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    Meningokokken und Haemophilus Influenzae

    Data of the German Reference Centre for Meningococci (NRZM) 2010

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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 (IMD). In the year 2010 453 samples originating from 400 individuals were processed. The NRZM detected Neisseria meningitidis in 335 individuals, in 320 of them in primary sterile materials (latter figure represents the number of cases with IMD). In contrast, 387 cases of IMD were notified to the RKI as of 10.2.2011, cf. SurvStat@RKI. These figures reflect a decrease of the incidence rate of IMD to 0.47/100,000 (according to notification data) compared to 2009. Since the NRZM reports all processed cases to the local health authorities (irrespective of prior reporting), one can assume that 83% of reported cases were processed by NRZM (this rate was 78% in the previous year). In 50 (of 320) cases verification of IMD was exclusively performed with molecular (non-cultural) methods.

    The proportions of serogroups C (22.2%) and B (67.1%) among IMD did not change compared to the previous year. The share of serogroup Y among IMD slightly rose to 7.0%, whereas the proportion of W135 remained unchanged with 3.2%.

    Apart from the serogroup PorA and FetA are important targets for finetyping (see our previous reports from the years 2009, 2008, 2007, 2006, 2005, and 2004).In 2010 135 distinct serogroup-PorA-FetA-combinations (= finetypes) were found. The most common finetypes were B:P1.7-2,4:F1-5 (43 cases, 13.9% of IMD), C:P1.5,2:F3-3 (33, 10.7%), B:P1.7,16:F3-3 (14, 4.5%), Y:P1.5-2,10-1:F4-1 (14, 4.5%), and B:P1.22,14:F5-5 (13, 4.2%).

    2) Distribution of serogroups according to federal states

    BW: Baden-Württemberg, BY: Bayern, BE: Berlin, BB: Brandenburg, HB: Bremen, HH: Hamburg, HE: Hessen, MV: Mecklenburg-Vorpommern, NI: Niedersachsen, NW: Nordrhein-Westfalen, RP: Rheinland-Pfalz, SL: Saarland, SN: Sachsen, ST: Sachsen-Anhalt, SH: Schleswig-Holstein, TH: Thüringen, Au: patient lives abroad, unk: unknown. The table comprises 314 cases. In 4 cases serogroup could not be determined. In two cases the place of residence was not available.

    3) Distribution of serogroups according to age groups

    4) Distribution of outer membrane protein PorA variants

    5) Distribution of outer membrane protein FetA variants

    6) Distribution of common finetypes according to age groups

    7) Antibiotic susceptibility of invasive strains (according to breakpoints of the Clinical and Laboratory Standards Institute)

    In contrast to the previous year only invasive isolates, i.e. strains isolated from primary sterile materials such as blood or cerebrospinal fluid, are shown. The proportion of phaenotypically penicillin-intermediate strains was 12.8%. One isolate was resistant against penicillin, and one isolate was resistant against rifampicin.

    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)

    Note: distribution of serogroups B and C is similar; the accumulation of B:P1.7-2,4:F1-5 in western NRW persists in 2010. Clustering of C:P1.5,2:F3-3 in southern states, however, has markedly decreased. Due to the low number of cases (see previous report) distribution of ET-15 was not followed up in 2010. All maps were generated using EpiScanGIS.

    9) Publications of the NRZM

    Original articles:

      1. Elias, J., Schouls, L. M., van de Pol, I., Keijzers, W. C., Martin, D. R., Glennie, A., Oster, P., Frosch, M., Vogel, U., van der Ende, A. (2010) 'Vaccine preventability of meningococcal clone, Greater Aachen Region, Germany', Emerging Infectious Diseases, 16 (3), pp. 465-472
      2. Claus, H., Matsunaga, W., Vogel, U. (2010) 'Molecular Discrimination between Neisseria meningitidis Serogroups W-135 and Y Based on the Nucleotide Recognition Domain Sequence of the Capsule Polymerases', J. Clin. Microbiol., 48 (9), pp. 3459-3460.
      3. Taha, M., Thulin Hedberg, S., Szatanik, M., Hong, E., Ruckly, C., Abad, R., Bertrand, S., Carion, F., Claus, H., Corso, A., Enriquez, R., Heuberger, S., Hryniewicz, W., Jolley, K. A., Kriz, P., Mollerach, M., Musilek, M., Neri, A., Olcen, P., Pana, M., Skoczynska, A., Sorhouet Pereira, C., Stefanelli, P., Tzanakaki, G., Unemo, M., Vazquez, J. A., Vogel, U., Wasko, I. (2010) 'Multicenter Study for Defining the Breakpoint for Rifampin Resistance in Neisseria meningitidis by rpoB Sequencing', Antimicrob. Agents Chemother., 54 (9), pp. 3651-3658

        Review articles:

          1. Vogel, U. (2010) 'Molecular epidemiology of meningococci: application of DNA sequence typing', International Journal of Medical Microbiology: IJMM, 300 (7), pp. 415-420
          2. Vogel, U., Claus, H. (2010) 'Vaccine development against Neisseria meningitidis', Microbial Biotechnology, 4 (1), pp. 20-31
          3. Burchard, G., Elias, J., Hatz, C., Jelinek, T., Steffen, R. (2010) 'Impfung mit konjugiertem Meningokokken ACWY-Impfstoff', Med Welt, 61 (3), pp. 164-167
          4. Elias, J., Vogel, U. (2010) 'Epidemiologie: Aktuelle Trends', Der Allgemeinarzt, 2010 (7), pp. 34-36.  
          5. Vogel, U., Elias, J., Hellenbrand, W. (2010) 'Epidemiologie der Meningokokken-Infektion in Deutschland', Kinderärztliche Praxis, 81 (Sonderheft "Meningokokken"), pp. 8-12

          Book chapters:

          1. Elias, J. (2009) 'Prävention von Sekundärfällen bei Erkrankungen durch Meningokokken und Haemophilus influenzae Serotyp b', Akute bakterielle Meningitis, pp. 114-120
          2. Elias, J., Frosch, M., Vogel, U. (2011) 'Neisseria', Manual of Clinical Microbiology, pp. in press
          3. Vogel U., C. Schoen, and J. Elias. 2010. Population Genetics of Neisseria meningitidis. In D.A. Robinson, D. Falush, and E.J. Feil (eds.), Bacterial Population Genetics in Infectious Disease. Wiley-Blackwell, Hoboken, NJ.

          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 0.2 © NRZM 2011