Intern
    Meningokokken und Haemophilus Influenzae

    Data on the laboratory-based surveillance of meningococci, 2014

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    1) Introduction

    The Reference Centre for Meningococci and Haemophilus influenzae (NRZMHi) is assigned by the RKI with the performance of laboratory based surveillance of invasive meningococcal disease (IMD). In the year 2014 393 samples from 338 individuals were analyzed. The NRZMHi confirmed Neisseria meningitidis in 269 patients, in 250 of them from primarily sterile compartments (latter figure corresponds to the number of cases with invasive disease). During the same period 275 cases of IMD were notified to the RKI (data as of 20.2.2015, cf. SurvStat@RKI). These figures reflect a further reduction of the incidence rate to 0.34/100,000 compared to 2013 (0.42/100,000). Given that all processed cases of IMD were notified retrospectively, one can assume a 91% coverage of disease by NRZMHi (in 2013: 86%). In 44 patients (out of 250) detection of meningococci was carried out using molecular techniques only.

    The proportion of serogroup C disease dropped slightly (17,5%), while that of serogroup B increased (70,1%). Serogroup Y isolates decreased to 7,7%, while serogroup W hardly changed (3,7%).

    In total 108 different finetypes were observed. The most common were B:P1.7-2,4:F1-5 (26, 11.1%), C:P1.5,2:F3-3 (16, 6.8%), B:P1.22,14:F5-5 (12, 5.1%), Y:P1.5-2,10-1:F4-1 (11, 4.7%) and B:P1.22,14:F5-1 (9, 3.8%).

    2) Serogroups 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. Above table contains 245 cases. In 4 cases the serogroup could not be determined. In 1 case the address of the patient remained unknown.

    3) Serogroups according to age groups

    4) Frequency distribution of common variants of PorA

    5) Frequency distribution of common variants of FetA

    6) Common finetypes according to age groups

    7) Antibiotic susceptibilities (according to EUCAST breakpoints)

    Penicillin-intermediate isolates decreased to 19,1%, while resistant isolates rose to 2,9%. Rifampicin-intermediate strains accounted for 0,5%. Ciprofloxacin-nonsusceptible strains were not detected.

    8) Geographic distribution of common types

    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)

    Note: The spatial distribution of  serogroup B and C cases is similar; finetype B:P1.7-2,4:F1-5 still appears to be more common in the west.  Finetype C:P1.5,2:F3-3 continues to appear sporadically. All 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 NRZMHi or RKI. Commercial use is strictly prohibited. Inclusion of figures or tables in talks or oral presentations is not allowed.

    Version 0.2 © NRZMHi 2015

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