Adult ; China ; Humans ; Male ; Neisseria meningitidis, Serogroup C ; drug effects ; genetics ; isolation & purification

Adult ; China ; epidemiology ; Humans ; Male ; Meningitis, Meningococcal ; epidemiology ; microbiology ; Neisseria meningitidis, Serogroup W-135 ; genetics ; isolation & purification

OBJECTIVETo study the molecular subtypes and microflora structure of Neisseria meningitidis (Nm) strains isolated in Jiangxi province.

METHODSA total of 123 Nm strains separately isolated from patients, close contacts and health people in 1976-1987 and 2005-2008 were investigated by multilocus sequence typing (MLST) and PorA subtyping, to test the characteristics of gene Nm and sequence porA. Minimum spanning tree was constructed by using BioNumerics software based on data of MLST; and the microflora structure was then analyzed.

RESULTSThe serogroups of 67 Nm strains isolated in 1976-1987 included group A (43 strains), group B (18 strains), group C (1 strains) and group W135 (5 strains); while the serogroups of 56 Nm strains isolated in 2005-2008 included group A (3 strains), group B (7 strains), group C (45 strains) and 1 ungrouped strain. The total 123 Nm strains could be divided into 40 MLST types; while the 46 strains in group A could be divided into 14 MLST types, 29 out of which belonged to ST-3 type, accounting for 63.0% (29/46) as the dominant type. All of the 29 strains were isolated between 1976 and 1987, while 14 strains were isolated from patients, 9 were from close contacts and 6 were from health people. The 46 strains in group C could be divided into 5 MLST types, 41 out of which belonged to ST-4821 type, accounting for 89.1% (41/46). All of the strains were isolated between 2005 and 2008, 6 strains were isolated from patients, 6 were from close contacts and 29 were from health people. The porA gene of the total 123 Nm strains were classified to 32 different types, including 24 different VR1 types and 22 different VR2 types. The dominant PorA type of the prevalent strain (ST-3 type, group A) between 1976 and 1987 was P1.7-1, 10, accounting for 39.1% (18/46) of the strains in group A; while the 18 strains were isolated from 11 patients, 4 close contacts and 3 health people. The dominant PorA type of the prevalent strain (ST-4821 type, group C) between 2005 and 2008 was P1.20, 9, accounting for 46.3% (19/41) of the ST-4821 strains in group C; while the 19 strains were isolated from 1 close contacts and 18 health people. P1.7-2, 14 dominated since 2006, including 22 strains, accounting for 53.7% (22/41) of the ST-4821 strains in group C, isolated from 6 patients, 5 close contacts and 11 health people. There were no dominant PorA type found in group B and all the 5 strains in group W135 belonged to ST-174 and the PorA type was P1.21, 16, isolating from 3 close contacts and 2 health people between 1979 and 1980.

CONCLUSIONNm isolated in Jiangxi province showed significant gene polymorphism, as well as predominant lineages existing. In different periods, the prevalent lineages varied a lot, as translating from serogroup A: ST-3:P1.7-1, 10 to serogroup C: ST-4821:P1.7-2, 14 nowadays.

Bacterial Typing Techniques ; China ; epidemiology ; Genotype ; Humans ; Meningococcal Infections ; epidemiology ; microbiology ; Neisseria meningitidis ; classification ; genetics ; isolation & purification ; Serotyping

OBJECTIVETo characterize the meningococcal strains isolated from cases and close contacts with meningococcal disease associated with an outbreak in a jail in May 2010 by investigating the national distribution of hyperinvasive ST-4821 serogroup C clone associated with this outbreak.

METHODSThe cases were described based on the clinical symptoms and laboratory results. Pharyngeal swabs were cultured for N. meningitidis from men in the jail. Meningococcal isolates were identified by serogrouping, pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST), respectively. Four hundred and sixteen serogroup C N. meningitidis strains were collected from 27 provinces between 2003 and 2010 for a nationwide survey and analyzed by PFGE and MLST.

RESULTSThree persons in a jail system were infected with invasive N. meningitidis serogroup C. All isolates tested had matching PFGE patterns and belonged to the multilocus sequence type (ST) 4821 clonal complex. All 47 N. meningitidis strains were identified from the pharyngeal swabs of 166 peoples in the jail, and 26 of them belonged to ST-4821 serogroup C clone, and 90.14% (375/416) serogroup C strains identified in the nationwide survey belonged to the ST-4821 complex. The ST-4821 serogroup C clone was spread nationwide, distributed in 24 provinces, especially in eastern provinces between 2003 and 2010.

CONCLUSIONEndemic transmission and carriage rate of ST-4821 serogroup C clone are high in this jail system. The ST-4821 serogroup C clone is spreading in China and nationwide distributed despite the existence of some effective vaccines.

Carrier State ; China ; epidemiology ; Disease Outbreaks ; Electrophoresis, Gel, Pulsed-Field ; Humans ; Meningitis, Meningococcal ; epidemiology ; microbiology ; Neisseria meningitidis ; genetics ; isolation & purification ; Pharynx ; microbiology ; Prisons

INTRODUCTIONThe aim of this case series is to describe the clinical course of 2 patients with Neisseria meningitidis corneal ulcers.

CLINICAL PICTUREA 49-year-old man (Patient 1) and a 22- year-old man (Patient 2) both experienced eye pain and were found to have corneal ulcers with surrounding infiltrate and ground-glass appearance. Gram-negative diplococci were seen in the first case. N. meningitidis was isolated in culture of corneal scrapings from both patients.

TREATMENTPatient 1 was treated with levofloxacin (0.5%) and cefazolin (50 mg/mL) eye drops hourly and intravenous ceftriaxone and oral rifampicin. Patient 2 was treated with cefazolin (50 mg/mL) and gentamicin (14 mg/mL) eye drops hourly, as well as intravenous ceftriaxone.

OUTCOMEThe corneal ulcers resolved with anterior stromal scarring and no impairment of vision.

CONCLUSIONSCorneal ulcers caused by N. meningitidis may respond well to treatment without permanent visual sequelae. However, in view of the potential ocular and systemic complications, it is important to investigate and treat patients with N. meningitidis infection aggressively.

Adult ; Cornea ; microbiology ; pathology ; Diagnosis, Differential ; Eye Infections, Bacterial ; microbiology ; pathology ; Humans ; Keratitis ; microbiology ; pathology ; Male ; Meningococcal Infections ; microbiology ; pathology ; Middle Aged ; Neisseria meningitidis ; isolation & purification

OBJECTIVETo study the pathogens of meningococcal meningitis (MM) in Beijing, 2005.

METHODSBlood and cerebrospinal fluid specimens from MM patients were detected by polymerase chain reaction. Bacterial strains were analyzed by pulsed-field gel electrophoresis and multilocus sequence typing.

RESULTS7 of the blood and 5 of cerebrospinal fluid specimens showed positive results. 105 of the Neisseria meningitides strains were isolated from the specimens of patients, close contacts and healthy carriers. Serogroup A and C Neisseria meningitides strains shared the same patterns of pulsed-fieldgel electrophoresis, respectively. The sequence type of serogroup A Neisseria meningitides belonged to ST7 while the sequence type of serogroup C Neisseria meningitides belonged to ST4821.

CONCLUSIONPatients suffered from meningococcal meningitis were caused by serogroup A (ST7) and C (ST4821) Neisseria meningitides in Beijing, 2005.

China ; DNA, Bacterial ; analysis ; Electrophoresis, Gel, Pulsed-Field ; Humans ; Meningitis, Meningococcal ; microbiology ; Neisseria meningitidis, Serogroup A ; genetics ; isolation & purification ; Polymerase Chain Reaction ; Sequence Analysis, DNA

OBJECTIVETo study the characteristics of epidemiology and molecular typing on Neisseria meningitidis serogroup C strains associated with outbreaks of Anhui province and sporadic cases in China, using pulsed field gel electrophoresis (PFGE).

METHODS212 Neisseria meningitidis serogroup C strains were isolated from invasive meningococcal cases, close contacts and healthy carriers, including 48 strains from Anhui province with 38 strains associated with serogroup C outbreaks. PFGE were performed by genomic DNA digestion with Nhe I restriction enzyme. The results of PFGE were analyzed by BioNumerics software (Version 4.0, Applied Maths BVBA, Belgium).

RESULTSA total number of 212 Neisseria meningitidis serogroup C isolates were typed by 43 patterns, named AH1 to AH43. In China, AH1 pattern was the major PFGE pattern with 69.3% (n = 147) of all strains, distributed in 11 provinces. Three types of PFGE patterns (AH1 to AH3) were found in 48 strains from Anhui province, in which, 93.8% (n = 45) belonged to AH1. 97.4% (n = 37) of 38 strains associated with serogroup C outbreaks in Anhui province showed AH1 pattern. A total of 53 serogroup C strains were isolated from invasive meningococcal cases with 67.9% (36/53) of AH pattern. 71.9% (87/121) of serogroup C strains isolated from contacts of invasive meningococcal cases was AH1 pattern and 63.2% (24/38) of the strains from healthy carriers showed AH1 pattern.

CONCLUSIONBy PFGE typing and analysis, AH1 pattern of Neisseria meningitidis serogroup C strains was proved to be the main clone which causing the outbreaks in Anhui province and might be responsible for the sporadic serogroup C meningococcal disease epidemics else where in the country.

Bacterial Typing Techniques ; China ; epidemiology ; DNA, Bacterial ; genetics ; Disease Outbreaks ; Electrophoresis, Gel, Pulsed-Field ; Meningococcal Infections ; epidemiology ; Neisseria meningitidis, Serogroup C ; classification ; genetics ; isolation & purification ; Sequence Analysis, DNA

Adolescent ; Amino Acid Sequence ; Humans ; Male ; Meningitis, Meningococcal ; microbiology ; Microbial Sensitivity Tests ; Molecular Sequence Data ; Neisseria meningitidis ; classification ; drug effects ; isolation & purification

We describe a group of 3 cases of invasive meningococcal disease that occurred in a military training camp in April 2011. All three patients were hospitalized. Ultimately, two patients recovered and one died. One patient had meningitis, one patient had septicemia and meningitis, and the other had no definite septicemia or meningitis. Neisseria meningitidis serogroup W-135 was detected in the serum and cerebrospinal fluid (CSF) of all patients by real-time polymerase chain reaction. In the one case of mortality, two strains were isolated from the patient's blood and CSF. Using multilocus sequence typing analysis, these strains were identified as a novel sequence type, ST-8912. Special attention is required for the meningococcal disease in military camp because the military personnels are in high risk of contact transmission.
DNA, Bacterial/blood/cerebrospinal fluid ; Electrophoresis, Gel, Pulsed-Field ; Humans ; Male ; Meningitis/complications/*diagnosis/microbiology ; Military Personnel ; Multilocus Sequence Typing ; Neisseria meningitidis, Serogroup W-135/genetics/*isolation & purification ; Real-Time Polymerase Chain Reaction ; Sepsis/complications/*diagnosis/microbiology ; Young Adult

OBJECTIVETo analyze the molecular characters of the W135 Neisseria meningitidis strain firstly isolated from patients in Guangdong province.

METHODSBiochemical profile by using the API NH system (bio-Merieux, France) was used for confirmation,and sero-grouping of the meningococcal isolates including one serogroup W135, one serogroup C and three serogroups of a Neisseria meningitidis isolated from patients in Guangdong province in recent two years were performed. The subtype was determined after amplifying porA and porB respectively from the genome DNA of Neisseria meningitidis. Multilocus sequence typing (MLST) was performed for determining the allele profiles and the sequence types (STs). The polygenetic tree was obtained by analyzing the allele profiles with program Splits tree online. The molecular characters of the serogroup W135 Neisseria meningitidis was analyzed by its evolution relationship and the variable regions in porA and porB which encoding the outer membranes proteins (OMPs).

RESULTSThe subtype determined by porA variable regions of the serogroup W135 Neisseria meningitidis was P1.5,2, which was one of the most invasive types. The types of variable regions (VRs) I, IV, V, VII with porB were 1, 1, 1, 17, and there was no VI and VIII in porB. The allele profile of the W135 strain in this study was 2, 123, 4, 3, 8, 4, 6, and its sequence type was ST-2960, which belonged to ST-11/ET-37 clone complex. The subtypes of the serogroup C and serogroup A strains were P1.20, while their types of VR IV were all 7, and they all hadn't VR VII in porB. The strain serogroup C belonged to ST-4821 clone complex, and the 3 serogroup A strains belonged to ST-5 clone complex.

CONCLUSIONThe molecular character of the serogroup W135 Neisseria meningitidis should be the same with the strains isolated in foreign country, and be different from the epidemic types in the area. This serogroup W135 Neisseria meningitis isolated from patients in Guangdong for the first time was thought to be a new type appearing in the local area.

Bacterial Typing Techniques ; China ; epidemiology ; DNA, Bacterial ; Disease Outbreaks ; Encephalomyelitis ; epidemiology ; microbiology ; Genotype ; Humans ; Molecular Sequence Data ; Neisseria meningitidis, Serogroup W-135 ; classification ; genetics ; isolation & purification ; Sequence Analysis, DNA