Neisseria meningitidis sequence type and risk for death, Iceland.
Invasive meningococcal infections are hyperendemic in Iceland, a relatively isolated country in the mid-Atlantic. We performed a nationwide study on all viable meningococcal strains (N = 362) from 1977 to 2004. We analyzed the association of patient's age and sex, meningococcal serogroups, and sequence types (STs) with outcomes. Overall, 59 different STs were identified, 19 of which were unique to Iceland. The most common STs were 32 (24.6%), 11 (19.9%), and 10 (10.2%). The unique ST-3492 ranked fourth (7.7%). The most common serogroups were B (56.4%), C (39.8%), and A (2.2%). Age (p < 0.001) and infection with a unique ST (p = 0.011) were independently associated with increased death rates, whereas isolation of meningococci from cerebrospinal fluid only was associated with lower death rates (p = 0.046). This study shows evolutionary trends of meningococcal isolates in a relatively isolated community and highlights an association between unique STs and poor outcome.
Gottfredsson
Magnús
M
Landspítali University Hospital, Reykjavík, Iceland. magnusgo@landspitali.is
Diggle
Mathew A
MA
Lawrie
David I
DI
Erlensdóttir
Helga
H
Hardardóttir
Hjördis
H
Kristinsson
Karl G
KG
Clarke
Stuart c
Sc
D000293:Adolescent; D000328:Adult; D000375:Aging; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D002648:Child; D002675:Child, Preschool; D024881:Drug Resistance, Bacterial; D005260:Female; D006801:Humans; D007055:Iceland / Q000453:epidemiology; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D008589:Meningococcal Infections / Q000453:epidemiology / Q000382:microbiology* / Q000401:mortality*; D009345:Neisseria meningitidis / Q000145:classification / Q000187:drug effects / Q000235:genetics*; D010802:Phylogeny; D012307:Risk Factors
D000900:Anti-Bacterial Agents