title: Characteristics of Neisseria meningitidis isolates causing fatal disease.
abstract: The objectives of the present study were to describe a selection of characteristics of all available fatal meningococcal isolates (n = 62) and to compare these with all the other invasive isolates (non-fatal, n = 474) collected in Sweden from 1995 to 2004 (fatality rate of 12%). The coverage of the fatal isolates by presently discussed outer membrane vesicle (OMV) vaccines was also estimated. The isolates were characterized by serogroup, serotype, genosubtype, multilocus sequence type and antibiogram. Basic epidemiological data were gathered. The results of the fatal isolates showed 55% serogroup B, 27% C, 15% Yand 3% W-135, with a fatality rate of 11% for B, 12% for C, 17% for Y and 8% for W-135. Characteristics associated with higher mortality were age, gender, serogroup Y, serotype 14 and 15 and genosubtypes P1.7,16-29,35 and P1.5-1,10-4,36-2. In contrast, non-14/non-15 serotypes, the genosubtypes P1.5-1,10-8,36-2; P1.7-2,4,37 and P1.7,16,35, as well as reduced sensitivity for penicillin G were associated with decreased mortality. The presently discussed OMV vaccines could, based solely on the complete genosubtype, theoretically cover up to 44% of the fatal serogroup B cases and up to 100% if every variable region by itself is capable to induce protective immunity.
authors.affiliation: National Reference Laboratory for Pathogenic Neisseria, Department of Clinical Microbiology, Orebro University Hospital, Orebro, Sweden. susanne.jacobsson@orebroll.se
authors.forename: Susanne
authors.initials: S
authors.lastname: Jacobsson
authors.forename: Per
authors.initials: P
authors.lastname: Olcén
authors.forename: Margareta
authors.initials: M
authors.lastname: Löfdahl
authors.forename: Hans
authors.initials: H
authors.lastname: Fredlund
authors.forename: Paula
authors.initials: P
authors.lastname: Mölling
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D002648:Child; D002675:Child, Preschool; D005260:Female; D005838:Genotype; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008585:Meningitis, Meningococcal / Q000453:epidemiology / Q000382:microbiology / Q000401:mortality; D008589:Meningococcal Infections / Q000453:epidemiology / Q000382:microbiology* / Q000401:mortality*; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009345:Neisseria meningitidis / Q000145:classification* / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification*; D011159:Population Surveillance; D017422:Sequence Analysis, DNA; D012703:Serotyping; D013548:Sweden / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents