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Cocirculation of Hajj and non-Hajj strains among serogroup W meningococci in Italy, 2000 to 2016
- Cecilia Fazio1 , Arianna Neri1 , Paola Vacca1 , Andrea Ciammaruconi2 , Milena Arghittu3 , Anna Maria Barbui4 , Caterina Vocale5 , Paola Bernaschi6 , Patrizia Isola7 , Irene Alessandra Galanti8 , Antonella Mencacci9 , Rosella De Nittis10 , Maria Chironna11 , Anna Giammanco12 , Elisabetta Pagani13 , Alessandro Bisbano14 , Paola Stefanelli1
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View Affiliations Hide AffiliationsAffiliations: 1 Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy 2 Molecular Biology Section, Army Medical and Veterinary Research Center, Rome, Italy 3 Microbiology Unit, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy 4 Microbiology and Virology Laboratory, Molinette Hospital, Turin, Italy 5 Unit of Clinical Microbiology, Regional Reference Centre for Microbiological Emergencies, St. Orsola Malpighi University Hospital, Bologna, Italy 6 Microbiology Laboratory, Bambino Gesù Hospital, Rome, Italy 7 Clinical Pathology Department, Azienda USL 6, Livorno, Italy 8 Microbiology Laboratory, Azienda USL Toscana sud est, Arezzo, Italy 9 Medical Microbiology Section, Dept. of Medicine, University of Perugia, Perugia, Italy 10 Clinical Pathology Department, University Hospital, Foggia, Italy 11 Biomedical Sciences and Human Oncology Department – Hygiene Section, University Hospital, Bari, Italy 12 Department of Sciences for Health Promotion and Mother and Child Care “G. D’Alessandro”, University of Palermo, Palermo, Italy 13 Microbiology and Virology Laboratory, Azienda Sanitaria dell’Alto Adige, Bolzano, Italy 14 Epidemiology Unit ASP Crotone, ItalyPaola Stefanellipaola.stefanelli iss.it
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Citation style for this article: Fazio Cecilia, Neri Arianna, Vacca Paola, Ciammaruconi Andrea, Arghittu Milena, Barbui Anna Maria, Vocale Caterina, Bernaschi Paola, Isola Patrizia, Galanti Irene Alessandra, Mencacci Antonella, De Nittis Rosella, Chironna Maria, Giammanco Anna, Pagani Elisabetta, Bisbano Alessandro, Stefanelli Paola. Cocirculation of Hajj and non-Hajj strains among serogroup W meningococci in Italy, 2000 to 2016. Euro Surveill. 2019;24(4):pii=1800183. https://doi.org/10.2807/1560-7917.ES.2019.24.4.1800183 Received: 11 Apr 2018; Accepted: 23 Oct 2018
Abstract
In Italy, B and C are the predominant serogroups among meningococci causing invasive diseases. Nevertheless, in the period from 2013 to 2016, an increase in serogroup W Neisseria meningitidis (MenW) was observed. This study intends to define the main characteristics of 63 MenW isolates responsible of invasive meningococcal disease (IMD) in Italy from 2000 to 2016. We performed whole genome sequencing on bacterial isolates or single gene sequencing on culture-negative samples to evaluate molecular heterogeneity. Our main finding was the cocirculation of the Hajj and the South American sublineages belonging to MenW/clonal complex (cc)11, which gradually surpassed the MenW/cc22 in Italy. All MenW/cc11 isolates were fully susceptible to cefotaxime, ceftriaxone, ciprofloxacin, penicillin G and rifampicin. We identified the full-length NadA protein variant 2/3, present in all the MenW/cc11. We also identified the fHbp variant 1, which we found exclusively in the MenW/cc11/Hajj sublineage. Concern about the epidemic potential of MenW/cc11 has increased worldwide since the year 2000. Continued surveillance, supported by genomic characterisation, allows high-resolution tracking of pathogen dissemination and the detection of epidemic-associated strains.
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