Forgor Abudulai Adams, Leimkugel Julia, Hodgson Abraham, Bugri Akalifa, Dangy Jean-Pierre, Gagneux Sébastien, Smith Tom, Pluschke Gerd
Navrongo Health Research Centre, Ministry of Health, Navrongo, Ghana.
Trop Med Int Health. 2005 Dec;10(12):1229-34. doi: 10.1111/j.1365-3156.2005.01520.x.
Neisseria meningitidis serogroup W135, well known for a long time as a cause of isolated cases of meningococcal meningitis, has recently increasingly been associated with disease outbreaks of considerable magnitude. Burkina Faso was hit by W135 epidemics in the dry seasons of 2002-2004, but only four W135 meningitis cases were recorded between February 2003 and March 2004 in adjoining Ghana. This reconfirms previous findings that bottlenecks exist in the spreading of new epidemic N. meningitidis clones within the meningitis belt of sub-Saharan Africa. Of the four Ghanaian W135 meningitis patients one died and three survived, of whom one had profound neurosensory hearing loss and speech impairment. All four disease isolates were sensitive to penicillin G, chloramphenicol, ciprofloxacin and cefotaxime and had the multi-locus sequence type (ST) 11, which is the major ST of the ET-37 clonal complex. Pulsed-field gel electrophoresis (PFGE) profiles of the Ghanaian disease isolates and recent epidemic isolates from Burkina Faso were largely identical. We conducted meningococcal colonization surveys in the home communities of three of the patients and in the Kassena Nankana District located at the border to Burkina Faso. W135 carriage rates ranged between 0% and 17.5%. When three consecutive surveys were conducted in the patient community with the highest carrier rate, persistence of W135 colonization over a period of 1 year was observed. Differences in PFGE profiles of carrier isolates taken at different times in the same patient community were indicative of rapid microevolution of the W135 bacteria, emphasizing the need for innovative fine typing methods to reveal the relationship between W135 isolates.
脑膜炎奈瑟菌W135群长期以来一直被认为是散发性脑膜炎球菌性脑膜炎的病因，最近它与大规模疾病暴发的关联日益增加。布基纳法索在2002 - 2004年旱季遭受了W135疫情，但在毗邻的加纳，2003年2月至2004年3月期间仅记录到4例W135脑膜炎病例。这再次证实了先前的研究结果，即在撒哈拉以南非洲脑膜炎带内，新的流行性脑膜炎奈瑟菌克隆传播存在瓶颈。加纳的4例W135脑膜炎患者中，1例死亡，3例存活，其中1例有严重的神经感觉性听力丧失和言语障碍。所有4株疾病分离株对青霉素G、氯霉素、环丙沙星和头孢噻肟敏感，且具有多位点序列类型（ST）11，这是ET - 37克隆复合体的主要ST。加纳疾病分离株和布基纳法索近期流行分离株的脉冲场凝胶电泳（PFGE）图谱基本相同。我们在其中3例患者的家庭社区以及与布基纳法索接壤的卡塞纳 - 南卡纳区进行了脑膜炎球菌定植调查。W135携带率在0%至17.5%之间。在携带率最高的患者社区连续进行3次调查时，观察到W135定植持续了1年。在同一患者社区不同时间采集的携带菌分离株的PFGE图谱差异表明W135细菌发生了快速微进化，这强调了需要创新的精细分型方法来揭示W135分离株之间的关系。
