Emergence of W135 meningococcal meningitis in Ghana
Emergence of W135 meningococcal meningitis in Ghana
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DOI：
10.1111/j.1365-3156.2005.01520.x
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发表时间：
2005-12-01
影响因子：
3.3
通讯作者：
Pluschke, G
中科院分区：
文献类型：
--
作者：
Forgor, AA;Leimkugel, J;Pluschke, G
脑膜炎奈瑟菌血清群W135长期以来作为脑膜炎球菌性脑膜炎孤立病例的病因而广为人知，最近越来越多地与相当大规模的疾病暴发有关。布基纳法索在2002年至2004年的旱季受到W135流行病的袭击，但在2003年2月至2004年3月期间，邻国加纳只记录了4例W135脑膜炎病例。这再次证实了以前的研究结果，即新的流行性N。在撒哈拉以南非洲的脑膜炎带内的脑膜炎病毒克隆。在4名加纳W135脑膜炎患者中，1人死亡，3人存活，其中1人有严重的神经感觉性听力损失和语言障碍。所有四种疾病分离物对青霉素G、氯霉素、环丙沙星和头孢噻肟敏感，并且具有多位点序列类型（ST）11，这是ET-37克隆复合物的主要ST。脉冲场凝胶电泳（PFGE）配置文件的加纳疾病分离株和最近流行的分离株从布基纳法索基本相同。我们在三名患者的家庭社区和位于布基纳法索边境的Kassena Nankana区进行了脑膜炎球菌定植调查。W135携带率范围为0%至17.5%。当在具有最高携带率的患者社区中进行三次连续调查时，观察到W135定殖持续超过1年。在同一患者群体中不同时间采集的携带者分离株的PFGE图谱差异表明W135细菌的快速微进化，强调需要创新的精细分型方法来揭示W135分离株之间的关系。
Neisseria meningitidis serogroup W135, well known for a long time as a cause of isolated cases of meningococcal meningitis, has recently increasingly been associated with disease outbreaks of considerable magnitude. Burkina Faso was hit by W135 epidemics in the dry seasons of 2002-2004, but only four W135 meningitis cases were recorded between February 2003 and March 2004 in adjoining Ghana. This reconfirms previous findings that bottlenecks exist in the spreading of new epidemic N. meningitidis clones within the meningitis belt of sub-Saharan Africa. Of the four Ghanaian W135 meningitis patients one died and three survived, of whom one had profound neurosensory hearing loss and speech impairment. All four disease isolates were sensitive to penicillin G, chloramphenicol, ciprofloxacin and cefotaxime and had the multi-locus sequence type (ST) 11, which is the major ST of the ET-37 clonal complex. Pulsed-field gel electrophoresis (PFGE) profiles of the Ghanaian disease isolates and recent epidemic isolates from Burkina Faso were largely identical. We conducted meningococcal colonization surveys in the home communities of three of the patients and in the Kassena Nankana District located at the border to Burkina Faso. W135 carriage rates ranged between 0% and 17.5%. When three consecutive surveys were conducted in the patient community with the highest carrier rate, persistence of W135 colonization over a period of 1 year was observed. Differences in PFGE profiles of carrier isolates taken at different times in the same patient community were indicative of rapid microevolution of the W135 bacteria, emphasizing the need for innovative fine typing methods to reveal the relationship between W135 isolates.