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    Meningokokken und Haemophilus Influenzae

    Data of the German Reference Centre for Meningococci, 2013

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    1) Introduction

    The German Reference Centre for Meningococci (NRZM) is assigned by the RKI to perform laboratory surveillance of invasive meningococcal disease. In 2013 the NRZM received 445 samples from 399 individuals. Neisseria meningitidis was detected in 315 patients, in 296 of them from sterile compartments like blood and cerebrospinal fluid (this figure corresponds to the number of patients with invasive disease). In comparison, 341 cases of invasive meningococcal disease were notified in 2013 to the RKI as of 2014-01-15, cf. SurvStat@RKI. This figure reflects an almost unchanged incidence rate of meningococcal disease (0.42/100.000, cf. SurvStat@RKI) compared to 2012. As the NRZM reports all processed cases (even retrospectively), a coverage of 86% of reported cases can be assumed (87% in the previous year). In 47 (out of 296) patients with invasive disease detection of meningococci was accomplished using non-cultural methods only.

    The proportion of disease due to serogroup C decreased slightly (19.8%), while that of  B did not change (67.7%). The proportion of Y slightly increased to 8.7%, while that of W135 remained almost unchanged at 3.8%.

    PorA and FetA continue to be used for "fine-typing" (cf. our reports from 2012, 2011, 2010, 2009, 2008, 2007, 2006, 2005 und 2004). In total 122 unique serogroup-PorA-FetA combinations (= "finetypes") were detected in 2013. The most common finetypes were B:P1.7-2,4:F1-5 (25, 9.1%), C:P1.5,2:F3-3 (20, 7.3%), C:P1.5-1,10-8:F3-6 (18, 6.5%), B:P1.7,16:F3-3 (17, 6.2%), and Y:P1.5-2,10-1:F4-1 (15, 5.5%).

    2) Serogroup distribution according to federal states

    BW: Baden-Württemberg, BY: Bavaria, BE: Berlin, BB: Brandenburg, HB: Bremen, HH: Hamburg, HE: Hesse, MV: Mecklenburg-West-Pomerania, NI: Lower-Saxony, NW: Nordrhine-Westphalia, RP: Rhineland-Palatinate, SL: Saarland, SN: Saxony, ST: Saxony-Anhalt, SH: Schleswig-Holstein, TH: Thuringia, Au: living abroad, unk: unknown. The table contains 288 cases. In 8 cases the serogroup could not be determined (these cases are not displayed). In two cases the address could not be verified.

    3) Serogroup distribution according to age groups

    4) Abundance of PorA types

    5) Abundance of FetA types

    6) Abundance of common finetypes according to age groups

    7) Antibiotic susceptibility of invasive isolates (using breakpoints issued by EUCAST)

    Penicillin intermediate and resistant strains rose to 38.1% and 2.4%, respectively. Non-susceptible isolates regarding rifampicin, ciprofloxacin, and cefotaxim were not detected.

    8) Geographic distributions

    serogroup B (pink triangles)
    serogroup C (yellow triangles)
    B:P1.7-2,4:F1-5 (blue circles)
    C:P1.5,2:F3-3 (orange circles)

    Comments: The geographic distribution of B and C is similar. Moderate clustering of B:P1.7-2,4:F1-5 in western North-Rhine-Westphalia continues to be present. Finetype C:P1.5,2:F3-3 displays a sporadic distribution. Maps were generated with EpiScanGIS.

    9) Disclaimer

    Disclaimer: the above data were generated with federal funds (RKI). Scientific use is prohibited without prior written consent by NRZM or RKI. Commercial use is strictly prohibited. Inclusion of figures or tables in talks or oral presentations is not allowed.

    Version 0.3 © NRZM 2015