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首页> 外文期刊>Vaccine >Epidemiology of pathogenic Neisseria meningitidis serogroup B serosubtypes in Malta: Implications for introducing PorA based vaccines
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Epidemiology of pathogenic Neisseria meningitidis serogroup B serosubtypes in Malta: Implications for introducing PorA based vaccines

机译：马耳他致病性脑膜炎奈瑟菌B群血清型的流行病学：引入基于PorA的疫苗的含义

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OBJECTIVE: To describe the epidemiology of the serosubtypes of Neisseria meningitidis serogroup B (MenB) in the most densely populated area in Europe and to review the MenB Porin A (PorA) based outer membrane vesicle (OMV) vaccines that could provide the broadest protection. STUDY DESIGN AND SETTING: Active surveillance of invasive meningococcal disease in a population of 400,000 inhabitants in Malta from 1999 to 2006. Serogroup B isolates were serosubtyped and analysed by age and year. The suitability of OMV vaccines was then assessed. RESULTS: Laboratory confirmation of invasive meningococcal disease was obtained in 48% (79/163) of notified cases. Serogroup B caused the majority of invasive meningococcal disease (76%, 60/79) with the greatest disease burden occurring in 0-14-year-old children (73%, 44/60). MenC caused 14% (11/79) of cases. The most prevalent MenB serotype:serosubtype combination was B:4:P1.19,15 which constituted 59% (34/58) of all phenotypeable MenB isolates. The PorA epitopes P1.15 and P1.19, detected in 74% (43/58) of isolates, were significantly more prevalent than serosubtypes with other PorA epitopes (chi(2): 7.18, P<0.01). CONCLUSION: An assessment of the usefulness of a MenB OMV vaccine in Malta requires further research. The wild-type OMV vaccine developed by the Finlay Institute (FI) in Cuba could potentially be used to control an outbreak with a MenB P1.19,15 clone. A multivalent OMV vaccine would however be needed for broader protection against the endemic heterogenous MenB strains. A serogroup B vaccine incorporating more conserved proteins than PorA would be more suitable for comprehensive control of meningococcal B disease.
机译：目的：描述欧洲人口最稠密地区脑膜炎奈瑟氏菌血清群B（MenB）血清型的流行病学，并审查基于MenB Porin A（PorA）的外膜囊泡（OMV）疫苗，该疫苗可提供最广泛的保护。研究设计与地点：从1999年到2006年，马耳他对40万居民进行了侵袭性脑膜炎球菌疾病的主动监测。对血清B型分离株进行血清亚型分析，并按年龄和年份进行分析。然后评估了OMV疫苗的适用性。结果：48％（79/163）的通报病例获得了浸润性脑膜炎球菌疾病的实验室确认。血清群B导致大多数侵袭性脑膜炎球菌疾病（76％，60/79），最大的疾病负担发生在0-14岁的儿童中（73％，44/60）。 MenC导致14％（11/79）的案件。最流行的MenB血清型：血清亚型组合是B：4：P1.19,15，占所有可表型MenB分离株的59％（34/58）。在74％（43/58）的分离物中检测到的PorA表位P1.15和P1.19明显比其他PorA表位的血清亚型普遍（chi（2）：7.18，P <0.01）。结论：评估马耳他的MenB OMV疫苗的有效性需要进一步研究。古巴Finlay研究所（FI）开发的野生型OMV疫苗可能具有MenB P1.19,15克隆，可用于控制暴发。但是，将需要多价OMV疫苗来更广泛地防御地方性异种MenB毒株。含有比PorA更多保守蛋白的B血清群疫苗更适合全面控制B型脑膜炎球菌。

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