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

Authors

Soon Kim, Translational Research Division, International Vaccine Institute, SNU Research ParkFollow
Dong Kim, Laboratory Science Division, International Vaccine Institute, Seoul, South KoreaFollow
Bai Dong, Guangxi Zhuang Autonomous Region Center for Disease Control & PreventionFollow
Jung Kim, Department of Pediatrics, Jeonbuk National University Hospital, Jeonju, South KoreaFollow
Dang Anh, National Institute of Hygiene and Epidemiology, Hanoi, VietnamFollow
Paul E. Kilgore, Translational Research Division, International Vaccine Institute, SNU Research ParkFollow

Document Type

Article

Abstract

Abstract

Background

To 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.

Methods

A 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.

Results

Among 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]).

Conclusions

These 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.

Disciplines

Pharmacy and Pharmaceutical Sciences

Recommended Citation

Kim et al.: An expanded age range for meningococcal meningitis: molecular diagnostic evidence from population-based surveillance in Asia. BMC Infectious Diseases 2012 12:310.