDI (10), while a lineage 3-specific R-M system was described by Bart et al. (3). The differential distribution of meningococcal genes can be caused by rapid expansion of lineages with increased fitness, bottlenecking, periodic selection, and immune selection, which are mechanisms antagonizing the effects of recombination (2,15,16,26,33). In addition, we recently provided evidence that sexual isolation of clonal groupings is caused by differentially distributed R-M systems which partially disrupt genetic transformation (10). In the present study we have extended the list of currently known differentially distributed genes. We compared the ET-37 complex with the ET-5 complex by plasmid profiling and representational difference analysis (RDA). We id...

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Section: Resultsmentioning

confidence: 99%

Genetic Isolation of Meningococci of the Electrophoretic Type 37 Complex

et al. 2001

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“…(ii) A short-term, spatially confined cluster with two banding patterns. This group is represented by a single cluster in the county of Rottal/Inn, which emerged in February 1998 after the carnival season (19). Here, IS1301-RFLP revealed two distinct patterns.…”

Section: Resultsmentioning

confidence: 77%

“…Germany, their rate between 2002 and 2005 was 6.1%), their particular epidemiologic profile sets them apart from other hypervirulent lineages. Since their emergence in Canada (2) and worldwide spread therefrom, they have featured regularly in reports describing outbreaks (5,19,20,25,26,44) and rises in incidences in several countries (29-31, 43, 51). Also, the generally graver clinical picture of invasive disease caused by this clone (14,30,51) further delineates its epidemiologic distinctiveness.…”

Section: Resultsmentioning

confidence: 99%

“…A difference of several independent markers, i.e., PorA, FetA, and IS1301 insertions, during a temporarily confined cluster is unlikely due to diversification occurring during the spread of the outbreak strain within a few days. It can rather be assumed that in the case of the carnival-associated cluster in Rottal/Inn (19), locally prevalent risk factors and risk behavior (45) promoted the independent attack by two different strains.…”

Section: Discussionmentioning

confidence: 99%

“…Finally, 57 strains were selected from the strain collection of the Reference Centre for Meningococci in Germany. Of these, five were previously typed by MLEE (19). For the remaining 50 serogroup C and 2 serogroup B strains, MLST confirmed ST-11.…”

Section: Methodsmentioning

confidence: 96%

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IS1301Fingerprint Analysis ofNeisseria meningitidisStrains Belonging to the ET-15 Clone

Elias

Vogel

2007

J Clin Microbiol

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Meningococci of the ET-15 clone frequently cause clusters of invasive meningococcal disease (IMD) and are associated with a high case-fatality ratio. Timely typing of strains from outbreaks of IMD caused by this clone is hampered by the low variability of its surface antigens. We present a new Southern blot-based typing method for ET-15 meningococci based on the insertion element IS1301, which was present in all 70 ET-15 strains tested. Fingerprints were stable in vitro over a period of 100 days of cultivation on agar plates. The discriminatory power of IS1301 fingerprinting exceeded that of typing by serogrouping and antigen sequencing of the outer membrane proteins PorA and FetA, as determined by the analysis of 52 epidemiologically unrelated strains. In addition, the method provided conclusive results with regard to the comparison of strains from clusters of IMD. The investigation of insertion sites of IS1301 revealed several new intragenic insertions, among others, into open reading frames homologous to mafB and tspB. A previously described insertion in nadA was present in more than two-thirds of the strains analyzed, suggesting that NadA is probably an unreliable vaccine candidate for the prevention of ET-15 disease.

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