title: National case-control study on risk of death and Neisseria meningitidis sequence types in Denmark, 2000-2007.
abstract: In the past decades efforts to further diminish the case-fatality rate from meningococcal disease have proven challenging due to the often rapid progression of the disease in patients. In this study our objective was to characterise a subset of Neisseria meningitidis isolates to establish which sequence types were associated with increased mortality in Denmark during the period 2000-2007. We designed a matched case control and performed serogrouping, serotyping, serosubtyping and multilocus sequence typing (MLST) on 100 isolates. The clonal complex ST-32/ET-5 was found in 36% of the isolates, followed by the ST-11/ET-37 complex (14%) and ST-41/44 complex/Lineage 3 (14%). Eight new sequence types were found. None of the clonal complexes were significantly associated with increased mortality. Phenotype B:15:P1.7,16 tended to be a better predictor of death than ST-32. Although the numbers were low, the present study indicates that phenotyping may be a better predictor of mortality than MLST, which suggests that each typing method has its advantages and disadvantages. If this notion can be confirmed by other studies, it may stimulate additional research regarding the pathogenesis of severe illness, for example, if certain surface molecules trigger a cytokine storm more than others.
authors.affiliation: Department of Epidemiology, Statens Serum Institut, Copenhagen, Denmark. how@ssi.dk
authors.forename: Michael
authors.initials: M
authors.lastname: Howitz
authors.forename: Lotte
authors.initials: L
authors.lastname: Lambertsen
authors.forename: Kåre
authors.initials: K
authors.lastname: Mølbak
authors.forename: Jens Jørgen
authors.initials: JJ
authors.lastname: Christensen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D004269:DNA, Bacterial / Q000235:genetics; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008589:Meningococcal Infections / Q000401:mortality*; D008875:Middle Aged; D009345:Neisseria meningitidis / Q000145:classification / Q000235:genetics* / Q000302:isolation & purification; D012307:Risk Factors; D017422:Sequence Analysis, DNA; D012703:Serotyping; D055815:Young Adult
chemical_list: D004269:DNA, Bacterial