title: Microheterogeneity of serogroup A (subgroup III) Neisseria meningitidis during an outbreak in northern Ghana.
abstract: During a meningitis outbreak in the eastern subdistrict of the Kassena-Nankana District of the Upper East Region of Ghana, we analysed cerebrospinal fluid from suspected meningitis cases for the most common causative organisms. In 50 of 92 samples analysed, serogroup A Neisseria meningitidis were detected. The ages of serogroup A N. meningitidis patients ranged from 4 months to 64 years. The case fatality ratio was 20%. Coma or stupor on presentation worsened the prognosis. All serogroup A N. meningitidis isolates recovered revealed the A: 4: P1.9, 20 phenotype characteristic for the subgroup III clonal grouping. No evidence for resistance to penicillin G, chloramphenicol, cefotaxime, ciprofloxacin, rifampicin or tetracycline was found. All strains were resistant to sulphadiazine. Restriction analysis patterns of opa, iga and ingA genes were characteristic for the majority of N. meningitidis serogroup A subgroup III bacteria isolated in Africa after the 1987 epidemic in Mecca. Differences in pulsed-field gel electrophoresis patterns of NheI and SpeI digested DNA revealed microheterogeneity among the Ghanaian isolates.
authors.affiliation: Swiss Tropical Institute, Basel, Switzerland.
authors.forename: S
authors.initials: S
authors.lastname: Gagneux
authors.forename: A
authors.initials: A
authors.lastname: Hodgson
authors.forename: I
authors.initials: I
authors.lastname: Ehrhard
authors.forename: G
authors.initials: G
authors.lastname: Morelli
authors.forename: B
authors.initials: B
authors.lastname: Genton
authors.forename: T
authors.initials: T
authors.lastname: Smith
authors.forename: M
authors.initials: M
authors.lastname: Tanner
authors.forename: F
authors.initials: F
authors.lastname: Binka
authors.forename: M
authors.initials: M
authors.lastname: Achtman
authors.forename: G
authors.initials: G
authors.lastname: Pluschke
mesh_terms: D000293:Adolescent; D000328:Adult; D000483:Alleles; D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks; D016521:Electrophoresis, Gel, Pulsed-Field; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005869:Ghana / Q000453:epidemiology; D006801:Humans; D007223:Infant; D008297:Male; D008585:Meningitis, Meningococcal / Q000453:epidemiology* / Q000382:microbiology / Q000401:mortality; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009345:Neisseria meningitidis / Q000145:classification / Q000187:drug effects / Q000235:genetics*; D010641:Phenotype; D016133:Polymerase Chain Reaction; D012150:Polymorphism, Restriction Fragment Length; D012703:Serotyping