title: A decade of invasive meningococcal disease surveillance in Poland.
abstract: BACKGROUND
  Neisseria meningitidis is a leading etiologic agent of severe invasive disease. The objective of the study was to characterise invasive meningococcal disease (IMD) epidemiology in Poland during the last decade, based on laboratory confirmed cases.
  
  
  METHODS
  The study encompassed all invasive meningococci collected between 2002 and 2011 in the National Reference Centre for Bacterial Meningitis. The isolates were re-identified and characterised by susceptibility testing, MLST analysis, porA and fetA sequencing. A PCR technique was used for meningococcal identification directly from clinical materials.
  
  
  RESULTS
  In the period studied, 1936 cases of IMD were confirmed, including 75.6% identified by culture. Seven IMD outbreaks, affecting mostly adolescents, were reported; all were caused by serogroup C meningococci of ST-11. The highest incidence was observed among children under one year of age (15.71/100,000 in 2011). The general case fatality rate in the years 2010-2011 was 10.0%. Meningococci of serogroup B, C, Y and W-135 were responsible for 48.8%, 36.6%, 1.2% and 1.2% of cases, respectively. All isolates were susceptible to third generation cephalosporins, chloramphenicol, ciprofloxacin, and 84.2% were susceptible to penicillin. MLST analysis (2009-2011) revealed that among serogroup B isolates the most represented were clonal complexes (CC) ST-32CC, ST-18CC, ST-41/44CC, ST-213CC and ST-269CC, and among serogroup C: ST-103CC, ST-41/44CC and ST-11CC.
  
  
  CONCLUSIONS
  The detection of IMD in Poland has changed over time, but observed increase in the incidence of the disease was mostly attributed to changes in the surveillance system including an expanded case definition and inclusion of data from non-culture diagnostics.
authors: National Reference Centre for Bacterial Meningitis, Department of Epidemiology and Clinical Microbiology, National Medicines Institute, Warsaw, Poland.
authors: Anna
authors: A
authors: Skoczyńska
authors: Izabela
authors: I
authors: Waśko
authors: Alicja
authors: A
authors: Kuch
authors: Marcin
authors: M
authors: Kadłubowski
authors: Agnieszka
authors: A
authors: Gołębiewska
authors: Małgorzata
authors: M
authors: Foryś
authors: Marlena
authors: M
authors: Markowska
authors: Patrycja
authors: P
authors: Ronkiewicz
authors: Katarzyna
authors: K
authors: Wasiak
authors: Aleksandra
authors: A
authors: Kozińska
authors: Bożena
authors: B
authors: Matynia
authors: Waleria
authors: W
authors: Hryniewicz
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D015373:Bacterial Typing Techniques; D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks; D024881:Drug Resistance, Bacterial; D062665:Epidemiological Monitoring; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008585:Meningitis, Meningococcal / Q000382:microbiology / Q000401:mortality*; D008875:Middle Aged; D009026:Mortality; D058885:Multilocus Sequence Typing; D009345:Neisseria meningitidis / Q000187:drug effects / Q000235:genetics*; D011044:Poland / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents
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