Falguières Michaël, Hong Eva, Denizon Mélanie, Terrade Aude, Taha Muhamed-Kheir, Deghmane Ala-Eddine
Invasive Bacterial Infections Unit and National Reference Centre for Meningococci and Haemophilus Influnezae, Institut Pasteur and Université Paris Cité, Paris, France.
Commun Med (Lond). 2025 Mar 25;5(1):87. doi: 10.1038/s43856-025-00800-2.
Invasive meningococcal disease (IMD) of serogroup B is preventable by protein-based vaccines targeting one (Bivalent rLP2086 vaccine) or several variable proteins (4CMenB vaccine) at the bacterial surface. The 4CMenB was licensed in Europe in 2013 but has been recommended and reimbursed in France for infants over 2 months old since April 2022. The bivalent rLP2086 vaccine was licensed in Europe in 2017 for subjects of 10 years and older. Evaluating strain coverage and fluctuations prior to large scale vaccine use is highly informative.
We analysed invasive isolates at the French National Reference Centre for meningococci between 1975 and 2022. The 1691 recovered isolates were sequenced. We scored sex, and age groups of subjects. We also scored clonal complexes (CC) and the predicted coverage rates of the corresponding isolates using the genetic Meningococcal Antigen Typing System (gMATS) and the Meningococcal Deduced Vaccine Antigen Reactivity (MenDeVAR).
The period was divided into four periods 1975-1986, 1987-1998-1999-2010 and 2011-2022. Our data clearly show significant differences in the distribution of alleles encoding the vaccine-covered antigens between these four periods. The clonal complex (CC) distribution also differed between the two periods with the disappearance of CC8 since 2011 and drastic decreases in CC11 since 1999. MenDeVar-predicted coverage fluctuated between 46.8% and 60.6% during the four periods for the 4CMenB and between 63.4% and 81.3% for rLP2086. For 4CMenB, coverage was higher using gMATS and varied between 74.5% and 85.0%. Fluctuations were also observed for all age groups.
IMD epidemiology is continuously changing with fluctuation in vaccine strain coverage over the 48 years prior to the routine implementation of the vaccines.
B 群侵袭性脑膜炎球菌病（IMD）可通过针对细菌表面一种（二价 rLP2086 疫苗）或几种可变蛋白（4CMenB 疫苗）的基于蛋白的疫苗来预防。4CMenB 于 2013 年在欧洲获得许可，但自 2022 年 4 月起在法国已被推荐用于 2 个月以上婴儿并纳入医保报销范围。二价 rLP2086 疫苗于 2017 年在欧洲获得许可，用于 10 岁及以上人群。在大规模疫苗使用之前评估菌株覆盖率和波动情况具有很高的参考价值。
我们分析了 1975 年至 2022 年期间法国国家脑膜炎球菌参考中心的侵袭性分离株。对回收的 1691 株分离株进行了测序。我们记录了受试者的性别和年龄组。我们还使用基因脑膜炎球菌抗原分型系统（gMATS）和脑膜炎球菌推导疫苗抗原反应性（MenDeVAR）对克隆复合体（CC）以及相应分离株的预测覆盖率进行了评分。
该时期分为四个阶段：1975 - 1986 年、1987 - 1998 年、1999 - 2010 年和 2011 - 2022 年。我们的数据清楚地表明，这四个时期之间编码疫苗覆盖抗原的等位基因分布存在显著差异。两个时期的克隆复合体（CC）分布也有所不同，自 2011 年以来 CC8 消失，自 1999 年以来 CC11 急剧减少。在四个时期内，4CMenB 的 MenDeVar 预测覆盖率在 46.8%至 60.6%之间波动，rLP2086 的预测覆盖率在 63.4%至 81.3%之间波动。对于 4CMenB，使用 gMATS 时覆盖率更高，在 74.5%至 85.0%之间变化。所有年龄组也都观察到了波动情况。
在疫苗常规接种前的 48 年里，IMD 的流行病学不断变化，疫苗菌株覆盖率存在波动。
