Caracterização fenotípica e genotípica de cepas invasivas de Neisseria meningitidis sorogrupo Y isoladas no Brasil durante o período de 2007 a 2011 / Phenotypic and genotypic characterization of invasive serogroup Y Neisseria meningitidis strains isolated in Brazil, 2007 and 2001

A Doença Meningocócica (DM) é de extrema importância para a Saúde Pública por sua tendência secular em causar surtos e epidemias, e pela alta letalidade e morbidade. Os sorogrupos A, B, C, W, Y e X de N. meningitidis são os responsáveis pela maioria dos casos de DM. Na última década observou-se, em cenário mundial, um crescente aumento no número de casos de DM pelo sorogrupo Y, e frequentemente associado ao complexo clonal ST-23/Cluster A3. Frente a este novo panorama epidemiológico da DM, o presente estudo teve como objetivo promover a caracterização fenotípica e genotípica das cepas de N. meningitidis sorogrupo Y isoladas no Brasil durante o período de 2007 a 2011. Das 68 cepas de N. meningitidis Y estudadas, isoladas de onze estados brasileiros, foram observados 20 genótipos diferentes para o gene porA, sendo o 18-1,3 o mais prevalente (22.1%), seguido pelo 5-1,2-2 (16.2%), 5-2,10-2 (14.7%) e 22,9 (7.4%). A maioria das amostras apresentou fHbp variante 2 (89.4%), seguido das variantes 3 (6.1%) e 1 (4.5%), e somente quatro (5.9%) cepas expressaram NadA. Um total de 21 STs foram determinados, sendo oito (36.4%) novos STs descritos neste estudo. As amostras foram agrupadas em sete diferentes complexos clonais, com a prevalência do complexo ST-23/Cluster A3 (25%), seguido do ST-175 (17.6%), ST-22 (7.4%), ST-174 (7.4%), ST-11 (3%), ST-167(3%), e ST-60 (3%). Os resultados demonstram, no Brasil, a circulação dos clones descritos como responsáveis pelo aumento do número de casos da DM pelo sorogrupo Y nos Estados Unidos e na Europa. Os dados reforçam a importância do monitoramento do sorogrupo Y na construção de novas estratégias de controle e prevenção da DM no país

Meningococcal disease (MD) is of great importance for public health for its tendency to cause outbreaks and epidemics, and for the high letality and morbidity. Serogroups A, B, C, W, Y and X of N. meningitidis are responsible for most of the MD cases. In the last decade, the increasing number of MD cases associated with serogroup Y, and often associated with the ST-23/Cluster A3 clonal complex has been observed worldwide. Facing this new epidemiological landscape of MD, the present study was aimed to characterize the phenotypically and genotypicaly of strains of N. meningitidis serogroup Y isolated in Brazil between 2007 and 2011. Among of 68 strains of N. meningitidis Y isolates from eleven Brazilian states, 20 different genotypes were observed for porA gene, 18-1,3 being the most prevalent (22.1%), followed by 5-1,2-2 (16.2% ), 5-2,10-2 (14.7%) and 22,9 (7.4%). Most of isolates showed fHbp variant 2 (89.4%), followed by variant 3 (6.1%) and 1 (4.5%), and only four (5.9%) strains expressed NadA. A total of 21 STs were determined, including eight (36.4%) new STs described in this study. The isolates were grouped into seven different clonal complexes, with the prevalence of the ST-23/Cluster A3 complex (25%), followed by ST-175 (17.6%), ST-22 (7.4%), ST-174 (7.4%), ST-11 (3%), 167 (3%), and ST-60 (3%). The results show, in Brazil, the circulation of the clones described as increasing the number of MD cases associated with serogroup Y in the United States and Europe. The data reinforce the importance of serogroup Y monitoring in the construction of new control strategies and prevention of DM in Brazil

Aislamiento de cepas invasivas de Neisseria meningitidis serogrupos B y Y en la ciudad de Cumaná, años 2009-2010 / Isolation of invasive strains of neisseria meningitides, serogroups B and Y, in Cumana, 2009-2010

Neisseria meningitidis es agente causal de meningitis y meningococcemia. Se realizó la presente investigación a fin de analizar fenotípicamente las cepas invasivas de N. meningitidis aisladas en Cumaná, estado Sucre. Se incluyó el total de cepas identificadas como N. meningitidis en el laboratorio de bacteriología del Hospital Universitario “Antonio Patricio de Alcalá”, durante los años 2009-2010; provenientes de muestras de líquido cefalorraquídeo (LCR) y sangre (hemocultivos). A cada aislamiento se le determinó la susceptibilidad antimicrobiana y el serogrupo respectivo. Durante el período en estudio se analizaron 10 cepas, de las cuales 5 provenían de LCR. El ensayo de susceptibilidad antimicrobiana reveló que las cepas presentaban sensibilidad a penicilina, cefotaxima, meropenem, rifampicina, ciprofloxacina y cloranfenicol siendo sólo resistentes al trimetoprim/ sulfametoxazol. El serogrupo más frecuente fue el B (8 cepas), aislándose un caso de serogrupo Y. Respecto al grupo etario de los pacientes, de las 10 cepas, 8 provenían de pacientes pediátricos. Este es el primer estudio con cepas de N. meningitidis aisladas en Cumaná, por lo que se hace imprescindible el análisis permanente de las cepas aisladas en la zona, con fines de monitoreo, principalmente, de la susceptibilidad antimicrobiana y los serogrupos circulantes.

Neisseria meningitidis is the causal agent for meningitis and meningococcemia. This research was performed to phenotypically analyze invasive strains of N. meningitidis isolated in Cumana, State of Sucre. The study included all strains identified as N. meningitidis isolated in the bacteriology laboratory at the University Hospital “Antonio Patricio de Alcalá,” during the years 2009-2010, coming from cerebrospinal fluid (CSF) samples and blood cultures. For each isolate, the antimicrobial susceptibility and respective serogroup were determined. During the period of study, 10 strains were analyzed, of which 5 came from CSF. The antimicrobial susceptibility test revealed that the strains showed sensitivity to penicillin, cefotaxime, meropenem, rifampicin, ciprofloxacin and chloramphenicol; they were resistant only to trimethoprim/ sulfamethoxazole. Serogroup B was the most frequent (8 strains); one case of serogroup Y was isolated. Regarding the patient’s ages, of the 10 strains, 8 were found in pediatric patients. This is the first study about strains of N. meningitidis isolated in Cumaná, so it is essential that permanent research regarding the strains isolated in the area is carried out for monitoring purposes, mainly in terms of antimicrobial susceptibility and the circulating serogroups.