An expanded age range for meningococcal meningitis: molecular diagnostic evidence from population-based surveillance in Asia

BMC Infectious Diseases

Research Article

Jung Soo Kim¹  Bai Qing Dong²  Dong Wook Kim³  Dang Duc Anh⁴  Soon Ae Kim⁵  Paul E Kilgore⁶ 

[1] Department of Pediatrics, Jeonbuk National University Hospital, Jeonju, South Korea;Guangxi Zhuang Autonomous Region Center for Disease Control & Prevention, Nanning, China;Laboratory Science Division, International Vaccine Institute, Seoul, South Korea;Department of Pharmacy, College of Pharmacy, Hanyang University, Suwon, South Korea;National Institute of Hygiene and Epidemiology, Hanoi, Vietnam;Translational Research Division, International Vaccine Institute, SNU Research Park, San 4-8 Nakseongdae-Dong, Kwanak Gu, 151-919, Seoul, South Korea;Translational Research Division, International Vaccine Institute, SNU Research Park, San 4-8 Nakseongdae-Dong, Kwanak Gu, 151-919, Seoul, South Korea;Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy & Health Sciences, Wayne State University, Detroit, USA;

关键词: Cerebrospinal fluid;    Meningococcal meningitis;    Neisseria meningitidis;    Serogroup;    Surveillance;   

DOI  :  10.1186/1471-2334-12-310

 received in 2012-05-29, accepted in 2012-11-05,  发布年份 2012

来源: Springer

【 摘 要 】

BackgroundTo understand epidemiologic patterns of meningococcal disease in Asia, we performed a retrospective molecular analysis of cerebrospinal fluid (CSF) specimens collected in prospective surveillance among children aged < 5 years of age in China, South Korea, and Vietnam.MethodsA total of 295 isolates and 2,302 CSFs were tested by a meningococcal species- and serogroup-specific polymerase chain reaction (PCR) assay targeting the Neisseria meningitidis (Nm) ctrA gene. Multi-locus sequence typing (MLST) was performed in Nm gene amplification analysis and incidence rates for meningococcal meningitis were estimated.ResultsAmong 295 isolates tested, 10 specimens from Vietnam were confirmed as serogroup B and all were Sequence Type (ST) 1576 by MLST. Among the 2,032 CSF specimen tested, 284 (14%) were confirmed by PCR (ctrA gene), including 67 (23.6%) from China, 92 (32.4%) from Korea, and 125 (44.0%) from Vietnam. Neonates and infants aged < 6 months of age accounted for more than 50% of Nm-PCR positive CSF. Two CSF specimens from Vietnam were identified as serogroup B using MLST. In addition, 44 specimens underwent sequencing to confirm meningococcal serogroup; of these, 21 (48%) were serogroup C, 12 (27%) were serogroup X, 9 (20%) were serogroup Y and 2 (5%) were serogroup B. The incidence rates of meningococcal meningitis among children < 5 years of age was highest in Vietnam (7.4/100,000 [95% CI, 3.6—15.3] followed by Korea (6.8/100,000 [95% CI, 3.5-13.5] and China (2.1/100,000) [95% CI, 0.7-6.2]).ConclusionsThese results suggest that there is a previously undetected, yet substantial burden of meningococcal meningitis among infants and young children. Standardized, sensitive and specific molecular diagnostic assays with Nm serogrouping capacity are needed throughout Asia to understand the true burden of N. meningitidis disease.

【 授权许可】

CC BY   
© Kim et al.; licensee BioMed Central Ltd. 2012