Περίληψη:
New vaccines targeting meningococci expressing serogroup B
polysaccharide have been developed, with some being licensed in Europe.
Coverage depends on the distribution of disease-associated genotypes,
which may vary by age. It is well established that a small number of
hyperinvasive lineages account for most disease, and these lineages are
associated with particular antigens, including vaccine candidates. A
collection of 4,048 representative meningococcal disease isolates from
18 European countries, collected over a 3-year period, were
characterized by multilocus sequence typing (MLST). Age data were
available for 3,147 isolates. The proportions of hyperinvasive lineages,
identified as particular clonal complexes (ccs) by MLST, differed among
age groups. Subjects <1 year of age experienced lower risk of sequence
type 11 (ST-11) cc, ST-32 cc, and ST-269 cc disease and higher risk of
disease due to unassigned STs, 1- to 4-year-olds experienced lower risk
of ST-11 cc and ST-32 cc disease, 5- to 14-year-olds were less likely to
experience ST-11 cc and ST-269 cc disease, and >= 25-year-olds were more
likely to experience disease due to less common ccs and unassigned STs.
Younger and older subjects were vulnerable to a more diverse set of
genotypes, indicating the more clonal nature of genotypes affecting
adolescents and young adults. Knowledge of temporal and spatial
diversity and the dynamics of meningococcal populations is essential for
disease control by vaccines, as coverage is lineage specific. The
nonrandom age distribution of hyperinvasive lineages has consequences
for the design and implementation of vaccines, as different variants, or
perhaps targets, may be required for different age groups.
Συγγραφείς:
Brehony, Carina
Trotter, Caroline L.
Ramsay, Mary E. and
Chandra, Manosree
Jolley, Keith A.
van der Ende, Arie and
Carion, Francoise
Berthelsen, Lene
Hoffmann, Steen and
Hardardottir, Hjordis
Vazquez, Julio A.
Murphy, Karen and
Toropainen, Maija
Canica, Manuela
Ferreira, Eugenia
Diggle,
Mathew
Edwards, Giles F.
Taha, Muhamed-Kheir
Stefanelli,
Paola
Kriz, Paula
Gray, Steve J.
Fox, Andrew J. and
Jacobsson, Susanne
Claus, Heike
Vogel, Ulrich
Tzanakaki,
Georgina
Heuberger, Sigrid
Caugant, Dominique A.
Frosch,
Matthias
Maiden, Martin C. J.
