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    Meningokokken und Haemophilus Influenzae

    Data of the German Reference Centre for Meningococci, 2011

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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 2011 470 samples originating from 394 individuals were processed. The NRZM detected Neisseria meningitidis in 322 individuals, in 307 of them in primary sterile materials (latter figure represents the number of cases with IMD). In contrast, 362 cases of IMD were notified to the RKI as of 16.1.2012, cf. SurvStat@RKI. These figures reflect a decrease of the incidence rate of IMD to 0.44/100,000 (according to notification data) compared to 2010 (0.47/100,000). Since the NRZM reports all processed cases to the local health authorities (irrespective of prior reporting), one can assume that 85% of reported cases were processed by NRZM (this rate was 83% in the previous year). In 47 (of 307) cases verification of IMD was exclusively performed with molecular (non-cultural) methods.

    The gap between the proportions of disease caused by serogroups C (21.2%) and B (68.9%) has slightly widened. The share of serogroup Y and W135 disease remained unchanged with 7.0% and 3.0%, respectively.

    Apart from the serogroup PorA and FetA are important targets for finetyping (see our previous reports from the years 2010, 2009, 2008, 2007, 2006).In 2011 130 distinct serogroup-PorA-FetA-combinations (= finetypes) were found. The most common finetypes were B:P1.7-2,4:F1-5 (35 cases, 12.5% of IMD), C:P1.5,2:F3-3 (23, 8.2%), B:P1.7,16:F3-3 (15, 5.3%), C:P1.5-1,10-8:F3-6 (12, 4.3%), and Y:P1.5-2,10-1:F4-1 (10, 3.6%).

    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 displays 297 cases of invasive meningococcal disease. From 5 cases the place of living could not be determined. In 5 cases serogrouping was not successful.

    3) Serogroup distribution according to age groups

    4) Abundance of PorA types, specified by variable regions VR1 and VR2

    5) Abundance of FetA types

    6) Abundance of common finetypes according to age groups

    7) Antibiotic susceptibility of invasive isolates (according to EUCAST criteria)

    The proportion of penicillin non-susceptible strains was 16.6%. No non-susceptible strains against rifampicin, riprofloxacin, or cefotaxim were found.

    8) Geographic distributions

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

    Comments: Both serogroups B and C show comparable (sporadic) spatial distributions; spatial clustering of B:P1.7-2,4:F1-5 has markedly decreased.  Finetype C:P1.5,2:F3-3 displays a random distribution. Maps were generated using EpiScanGIS.

    9) Publications of the NRZM

    Original articles:

      1. Claus, Heike, Jördens, M. S., Kriz, P., Musilek, M., Jarva, H., Pawlik, M.-C., Meri, S., Vogel, Ulrich. (2012) 'Capsule null locus meningococci: Typing of antigens used in an investigational multicomponent meningococcus serogroup B vaccine', Vaccine, 30 (2), pp. 155-160.
      2. Meyer, S., Elias, J., Höhle, M. 'A Space–Time Conditional Intensity Model for Invasive Meningococcal Disease Occurrence', Biometrics, epub before print
      3. Zlamy, M., Elias, J., Vogel, U., Frosch, M., Jeller, V., Cortina, G., Jungraithmayr, T., Prelog, M. (2011) 'Immunogenicity of conjugate Meningococcus C vaccine in pediatric solid organ transplant recipients', Vaccine, 29 (37), pp. 6163-6166.
      4. Zlamy, M., Hofer, J., Elias, J., Vogel, U., Frosch, M., Jungraithmayr, T., Zimmerhackl, L. B., Prelog, M. (2011) 'Immunogenicity of meningococcus C vaccination in a patient with atypical hemolytic uremic syndrome (aHUS) on eculizumab therapy', Pediatric Transplantation, epub before print

        Review articles and book chapters:

        1. Elias J, Frosch M, Vogel U. Neisseria. In: Versalovic J, Carroll KC, Funke G, Jorgensen JH, Landry ML, Warnock DW, editors. Manual of Clinical Microbiology. Washington, DC: ASM Press; 2011. p. 559–73.
        2. Lâm, T. T., Claus, H, Elias, J., Hellenbrand, W., Imöhl, M., Prelog, M., Sing, A., van der Linden, M., Vogel, U. (2011) 'Infections with Pneumococci, Menigococci, H. influenzae and Diphtheria in Germany: the RKI Reference Network for Invasive Bacterial Infections (IBI) at the 5th Würzburg Workshop on Epidemiology, Prevention and Therapy for Invasive Meningococcal Diseases 2010 (Meeting Report).', Gesundheitswesen (Bundesverband der Ärzte des Öffentlichen Gesundheitsdienstes), epub before print
        3. Vogel, U. (2011) 'European efforts to harmonize typing of meningococci', International Journal of Medical Microbiology, 301 (8), pp. 659-662.
        4. Vogel, U., Claus, H. (2011) 'Vaccine development against Neisseria meningitidis', Microbial Biotechnology, 4 (1), pp. 20-31.

          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 2012