Meningococcal serogroup B strain coverage of the multicomponent 4CMenB vaccine with corresponding regional distribution and clinical characteristics in England, Wales, and Northern Ireland, 2007-08 and 2014-15: a qualitative and quantitative assessment
Meningococcal serogroup B strain coverage of the multicomponent 4CMenB vaccine with corresponding regional distribution and clinical characteristics in England, Wales, and Northern Ireland, 2007-08 and 2014-15: a qualitative and quantitative assessment
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DOI：
10.1016/s1473-3099(17)30170-6
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发表时间：
2017-07-01
影响因子：
56.3
通讯作者：
Borrow, Ray
中科院分区：
文献类型：
--
作者：
Parikh, Sydel R.;Newbold, Lynne;Borrow, Ray
背景英国于2015年9月将4CMenB--一种针对B组脑膜炎双球菌疾病的多组分疫苗--引入国家婴儿免疫计划。使用脑膜炎球菌抗原分型系统(MATS)估计2007-08年间在英格兰和威尔士获得的侵袭性B组脑膜炎球菌B组分离株的4CMenB覆盖率(MATS覆盖率)。我们的目标是在引入4CMenB之前，重复对2014-15年间获得的侵袭性B组脑膜炎球菌分离株的MATS调查；比较2007-08年度和2014-15年度的菌株覆盖率；并调查MATS覆盖范围、年龄、地区和疾病结局之间的关系。方法使用MATS对2014-15年度英格兰、威尔士和北爱尔兰病例中的B群脑膜炎球菌侵袭性分离株进行检测，并与2007-08年的数据进行比较。MATS覆盖率按地理区域和年龄组进行评估。根据2014-15年英国病例的MATS覆盖率评估临床特征、风险因素和预后。2014-15年的发现，MATS估计251株B组脑膜炎球菌中有165株(66%；95%可信区间52-80)被4CMenB覆盖，而2007-08年的这一数字为391株(73%；95%可信区间57-87)。带有一种疫苗抗原的MATS阳性菌株的比例从2007-08年度的23%(122株)上升到2014-15年度的31%(251株中的78株)，而含有多种抗原的菌株的比例从50%(269株)下降到35%(251株中的87株)。这种效应反映了循环菌株的变化，特别是ST-269克隆性复合菌株。MATS的覆盖率随着年龄的增长而增加，随地理区域的不同而变化，并与更严重的疾病有关。据解释，2014-15年度，三分之二的B组脑膜炎球菌分离株被4CMenB覆盖。MAT覆盖面的时间变化突出表明有必要继续监测抗原表达和多样性，特别是在有4CMenB方案的国家。
Background The UK introduced 4CMenB-a multicomponent vaccine against serogroup B meningococcal disease-into the national infant immunisation programme in September, 2015. The Meningococcal Antigen Typing System (MATS) was used to estimate coverage by 4CMenB of invasive meningococcal group B isolates obtained during 2007-08 in England and Wales (MATS coverage). We aimed to repeat the MATS survey for invasive meningococcal group B isolates obtained during 2014-15, before 4CMenB introduction; compare strain coverage between 2007-08 and 2014-15; and investigate associations between MATS coverage, age, region, and disease outcomes.Methods Invasive serogroup B meningococcal isolates from cases in England, Wales, and Northern Ireland during 2014-15 were assayed using MATS and compared with 2007-08 data. MATS coverage was assessed by geographical region and age group. Clinical characteristics, risk factors, and outcomes were assessed according to MATS coverage for 2014-15 English cases.Findings In 2014-15, 165 of 251 (66%; 95% CI 52-80) meningococcal group B isolates were estimated by MATS to be covered by 4CMenB, compared with 391 of 535 (73%; 95% CI 57-87) in 2007-08. The proportion of MATS-positive isolates with one vaccine antigen increased from 23% (122 of 535) in 2007-08 to 31% (78 of 251) in 2014-15, whereas the proportion with more than one antigen fell from 50% (269 of 535) to 35% (87 of 251). This effect reflected changes in circulating strains, particularly ST-269 clonal complex strains. MATS coverage increased with age, varied by geographical region, and was associated with more severe disease.Interpretation In 2014-15, two-thirds of meningococcal group B isolates were predicted to be covered by 4CMenB. Temporal changes in MATS coverage underscore the need for continued monitoring of antigen expression and diversity, particularly in countries with 4CMenB programmes.