Lahra Monica M, Enriquez Rodney P, Hogan Tiffany P
The National Neisseria Network, Australia; Neisseria Reference Laboratory and World Health Organisation Collaborating Centre for STD, Sydney; New South Wales Health Pathology, Microbiology, The Prince of Wales Hospital, Randwick, NSW Australia;School of Medical Sciences, Faculty of Medicine, The University of New South Wales, 2053 Australia.
The National Neisseria Network, Australia; Neisseria Reference Laboratory and World Health Organisation Collaborating Centre for STD, Sydney; New South Wales Health Pathology, Microbiology, The Prince of Wales Hospital, Randwick, NSW Australia.
Commun Dis Intell (2018). 2020 Mar 16;44. doi: 10.33321/cdi.2020.44.10.
Invasive meningococcal disease (IMD) is a notifiable disease in Australia, and both probable and laboratory-confirmed cases of IMD are reported to the National Notifiable Diseases Surveillance System (NNDSS). In 2018, there were 281 IMD cases notified to the NNDSS. Of these, 278 were laboratory-confirmed cases analysed by the reference laboratories of the Australian National Neisseria Network (NNN). On investigation, the serogroup was able to be determined for 98.6% (274/278) of laboratory-confirmed cases. Serogroup B infections accounted for 44.2% of cases (123 cases); serogroup W for 36.3% of cases (101 cases); serogroup Y infections for 15.8% (44 cases) and serogroup C 1.4% (4 cases); and there were two unrelated cases (0.7%) of IMD attributable to serogroup E. Using molecular methods, 181/278 IMD cases were able to be typed. Of note was that 89% of typed serogroup W IMD cases (66/74) were porA antigen type P1.5,2; of this number, 44% (29/66) were sequence type 11, the hypervirulent strain reported in recent outbreaks in Australia and overseas. The primary age peak of IMD in Australia in 2018 was again observed in adults aged 45 years or more; a secondary disease peak was observed in children and infants aged less than 5 years. Serogroup B infections predominated in those aged less than 5 years, whereas serogroup W and serogroup Y infections predominated in those aged 45 years or more. Of the IMD isolates tested for antimicrobial susceptibility, 1.4% (3/210) were resistant to penicillin with an MIC ≥ 1 mg/L, and decreased susceptibility to penicillin was observed in a further 93.8% (197/210) of isolates. All isolates were susceptible to ceftriaxone and rifampicin; there was one isolate less susceptible to ciprofloxacin.
侵袭性脑膜炎球菌病（IMD）在澳大利亚属于法定报告疾病，疑似和实验室确诊的IMD病例均需上报至国家法定传染病监测系统（NNDSS）。2018年，NNDSS共收到281例IMD病例报告。其中，278例为经澳大利亚国家奈瑟菌网络（NNN）参考实验室分析的实验室确诊病例。经调查，98.6%（274/278）的实验室确诊病例能够确定血清群。B群感染占病例的44.2%（123例）；W群占36.3%（101例）；Y群感染占15.8%（44例），C群占1.4%（4例）；另有两例（0.7%）不相关的IMD病例归因于E群。采用分子方法，278例IMD病例中有181例能够分型。值得注意的是，W群IMD分型病例中89%（66/74）为P1.5,2型孔蛋白抗原；其中44%（29/66）为序列型11，即澳大利亚和海外近期疫情中报告的高毒力菌株。2018年澳大利亚IMD的主要发病年龄高峰再次出现在45岁及以上成年人中；次要发病高峰出现在5岁以下儿童和婴儿中。B群感染在5岁以下人群中占主导，而W群和Y群感染在45岁及以上人群中占主导。在检测抗菌药物敏感性的IMD分离株中，1.4%（3/210）对青霉素耐药，最低抑菌浓度（MIC）≥1mg/L，另有93.8%（197/210）的分离株对青霉素敏感性降低。所有分离株对头孢曲松和利福平敏感；有1株对环丙沙星敏感性较低。
