2015 - 2019年美国加强脑膜炎球菌病监测 - Suppr

Enhanced Surveillance for Meningococcal Disease-United States, 2015-2019.

作者信息

Rubis Amy B, Marasini Daya, Howie Rebecca, Wagle Basanta, Sharma Shalabh, Thomas Brittney, Eisen Sara, Shrestha Sandip, Marjuki Henju, McNamara Lucy A

机构信息

Meningitis and Vaccine Preventable Diseases Branch, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.

Applied Science Research and Technology, Contractor assigned to Meningitis and Vaccine Preventable Diseases Branch, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.

出版信息

PLoS One. 2025 Jun 9;20(6):e0319940. doi: 10.1371/journal.pone.0319940. eCollection 2025.

BACKGROUND

High quality surveillance data are important to monitor U.S. epidemiology of meningococcal disease. Enhanced Meningococcal Disease Surveillance (EMDS) was established in 2015 to collect additional data and isolates from reported cases.

METHODS

Epidemiologic information and isolates obtained through EMDS for meningococcal disease cases reported through the National Notifiable Diseases Surveillance System (NNDSS) during 2015-2019 were included in the analysis. Isolates were characterized by serogrouping and molecular typing using either Sanger sequencing or whole genome sequencing. Case fatality ratios (CFRs) were calculated using cases with known outcome as the denominator. Odds ratios (ORs) were calculated using logistic regression.

RESULTS

A total of 1,806 meningococcal disease cases were reported during 2015-2019. The average annual incidence was 0.11 cases per 100,000 population. For key variables already collected through NNDSS, EMDS improved completeness over NNDSS by 21%-39% each year during 2015-2019. Completeness of key variables in EMDS improved over time by an average of 18%. Testing of isolates submitted through EMDS showed that serogroups B and C were predominant in all five years. For serogroup B, the most common clonal complex (CC) was CC32 in 2015-2017 and CC41/44 in 2018-2019; for serogroup C, CC11 was most common in 2015-2017 and CC103 in 2018-2019. The CFR was significantly lower for CC103 (6.7%) compared to other CCs (13.6%) (OR 0.44, 95% CI: 0.22-0.89).

CONCLUSIONS

U.S. incidence of meningococcal disease remained low during 2015-2019. Data and isolates obtained from EMDS supplement NNDSS and are critical to monitor U.S. meningococcal disease epidemiology.

背景

高质量的监测数据对于监测美国脑膜炎球菌病的流行病学情况至关重要。强化脑膜炎球菌病监测（EMDS）于2015年设立，旨在从报告病例中收集更多数据和分离株。

方法

分析2015 - 2019年期间通过强化脑膜炎球菌病监测（EMDS）获得的、通过国家法定传染病监测系统（NNDSS）报告的脑膜炎球菌病病例的流行病学信息和分离株。分离株通过血清分型以及使用桑格测序或全基因组测序进行分子分型来鉴定。病死率（CFR）以已知结局的病例作为分母进行计算。比值比（OR）使用逻辑回归进行计算。

结果

2015 - 2019年期间共报告了1806例脑膜炎球菌病病例。年平均发病率为每10万人0.11例。对于已通过国家法定传染病监测系统（NNDSS）收集的关键变量，在2015 - 2019年期间，强化脑膜炎球菌病监测（EMDS）每年比国家法定传染病监测系统（NNDSS）的完整性提高21% - 39%。强化脑膜炎球菌病监测（EMDS）中关键变量的完整性随时间平均提高了18%。对通过强化脑膜炎球菌病监测（EMDS）提交的分离株检测显示，血清群B和C在所有五年中均占主导地位。对于血清群B，最常见的克隆复合体（CC）在2015 - 2017年是CC32，在2018 - 2019年是CC41/44；对于血清群C，CC11在2015 - 2017年最常见，在2018 - 2019年是CC103。与其他克隆复合体（13.6%）相比，CC103的病死率（6.7%）显著更低（比值比0.44，95%置信区间：0.22 - 0.89）。