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. 2013 Aug 20;8(8):e71943.
doi: 10.1371/journal.pone.0071943. eCollection 2013.

A decade of invasive meningococcal disease surveillance in Poland

Anna Skoczyńska  1 , Izabela Waśko, Alicja Kuch, Marcin Kadłubowski, Agnieszka Gołębiewska, Małgorzata Foryś, Marlena Markowska, Patrycja Ronkiewicz, Katarzyna Wasiak, Aleksandra Kozińska, Bożena Matynia, Waleria Hryniewicz; participants of of a laboratory-based surveillance of community acquired invasive bacterial infections (BINet)
Affiliations

A decade of invasive meningococcal disease surveillance in Poland

Anna Skoczyńska et al. PLoS One. .

Abstract

Background: Neisseria meningitidis is a leading etiologic agent of severe invasive disease. The objective of the study was to characterise invasive meningococcal disease (IMD) epidemiology in Poland during the last decade, based on laboratory confirmed cases.

Methods: The study encompassed all invasive meningococci collected between 2002 and 2011 in the National Reference Centre for Bacterial Meningitis. The isolates were re-identified and characterised by susceptibility testing, MLST analysis, porA and fetA sequencing. A PCR technique was used for meningococcal identification directly from clinical materials.

Results: In the period studied, 1936 cases of IMD were confirmed, including 75.6% identified by culture. Seven IMD outbreaks, affecting mostly adolescents, were reported; all were caused by serogroup C meningococci of ST-11. The highest incidence was observed among children under one year of age (15.71/100,000 in 2011). The general case fatality rate in the years 2010-2011 was 10.0%. Meningococci of serogroup B, C, Y and W-135 were responsible for 48.8%, 36.6%, 1.2% and 1.2% of cases, respectively. All isolates were susceptible to third generation cephalosporins, chloramphenicol, ciprofloxacin, and 84.2% were susceptible to penicillin. MLST analysis (2009-2011) revealed that among serogroup B isolates the most represented were clonal complexes (CC) ST-32CC, ST-18CC, ST-41/44CC, ST-213CC and ST-269CC, and among serogroup C: ST-103CC, ST-41/44CC and ST-11CC.

Conclusions: The detection of IMD in Poland has changed over time, but observed increase in the incidence of the disease was mostly attributed to changes in the surveillance system including an expanded case definition and inclusion of data from non-culture diagnostics.

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Conflict of interest statement

Competing Interests: The authors have the following interests. They received assistance to attend scientific meetings and honoraria for lecturing funded from Baxter, GlaxoSmithKline, Novartis and Pfizer (AS), an Honorarium for lecturing funded from Baxter (WH),and attendance in the Advisory Boards of GlaxoSmithKline (AS,WH) and Pfizer (AS). Other authors report no conflicts of interest. This study was partly supported by by an unrestricted grant from Glaxo SmithKline (114538). There are no patents, products in development or marketed products to declare. This does not alter the authors’ adherence to all the PLOS ONE policies on sharing data and materials, as detailed online in the guide for authors.

Figures

Figure 1
Figure 1. Map of Poland with the incidence rates (per 100,000) of invasive meningococcal disease in children under 1 year of age/all age groups, in 16 voivodeships, in years 2010–2011.
The voivodeships with notified outbreaks during study period are marked in yellow (OUT. – outbreak, numbered like in the text, the year of the outbreak, in bracket there is number of outbreak cases).
Figure 2
Figure 2. Serogroup distribution of meningococci responsible for invasive infections in Poland, 2002–2011.
(n = 1936; UNK - cases with unknown serogroup).
Figure 3
Figure 3. Distribution of clonal complexes between 2009 and 2011 among Polish meningococci of serogroup B (A) and C (B).
See this image and copyright information in PMC

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