RESUMO
During 2003-2012, 8 clusters of meningococcal disease were identified in Rio de Janeiro State, Brazil, all caused by serogroup C Neisseria meningitidis. The isolates were assigned to 3 clonal complexes (cc): cc11, cc32, and cc103. These hyperinvasive disease lineages were associated with endemic disease, outbreaks, and high case-fatality rates.
Assuntos
Surtos de Doenças , Meningite Meningocócica/epidemiologia , Neisseria meningitidis Sorogrupo C/classificação , Adolescente , Adulto , Brasil/epidemiologia , Criança , Pré-Escolar , Humanos , Lactente , Pessoa de Meia-Idade , Tipagem de Sequências Multilocus , Neisseria meningitidis Sorogrupo C/genética , Vigilância em Saúde Pública , Sorotipagem , Topografia Médica , Adulto JovemAssuntos
Cápsulas Bacterianas/genética , Surtos de Doenças , Meningite Meningocócica/microbiologia , Neisseria meningitidis/classificação , Adolescente , Adulto , Proteínas da Membrana Bacteriana Externa/genética , Brasil/epidemiologia , Criança , Pré-Escolar , Feminino , Genótipo , Humanos , Lactente , Recém-Nascido , Masculino , Meningite Meningocócica/epidemiologia , Pessoa de Meia-Idade , Neisseria meningitidis/genética , Neisseria meningitidis/isolamento & purificação , SorotipagemRESUMO
During the 1990s, an epidemic of B:4 Neisseria meningitidis infections affected Brazil. Subsequent increase in C:4 disease suggested B â C capsular switching. This study identified B â C switches within the sequence type 32 complex. Substantial disease related to capsular switching emphasizes the need for surveillance of circulating meningococcal strains to optimize disease control.
Assuntos
Variação Antigênica/genética , Cápsulas Bacterianas/genética , Epidemias , Neisseria meningitidis Sorogrupo B/genética , Neisseria meningitidis Sorogrupo C/genética , Adolescente , Adulto , Brasil/epidemiologia , Criança , Pré-Escolar , Feminino , Genótipo , Humanos , Lactente , Masculino , Infecções Meningocócicas/epidemiologia , Pessoa de Meia-Idade , Tipagem de Sequências Multilocus , Neisseria meningitidis Sorogrupo B/classificação , Neisseria meningitidis Sorogrupo C/classificação , Análise de Sequência de DNA , Sorotipagem , Adulto JovemRESUMO
BACKGROUND: Here, we report a laboratory-based study of Streptococcus pneumoniae recovered from patients with meningitis in Rio de Janeiro State, Brazil. METHODS: The aim of this study was to determine the evolution of ß-lactam resistance, antimicrobial susceptibility pattern, serotypes, and genetic diversity of S. pneumoniae, isolated from meningitis patients between 2000 and 2008. RESULTS: A total of 264 S. pneumoniae recovered from patients between 2000 and 2008 were included. Susceptibility testing (E-test) of S. pneumoniae showed resistance to penicillin, ceftriaxone, oxacillin, cotrimoxazole, tetracycline, ofloxacin, erythromycin, chloramphenicol, and rifampicin. Penicillin resistance (PEN-R, minimal inhibitory concentration [MIC] ≥ 0.12 µg/mL) increased from 8% of isolates in 2000-2002, to 12% in 2003-2005, and to 20% in 2006-2008. Ceftriaxone resistance (MIC ≥ 1.0 µg/mL) was detected among some PEN-R isolates (13%) from 2004 onward. Within the PEN-R isolates, serotypes that are included in 10-valent pneumococcal conjugate vaccine predominated (90%), and resistance was detected mostly in isolates of serotypes 14 (61%), 23F (16%), 6B (10%), and 19F (3%). Multilocus sequence typing showed that 52% of the PEN-R isolates, and 89% of those with MICs ≥ 0.5 µg/mL, were sequence type (ST)-156 or single-locus variants of this ST (ST-557 or ST-4388); all of these isolates were serotype 14 and were assigned to the Spain-3 clone. CONCLUSIONS: ß-lactam resistance increased recently among cerebrospinal fluid isolates and was mainly due to the surge of the ST-4388, a previously undescribed gki single-locus variants of ST-156. Regional surveillance is shown to be essential to provide optimal antimicrobial therapy, monitor highly successful clones, and formulate adequate vaccination strategy.