Mattheus Wesley, Hanquet Germaine, Collard Jean-Marc, Vanhoof Raymond, Bertrand Sophie
Sections of Bacterial Diseases, Scientific Institute of Public Health, Brussels, Belgium.
Medical Epidemiologist, Health Care Knowledge Centre, Brussels, Belgium.
PLoS One. 2015 Oct 1;10(10):e0139615. doi: 10.1371/journal.pone.0139615. eCollection 2015.
Invasive meningococcal disease (IMD) is a major cause of bacterial meningitides and septicaemia. This study shows the results of the laboratory-based surveillance of IMD in Belgium over the period 1997-2012.
The results are based on microbiological and molecular laboratory surveillance of 2997 clinical isolates of N. meningitides received by the Belgian Meningococcal Reference Centre (BMRC) over the period 1997-2012.
Serogroup B has always been a major cause of meningococcal disease in Belgium, with P3.4 as most frequent serotype till 2008, while an increase in non-serotypable strains has been observed in the last few years. Clonal complexes cc-41/44 and cc-269 are most frequently observed in serogroup B strains. In the late nineties, the incidence of serogroup C disease increased considerably and peaked in 2001, mainly associated with phenotypes C:2a:P1.5,2, C:2a:P1.5 and C:2a:P1.2 (ST-11/ET-37 clonal complex). The introduction of the meningococcal C conjugate vaccine has been followed by an 88% significant decrease in serogroup C disease from 2001 to 2004 nationally, yet sharper in Flanders (92%) compared to Wallonia (77%). Since 2008 a difference in incidence of serogroup C was observed in Flanders (0-0.1/100,000) versus Wallonia (0.1-0.3/100,000).
This study showed the change in epidemiology and strain population over a 16 years period spanning an exhaustive vaccination campaign and highlights the influence of regional vaccination policies with different cohorts sizes on short and long-term IMD incidences.
侵袭性脑膜炎球菌病（IMD）是细菌性脑膜炎和败血症的主要病因。本研究展示了1997年至2012年期间比利时基于实验室的IMD监测结果。
研究结果基于1997年至2012年期间比利时脑膜炎球菌参考中心（BMRC）接收的2997株脑膜炎奈瑟菌临床分离株的微生物学和分子实验室监测。
B群一直是比利时脑膜炎球菌病的主要病因，直到2008年P3.4是最常见的血清型，而在过去几年中观察到不可分型菌株有所增加。克隆复合体cc-41/44和cc-269在B群菌株中最常被观察到。在九十年代后期，C群疾病的发病率大幅上升，并在2001年达到峰值，主要与C:2a:P1.5,2、C:2a:P1.5和C:2a:P1.2表型（ST-11/ET-37克隆复合体）相关。自2001年至2004年全国范围内引入脑膜炎球菌C结合疫苗后，C群疾病显著下降了88%，但在弗拉芒地区（92%）比瓦隆地区（77%）下降得更明显。自2008年以来，弗拉芒地区（0-0.1/100,000）和瓦隆地区（0.1-0.3/100,000）的C群发病率出现差异。
本研究显示了在长达16年的全面疫苗接种运动期间流行病学和菌株群体的变化，并突出了不同队列规模的区域疫苗接种政策对短期和长期IMD发病率的影响。
