title: Molecular characteristics of Neisseria meningitidis isolated during an outbreak in a jail: association with the spread and distribution of ST-4821 complex serogroup C clone in China.
abstract: OBJECTIVE
  To characterize the meningococcal strains isolated from cases and close contacts with meningococcal disease associated with an outbreak in a jail in May 2010 by investigating the national distribution of hyperinvasive ST-4821 serogroup C clone associated with this outbreak.
  
  
  METHODS
  The cases were described based on the clinical symptoms and laboratory results. Pharyngeal swabs were cultured for N. meningitidis from men in the jail. Meningococcal isolates were identified by serogrouping, pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST), respectively. Four hundred and sixteen serogroup C N. meningitidis strains were collected from 27 provinces between 2003 and 2010 for a nationwide survey and analyzed by PFGE and MLST.
  
  
  RESULTS
  Three persons in a jail system were infected with invasive N. meningitidis serogroup C. All isolates tested had matching PFGE patterns and belonged to the multilocus sequence type (ST) 4821 clonal complex. All 47 N. meningitidis strains were identified from the pharyngeal swabs of 166 peoples in the jail, and 26 of them belonged to ST-4821 serogroup C clone, and 90.14% (375/416) serogroup C strains identified in the nationwide survey belonged to the ST-4821 complex. The ST-4821 serogroup C clone was spread nationwide, distributed in 24 provinces, especially in eastern provinces between 2003 and 2010.
  
  
  CONCLUSIONS
  Endemic transmission and carriage rate of ST-4821 serogroup C clone are high in this jail system. The ST-4821 serogroup C clone is spreading in China and nationwide distributed despite the existence of some effective vaccines.
authors.affiliation: Jinan Municipal Center for Disease Control and Prevention, Jinan, Shandong 250014, China.
authors.forename: Ji
authors.initials: J
authors.lastname: Zhang
authors.forename: Hai Jian
authors.initials: HJ
authors.lastname: Zhou
authors.forename: Li
authors.initials: L
authors.lastname: Xu
authors.forename: Guang Chun
authors.initials: GC
authors.lastname: Hu
authors.forename: Xue Hua
authors.initials: XH
authors.lastname: Zhang
authors.forename: Sheng Ping
authors.initials: SP
authors.lastname: Xu
authors.forename: Zun Yu
authors.initials: ZY
authors.lastname: Liu
authors.forename: Zhu Jun
authors.initials: ZJ
authors.lastname: Shao
mesh_terms: D002353:Carrier State; D002681:China / Q000453:epidemiology; D004196:Disease Outbreaks; D016521:Electrophoresis, Gel, Pulsed-Field; D006801:Humans; D008585:Meningitis, Meningococcal / Q000453:epidemiology* / Q000382:microbiology; D009345:Neisseria meningitidis / Q000235:genetics / Q000302:isolation & purification*; D010614:Pharynx / Q000382:microbiology; D011330:Prisons
keywords: Multilocus sequence typing; Neisseria meningitidis; Pulsed-field gel electrophoresis; ST-4821; Serogroup C