An outbreak of severe invasive meningococcal disease due to a capsular switched Neisseria meningitidis hypervirulent strain B:cc11

Stefanelli, Paola; Fazio, Cecilia; Vacca, Paola; Palmieri, Annapina; Ambrosio, Luigina; Neri, Arianna; Piana, Andrea; Castiglia, Paolo; Argiolas, F; Santus, S.; Masala, Laura; Steri, Gary; Riccardo, Flavia; Iannazzo, Stefania; Maraglino, Francesco; D’Amario, Claudio; Rezza, Giovanni

doi:10.1016/j.cmi.2018.07.014

Cited by 19 publications

(22 citation statements)

References 6 publications

(8 reference statements)

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“…A higher incidence of MenB was observed in the age group less than 1 year of age (1.53 cases per 100,000 inhabitants), in the age groups 10-14 (0.10 cases per 100,000 inhabitants) and 15-24 (0.25 cases per 100,000 inhabitants) years of age, data from the Italian National Surveillance System. An outbreak of MenB has described in Italy due to the switch from C to B of cc11 strain [22].…”

Section: Discussionmentioning

confidence: 99%

Meningococcal B vaccine antigen FHbp variants among disease-causing Neisseria meningitidis B isolates, Italy, 2014–2017

et al. 2020

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Background Typing of Neisseria meningitidis isolates is crucial for the surveillance of invasive meningococcal disease (IMD). We performed a molecular epidemiology study of N. meningitidis serogroup B (MenB) causing IMD in Italy between 2014 and 2017 to describe circulating strains belonging to this serogroup, with particular regards to the two factor H-binding protein (FHbp) subfamilies present in the bivalent MenB vaccine. Materials and methods A total of 109 culture positive and 46 culture negative MenB samples were collected within the National Surveillance System (NSS) of IMD in Italy and molecularly analyzed by conventional methods. Results Overall, 71 MenB samples showed the FHbp subfamily A and 83 the subfamily B. The subfamily variants were differently distributed by age. The most frequent variants, A05 and B231, were associated with cc213 and cc162, respectively. All MenB with the FHbp A05 variant displayed the PorA P1.22,14 and 85.7% of them the FetA F5-5. The majority of MenB with the FHbp B231 variant showed the PorA P1.22,14 (65.4%) and 84.6%, the FetA F3-6. Conclusion MenB circulating in Italy were characterized by a remarkable association between clonal complex and FHbp variants, although a high degree of genetic diversity observed over time. A dynamic trend in clonal complexes distribution within MenB was detected. Our results stress the importance of continued meningococcal molecular surveillance to evaluate the potential vaccine coverage of the available MenB vaccines.

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Section: Discussionmentioning

confidence: 99%

Meningococcal B vaccine antigen FHbp variants among disease-causing Neisseria meningitidis B isolates, Italy, 2014–2017

et al. 2020

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“…Adolescents are a major source of transmission of the micro-organism, as they often frequent crowded places of social aggregation (e.g., schools, universities and pubs), as revealed by some recent outbreaks [50]. In 2018, seven cases of meningitis caused by N. meningitidis B were reported in Sardinia (Italy) in young people who had attended a nightclub [51], none of whom had been vaccinated.…”

Section: Discussionmentioning

confidence: 99%

Why the Anti-Meningococcal B Vaccination during Adolescence Should Be Implemented in Italy: An Overview of Available Evidence

et al. 2020

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Although meningococcal disease has a low incidence in Italy, it is a public health concern owing to its high lethality rate and high frequency of transitory and/or permanent sequelae among survivors. The highest incidence rates are recorded in infants, children and adolescents, and most of the cases are due to Neisseria meningitidis B. In Italy, anti-meningococcal B (anti-MenB) vaccination is free for infants but, despite the considerable disease burden in adolescents, no national recommendation to vaccinate in this age-group is currently available. The aim of this study was to assess the main available scientific evidence to support the Italian health authorities in implementing a program of free anti-MenB vaccination for adolescents. We conducted an overview of the scientific literature on epidemiology, disease burden, immunogenicity and safety of available vaccines, and economic evaluations of vaccination strategies. Each case of invasive meningococcal disease generates a considerable health burden (lethality rate: 9%; up to 60% of patients experience at least one sequela) in terms of impaired quality of life for survivors and high direct and indirect costs (the mean overall cost of acute phase for a single case amounts to about EUR 13,952; the costs for post-acute and the long-term phases may vary widely depending of the type of sequela, reaching an annual cost of about EUR 100,000 in cases of severe neurological damage). Furthermore, vaccination against meningococcus B in adolescence proved cost-effective. The study highlights the need to actively offer the anti-MenB vaccination during adolescence at a national level. This would make it possible to avoid premature deaths and reduce the high costs borne by the National Health Service and by society of supporting survivors who suffer temporary and/or permanent sequelae.

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“…The MenC ST-11 cc has been responsible for sporadic cases or outbreaks in several countries, even after the introduction of the meningococcal serogroup C conjugate vaccine [ 25 , 26 ]. Capsular switching events from C to B or W strains are not rare within the cc11 [ 24 , 27 ]. However, in contrast to findings obtained in other countries [ 25 , 28 ], all isolates associated with the ST-11 cc in this study were serogroup C. ST-178 was previously reported in nongroupable meningococcal carriage isolates collected in students aged 15–21 years in Colombia [ 12 ], in military recruits in Finland [ 29 ] and in students in the United Kingdom [ 30 ], but only one invasive isolate was found in the PubMLST database ( http://pubmlst.org/software/database/bigsdb Accessed 16 November 2019).…”

Section: Discussionmentioning

confidence: 99%

Molecular characterization of Neisseria meningitidis isolates recovered from patients with invasive meningococcal disease in Colombia from 2013 to 2016

et al. 2020

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Background Neisseria meningitidis is a significant cause of morbidity and mortality worldwide. Meningococcal isolates have a highly dynamic population structure and can be phenotypically and genetically differentiated into serogroups and clonal complexes. The aim of this study was to describe the phenotypic and genotypic characteristics of invasive isolates recovered in Colombia from 2013 to 2016. Methodology A total of 193 invasive isolates were analyzed. Phenotypic and genotypic characteristics were determined by serotyping, antimicrobial susceptibility testing, pulsed-field gel electrophoresis (PFGE) and whole-genome sequencing. Results Based on the results, meningococcal serogroups C, B and Y were responsible for 47.9%, 41.7%, and 9.4% of cases, respectively, and the distribution of serogroups B and C changed over time. Fifteen clonal groups and 14 clonal complexes (cc) were identified by PFGE and genome sequencing. The main clonal group included serogroup B isolates with sequence type (ST)-9493 and its four single-locus variants, which has only been identified in Colombian isolates. The clonal population structure demonstrates that the isolates in this study mainly belong to four clonal complexes: ST-11 cc, ST-32 cc, ST-35 cc and ST-41/44 cc. Thirty-eight pen A alleles were identified, but no correlation between MICs and specific sequences was observed. Conclusion This study shows that most meningococcal isolates recovered from patients with invasive meningococcal disease in Colombia are strains associated with distinct globally disseminated hyperinvasive clones.

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An outbreak of severe invasive meningococcal disease due to a capsular switched Neisseria meningitidis hypervirulent strain B:cc11

Cited by 19 publications

References 6 publications

Meningococcal B vaccine antigen FHbp variants among disease-causing Neisseria meningitidis B isolates, Italy, 2014–2017

Meningococcal B vaccine antigen FHbp variants among disease-causing Neisseria meningitidis B isolates, Italy, 2014–2017

Why the Anti-Meningococcal B Vaccination during Adolescence Should Be Implemented in Italy: An Overview of Available Evidence

Molecular characterization of Neisseria meningitidis isolates recovered from patients with invasive meningococcal disease in Colombia from 2013 to 2016

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