Pediatria pre prax 3/2017

Invasive meningococcal diseases and aspect of nasofaryngeal state carrier in Slovakia in a year 2015 a 2016. Actual options of vaccination

Within the surveillance program, 56 cases of invasive meningococcal disease (IMD) were reported in the Slovakia in 2015 and 2016. We confirmed in National Reference centrum (NRC) for Meningococci 47. The serogroup B prevailed in number 28x, serogroup C 13x, W135 and Y 1x and 4x the group was not determined. The highest morbidity was recorded in Prešov region. Clinically in 57% (in y. 2015) and in 40% (in y. 2016) it was meningitis, in other cases sepsis or meningitis with sepsis or Waterhouse-Friderichsen syndrome. Nine of the 56 diseases were fatal. 7 deaths were about 0-2 years old children (serogroups 5xB, 1xC, 1x indefined). Next two deaths were about 17 and 68 years old patients and were caused by serogroup C with identified hypervirulent clonal complex 11. By 820 carrier strains analyse we found out the most occurence of serogroup B (46%). The next biggest group (35%) is represented by serogroup indefined strains. Serogroup C and W135 occured in 3%, Y 6%, E29 5% and X 2%. The highest incidence of healthy carriers was in Košice region. In the group of 123 tested strains N. meningitidiswe noticed 13 resistant strains to PNC (5 invasive, 8 carrier), 46 strains of with threshold sensitivity against PNC. Resistant strains were betalactam-negative. Remains strains were sensitive to PNC and all tested strains were sensitive to CTX, CIP, RIF. We performed multilocus sequence typing (MLST) of some selected strains from IMD. By clonal analysis of 55 invasive strains we determine that the most common causative hypervirulent clonal complex involved in IMD in 2008 – 2016 was cc11 typical for serogroup C and 32, 41/44, 18 a 269 typical for serogroup B. To IMD prevent there are 4 vakccines (Nimenrix, Menveo, Bexsero,NeisVacC) in the Slovakia with the valid registration at which only one of them (NeisVacC) is categorized.

Keywords: N. meningitidis, invasive meningococcal disease, meningitis, sepsis, surveillance of infectious diseases, vaccination, epidemiology