Changes in Serogroup and Genotype Prevalence among Carried Meningococci in the United Kingdom during Vaccine Implementation

Ana Belén Ibarz-Pavón; Jenny MacLennan; Nicholas J. Andrews; Stephen J. Gray; Rachel Urwin; Stuart C. Clarke; A. Mark Walker; Meirion R. Evans; J. Simon Kroll; Keith R. Neal; Dlawer Ala'Aldeen; Derrick W. Crook; Kathryn Cann; Sarah Harrison; Richard Cunningham; David Baxter; Edward Kaczmarski; Noel D. McCarthy; Keith A. Jolley; J. Claire Cameron; James M. Stuart; Martin C.J. Maiden

doi:10.1093/infdis/jir466

Changes in Serogroup and Genotype Prevalence among Carried Meningococci in the United Kingdom during Vaccine Implementation

Ana Belén Ibarz-Pavón, Jenny MacLennan, Nicholas J. Andrews, Stephen J. Gray, Rachel Urwin, Stuart C. Clarke, A. Mark Walker, Meirion R. Evans, J. Simon Kroll, Keith R. Neal, Dlawer Ala'Aldeen, Derrick W. Crook, Kathryn Cann, Sarah Harrison, Richard Cunningham, David Baxter, Edward Kaczmarski, Noel D. McCarthy, Keith A. Jolley, J. Claire CameronJames M. Stuart, Martin C.J. Maiden^*

^*Corresponding author for this work

HCAI and AMR Divisional Office

Research output: Contribution to journal › Article › peer-review

44 Citations (Scopus)

Abstract

Background. Herd immunity is important in the effectiveness of conjugate polysaccharide vaccines against encapsulated bacteria. A large multicenter study investigated the effect of meningococcal serogroup C conjugate vaccine introduction on the meningococcal population. Methods. Carried meningococci in individuals aged 15-19 years attending education establishments were investigated before and for 2 years after vaccine introduction. Isolates were characterized by multilocus sequence typing, serogroup, and capsular region genotype and changes in phenotypes and genotypes assessed. Results. A total of 8462 meningococci were isolated from 47 765 participants (17.7%). Serogroup prevalence was similar over the 3 years, except for decreases of 80% for serogroup C and 40% for serogroup 29E. Clonal complexes were associated with particular serogroups and their relative proportions fluctuated, with 12 statistically significant changes (6 up, 6 down). The reduction of ST-11 complex serogroup C meningococci was probably due to vaccine introduction. Reasons for a decrease in serogroup 29E ST-254 meningococci (from 1.8% to 0.7%) and an increase in serogroup B ST-213 complex meningococci (from 6.7% to 10.6%) were less clear. Conclusions. Natural fluctuations in carried meningococcal genotypes and phenotypes a can be affected by the use of conjugate vaccines, and not all of these changes are anticipatable in advance of vaccine introduction.

Original language	English
Pages (from-to)	1046-1053
Number of pages	8
Journal	Journal of Infectious Diseases
Volume	204
Issue number	7
DOIs	https://doi.org/10.1093/infdis/jir466
Publication status	Published - 1 Oct 2011

Bibliographical note

Funding Information:
The authors are grateful to the following organizations for providing research funding: the Wellcome Trust (sampling in England and Wales); the Chief Scientist Office of the Scottish Executive Health Department (sampling in Scotland); and the Meningitis Trust (questionnaire). We thank the following for their assistance with implementation of the study: A. D. Carr, C. Lewis, D. Casey, K. T. Dunkin, C. Roberts, R. A. Barnes, J. Murray, A. Paull, Y. K. Lau (deceased), S. Welch, P. Marks, D. Turner, D. Griffiths, M. Clacher, G. Lewendon, R. Mathews, and M. E. Ramsay. We are indebted to the student volunteers and the many other individuals who made this study possible, including nurses, laboratory staff, school principals and staff, and colleagues who supported the study in various ways. Martin Maiden is a Wellcome Trust Senior Fellow in Basic Biomedical Sciences; and Derrick Crook is supported by the NIHR Biomedical Research Centre, Oxford.

Funding Information:
This work was supported by the Wellcome Trust (062057).

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10.1093/infdis/jir466

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Ibarz-Pavón, A. B., MacLennan, J., Andrews, N. J., Gray, S. J., Urwin, R., Clarke, S. C., Walker, A. M., Evans, M. R., Kroll, J. S., Neal, K. R., Ala'Aldeen, D., Crook, D. W., Cann, K., Harrison, S., Cunningham, R., Baxter, D., Kaczmarski, E., McCarthy, N. D., Jolley, K. A., ... Maiden, M. C. J. (2011). Changes in Serogroup and Genotype Prevalence among Carried Meningococci in the United Kingdom during Vaccine Implementation. Journal of Infectious Diseases, 204(7), 1046-1053. https://doi.org/10.1093/infdis/jir466

@article{3ceeac88690d455993be931f617a203d,

title = "Changes in Serogroup and Genotype Prevalence among Carried Meningococci in the United Kingdom during Vaccine Implementation",

abstract = "Background. Herd immunity is important in the effectiveness of conjugate polysaccharide vaccines against encapsulated bacteria. A large multicenter study investigated the effect of meningococcal serogroup C conjugate vaccine introduction on the meningococcal population. Methods. Carried meningococci in individuals aged 15-19 years attending education establishments were investigated before and for 2 years after vaccine introduction. Isolates were characterized by multilocus sequence typing, serogroup, and capsular region genotype and changes in phenotypes and genotypes assessed. Results. A total of 8462 meningococci were isolated from 47 765 participants (17.7%). Serogroup prevalence was similar over the 3 years, except for decreases of 80% for serogroup C and 40% for serogroup 29E. Clonal complexes were associated with particular serogroups and their relative proportions fluctuated, with 12 statistically significant changes (6 up, 6 down). The reduction of ST-11 complex serogroup C meningococci was probably due to vaccine introduction. Reasons for a decrease in serogroup 29E ST-254 meningococci (from 1.8% to 0.7%) and an increase in serogroup B ST-213 complex meningococci (from 6.7% to 10.6%) were less clear. Conclusions. Natural fluctuations in carried meningococcal genotypes and phenotypes a can be affected by the use of conjugate vaccines, and not all of these changes are anticipatable in advance of vaccine introduction.",

author = "Ibarz-Pav{\'o}n, {Ana Bel{\'e}n} and Jenny MacLennan and Andrews, {Nicholas J.} and Gray, {Stephen J.} and Rachel Urwin and Clarke, {Stuart C.} and Walker, {A. Mark} and Evans, {Meirion R.} and Kroll, {J. Simon} and Neal, {Keith R.} and Dlawer Ala'Aldeen and Crook, {Derrick W.} and Kathryn Cann and Sarah Harrison and Richard Cunningham and David Baxter and Edward Kaczmarski and McCarthy, {Noel D.} and Jolley, {Keith A.} and Cameron, {J. Claire} and Stuart, {James M.} and Maiden, {Martin C.J.}",

note = "Funding Information: The authors are grateful to the following organizations for providing research funding: the Wellcome Trust (sampling in England and Wales); the Chief Scientist Office of the Scottish Executive Health Department (sampling in Scotland); and the Meningitis Trust (questionnaire). We thank the following for their assistance with implementation of the study: A. D. Carr, C. Lewis, D. Casey, K. T. Dunkin, C. Roberts, R. A. Barnes, J. Murray, A. Paull, Y. K. Lau (deceased), S. Welch, P. Marks, D. Turner, D. Griffiths, M. Clacher, G. Lewendon, R. Mathews, and M. E. Ramsay. We are indebted to the student volunteers and the many other individuals who made this study possible, including nurses, laboratory staff, school principals and staff, and colleagues who supported the study in various ways. Martin Maiden is a Wellcome Trust Senior Fellow in Basic Biomedical Sciences; and Derrick Crook is supported by the NIHR Biomedical Research Centre, Oxford. Funding Information: This work was supported by the Wellcome Trust (062057).",

year = "2011",

month = oct,

day = "1",

doi = "10.1093/infdis/jir466",

language = "English",

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Ibarz-Pavón, AB, MacLennan, J, Andrews, NJ, Gray, SJ, Urwin, R, Clarke, SC, Walker, AM, Evans, MR, Kroll, JS, Neal, KR, Ala'Aldeen, D, Crook, DW, Cann, K, Harrison, S, Cunningham, R, Baxter, D, Kaczmarski, E, McCarthy, ND, Jolley, KA, Cameron, JC, Stuart, JM & Maiden, MCJ 2011, 'Changes in Serogroup and Genotype Prevalence among Carried Meningococci in the United Kingdom during Vaccine Implementation', Journal of Infectious Diseases, vol. 204, no. 7, pp. 1046-1053. https://doi.org/10.1093/infdis/jir466

TY - JOUR

T1 - Changes in Serogroup and Genotype Prevalence among Carried Meningococci in the United Kingdom during Vaccine Implementation

AU - Ibarz-Pavón, Ana Belén

AU - MacLennan, Jenny

AU - Andrews, Nicholas J.

AU - Gray, Stephen J.

AU - Urwin, Rachel

AU - Clarke, Stuart C.

AU - Walker, A. Mark

AU - Evans, Meirion R.

AU - Kroll, J. Simon

AU - Neal, Keith R.

AU - Ala'Aldeen, Dlawer

AU - Crook, Derrick W.

AU - Cann, Kathryn

AU - Harrison, Sarah

AU - Cunningham, Richard

AU - Baxter, David

AU - Kaczmarski, Edward

AU - McCarthy, Noel D.

AU - Jolley, Keith A.

AU - Cameron, J. Claire

AU - Stuart, James M.

AU - Maiden, Martin C.J.

N1 - Funding Information: The authors are grateful to the following organizations for providing research funding: the Wellcome Trust (sampling in England and Wales); the Chief Scientist Office of the Scottish Executive Health Department (sampling in Scotland); and the Meningitis Trust (questionnaire). We thank the following for their assistance with implementation of the study: A. D. Carr, C. Lewis, D. Casey, K. T. Dunkin, C. Roberts, R. A. Barnes, J. Murray, A. Paull, Y. K. Lau (deceased), S. Welch, P. Marks, D. Turner, D. Griffiths, M. Clacher, G. Lewendon, R. Mathews, and M. E. Ramsay. We are indebted to the student volunteers and the many other individuals who made this study possible, including nurses, laboratory staff, school principals and staff, and colleagues who supported the study in various ways. Martin Maiden is a Wellcome Trust Senior Fellow in Basic Biomedical Sciences; and Derrick Crook is supported by the NIHR Biomedical Research Centre, Oxford. Funding Information: This work was supported by the Wellcome Trust (062057).

PY - 2011/10/1

Y1 - 2011/10/1

N2 - Background. Herd immunity is important in the effectiveness of conjugate polysaccharide vaccines against encapsulated bacteria. A large multicenter study investigated the effect of meningococcal serogroup C conjugate vaccine introduction on the meningococcal population. Methods. Carried meningococci in individuals aged 15-19 years attending education establishments were investigated before and for 2 years after vaccine introduction. Isolates were characterized by multilocus sequence typing, serogroup, and capsular region genotype and changes in phenotypes and genotypes assessed. Results. A total of 8462 meningococci were isolated from 47 765 participants (17.7%). Serogroup prevalence was similar over the 3 years, except for decreases of 80% for serogroup C and 40% for serogroup 29E. Clonal complexes were associated with particular serogroups and their relative proportions fluctuated, with 12 statistically significant changes (6 up, 6 down). The reduction of ST-11 complex serogroup C meningococci was probably due to vaccine introduction. Reasons for a decrease in serogroup 29E ST-254 meningococci (from 1.8% to 0.7%) and an increase in serogroup B ST-213 complex meningococci (from 6.7% to 10.6%) were less clear. Conclusions. Natural fluctuations in carried meningococcal genotypes and phenotypes a can be affected by the use of conjugate vaccines, and not all of these changes are anticipatable in advance of vaccine introduction.

AB - Background. Herd immunity is important in the effectiveness of conjugate polysaccharide vaccines against encapsulated bacteria. A large multicenter study investigated the effect of meningococcal serogroup C conjugate vaccine introduction on the meningococcal population. Methods. Carried meningococci in individuals aged 15-19 years attending education establishments were investigated before and for 2 years after vaccine introduction. Isolates were characterized by multilocus sequence typing, serogroup, and capsular region genotype and changes in phenotypes and genotypes assessed. Results. A total of 8462 meningococci were isolated from 47 765 participants (17.7%). Serogroup prevalence was similar over the 3 years, except for decreases of 80% for serogroup C and 40% for serogroup 29E. Clonal complexes were associated with particular serogroups and their relative proportions fluctuated, with 12 statistically significant changes (6 up, 6 down). The reduction of ST-11 complex serogroup C meningococci was probably due to vaccine introduction. Reasons for a decrease in serogroup 29E ST-254 meningococci (from 1.8% to 0.7%) and an increase in serogroup B ST-213 complex meningococci (from 6.7% to 10.6%) were less clear. Conclusions. Natural fluctuations in carried meningococcal genotypes and phenotypes a can be affected by the use of conjugate vaccines, and not all of these changes are anticipatable in advance of vaccine introduction.

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U2 - 10.1093/infdis/jir466

DO - 10.1093/infdis/jir466

M3 - Article

C2 - 21881120

AN - SCOPUS:80052403059

SN - 0022-1899

VL - 204

SP - 1046

EP - 1053

JO - Journal of Infectious Diseases

JF - Journal of Infectious Diseases

IS - 7

ER -

Changes in Serogroup and Genotype Prevalence among Carried Meningococci in the United Kingdom during Vaccine Implementation

Abstract

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