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1.
Eur J Clin Microbiol Infect Dis ; 24(4): 280-3, 2005 Apr.
Article in English | MEDLINE | ID: mdl-15902536

ABSTRACT

In the study presented here 26 recent Danish clinical isolates of prolyliminopeptidase (PIP)-negative Neisseria gonorrhoeae were phenotypically and genotypically characterized to investigate whether one or more PIP-negative strains are circulating in the Danish community. The profiles of these isolates were compared with those of three isolates from a recent outbreak of PIP-negative N. gonorrhoeae infection in the UK. Twenty-five of the Danish isolates and all three UK isolates had similar antibiograms and were designated serovar IB-4. Genotypic characterization by pulsed-field gel electrophoresis, porB1b gene sequencing, and opa-typing revealed that these isolates were indistinguishable or closely related. The results indicate that at least one PIP-negative N. gonorrhoeae strain is currently circulating in the Danish community, and this strain is indistinguishable from the one that caused an outbreak in the UK.


Subject(s)
Neisseria gonorrhoeae/enzymology , Neisseria gonorrhoeae/genetics , Adult , Aminopeptidases , Denmark/epidemiology , Female , Genotype , Gonorrhea/epidemiology , Gonorrhea/microbiology , Humans , Male , Neisseria gonorrhoeae/classification , Phenotype , Phylogeny , Porins/genetics
2.
Epidemiol Infect ; 133(2): 205-15, 2005 Apr.
Article in English | MEDLINE | ID: mdl-15816145

ABSTRACT

The Danish meningococcal disease laboratory surveillance system was established in 1974, based on close collaboration between local Departments of Clinical Microbiology and the Reference Laboratory at Statens Serum Institut. The completeness of the clinical notification system integrated with the laboratory surveillance system has been estimated to be more than 95%. Overall 4257 (79%) of 5356 cases of meningococcal disease notified during 1974-1999 were confirmed by culture of Neisseria meningitidis. The proportion of culture-confirmed cases ranged from 70% in 1989 to 89% in 1980. Only 26 patients (0.6%) with culture-confirmed meningococcal disease were not notified. Serological phenotype and susceptibility to penicillin and sulphonamide were determined for all isolates. Multilocus enzyme electrophoresis and/or DNA-based analyses were used for the assessment of clusters and outbreaks. Meningococcal antibody tests and counter-immunoelectrophoresis were used for the ascertainment of suspected cases. These combined systems allowed timely and reliable management of outbreaks and identification of clusters.


Subject(s)
Disease Outbreaks , Meningococcal Infections/epidemiology , Neisseria meningitidis/genetics , Neisseria meningitidis/pathogenicity , Population Surveillance , DNA, Bacterial , Denmark/epidemiology , Drug Resistance, Bacterial , Enzyme-Linked Immunosorbent Assay , Epidemiologic Studies , Humans , Laboratories/standards , Neisseria meningitidis/isolation & purification , Phenotype , Retrospective Studies
3.
Epidemiol Infect ; 133(2): 217-27, 2005 Apr.
Article in English | MEDLINE | ID: mdl-15816146

ABSTRACT

Based on 9257 [correction] blood samples received from 7365 patients with a request for a meningococcal antibody test (MAT) during a 10-year period (1986-1995), the usefulness of the test in the diagnosis of meningococcal disease was assessed. Of 635 patients with culture-confirmed meningococcal disease, 88% were seronegative on admittance to hospital and 90% were seropositive 10-15 days after onset of disease. The humoral immune response in children <2 years of age was weaker than in older children and adults. Among 893 MAT-positive patients without culture-confirmed meningococcal disease, 261 (29%) had been notified as cases of meningococcal disease. Among 228 patients notified as serologically confirmed the MAT results were consistent with the clinical diagnosis in 86%. MAT is a reliable tool for establishing a diagnosis in patients with suspected meningococcal disease. Key factors facilitating appropriate interpretation of negative as well as positive test results were: time(s) of sampling(s) after onset of disease, age of the patient and clinical features.


Subject(s)
Antibodies, Bacterial/analysis , Disease Outbreaks , Meningococcal Infections/diagnosis , Meningococcal Infections/immunology , Neisseria meningitidis/immunology , Neisseria meningitidis/isolation & purification , Adolescent , Adult , Age Factors , Aged , Antibody Formation , Child , Child, Preschool , Female , Humans , Infant , Infant, Newborn , Male , Middle Aged , Neisseria meningitidis/pathogenicity , Reproducibility of Results , Retrospective Studies , Sensitivity and Specificity , Serologic Tests
4.
Eur J Clin Microbiol Infect Dis ; 21(7): 506-12, 2002 Jul.
Article in English | MEDLINE | ID: mdl-12172741

ABSTRACT

In a recent 20-year Danish survey, Neisseria meningitidis phenotypes B:15:P1.7,16 and C:2a:P1.2,5 were associated with an increased case-fatality rate of meningococcal disease - 15% and 23% - compared to the case-fatality rate of 8% for any other strain. The aim of the present study was to investigate (i) the mutual genetic relatedness of strains with phenotype B:15:P1.7,16, phenotype C:2a:P1.2,5 or serologically related phenotypes; (ii) the changes in the prevalence of distinctive clone complexes over time; and (iii) whether distinctive clone complexes are associated with an increased case-fatality rate. During the period 1980-1999, 181 of a total of 315 invasive strains obtained in North Jutland County, Denmark, were chosen on the basis of serological characteristics for characterization by multilocus enzyme electrophoresis and ribotyping. Two major complexes were identified on the basis of electrophoretic type (ET): the ET-4/23 complex ( n=111), which included all B:15:P1.7,16 strains ( n=100), and the ET-15/25 complex ( n=44), which included all C:2a:P1.2,5 strains ( n=31). Two ribotype complexes were identified within the ET-4/23 complex and one within the ET-15/25 complex, all of which were designated clone complexes. All three clone complexes were associated with an increased case-fatality rate (13-20%). The results show that, among invasive Neisseria meningitidis B:15:P1.7,16, C:2a:P1.2,5 and phenotypically related strains, three distinctive clone complexes are more virulent than any other ET/ribotype combination.


Subject(s)
Meningococcal Infections/microbiology , Meningococcal Infections/mortality , Neisseria meningitidis/classification , Neisseria meningitidis/physiology , Bacterial Typing Techniques , Denmark/epidemiology , Genotype , Humans , Meningococcal Infections/epidemiology , Neisseria meningitidis/enzymology , Neisseria meningitidis/genetics , Phenotype , Prevalence , Ribotyping
5.
Ugeskr Laeger ; 163(34): 4583-6, 2001 Aug 20.
Article in Danish | MEDLINE | ID: mdl-11530566

ABSTRACT

INTRODUCTION: Chlamydia is the most common sexually transmitted bacterial infection in Denmark. Each year 13-14,000 cases are diagnosed; of these about 3000 occur in men. In order to describe the prevalence of chlamydia among young men, screening for chlamydia was conducted in those liable for military service and coming before the medical board. MATERIALS AND METHODS: Of 2500 men coming before the medical boards in North Jutland State County, Arhus State County, and Copenhagen County during the winter of 1996-97, 1345 men aged 17-32 (median 18 years) were entered in the study. The participants sent a urine sample and a filled-in questionnaire to Statens Serum Institut. The urine samples were analysed by an in-house PCR and the test results were sent to the participant; if permission had been granted, the positive test results were further sent to the general practitioner, along with a second questionnaire. RESULTS: Chlamydia was found in 4.8% (65/1345) of all participants and in 6.9% of those sexually active. In North Jutland State County 7.1 and 9.8%, respectively, had chlamydia, whereas the corresponding figures for Arhus State County and Copenhagen County were about 4% and 6%. Two-thirds of the patients had no symptoms of urethritis. DISCUSSION: The results of this study indicate that a considerable reservoir of unrecognised chlamydia must exist in young men. The prevalence of chlamydia was higher in North Jutland State County than in the other two districts. One explanation could be that there is more focus on sexually transmitted infections and contact tracing in the largest cities than in the rest of the country.


Subject(s)
Chlamydia Infections/epidemiology , Military Personnel , Adolescent , Adult , Chlamydia Infections/urine , Denmark/epidemiology , Humans , Incidence , Male , Mass Screening/methods , Polymerase Chain Reaction , Prevalence , Surveys and Questionnaires
6.
Eur J Clin Microbiol Infect Dis ; 20(5): 350-3, 2001 May.
Article in English | MEDLINE | ID: mdl-11453598

ABSTRACT

The aim of this study was to investigate the Neisseria meningitidis carriage rate among two cohorts of Polish recruits upon entry to the military and during the first 2 months of their service, i.e. in the spring and autumn of 1998, and to characterize the meningococcal strains isolated. Pharyngeal swabs were taken four and five times from 151 and 168 men, respectively. Altogether, 81 and 180 meningococcal isolates representing 54 and 102 different strains were recovered. The overall rates of carriage in the spring and in the autumn were 36% and 61%, and, among recruits who submitted to sampling on at least three occasions, 39% and 55%. Eighty-three of 156 (53%) meningococcal carrier strains were nongroupable; among the remaining strains, serogroup B was predominant (32% of all carrier strains). In both surveys the predominant phenotype was Neisseria meningitidis NG:21:P1.7.


Subject(s)
Carrier State/epidemiology , Meningococcal Infections/epidemiology , Neisseria meningitidis/classification , Adult , Carrier State/microbiology , Cohort Studies , Genotype , Humans , Male , Meningococcal Infections/microbiology , Military Personnel , Neisseria meningitidis/genetics , Neisseria meningitidis/isolation & purification , Pharynx/microbiology , Phenotype , Poland/epidemiology , Serotyping
7.
Eur J Clin Microbiol Infect Dis ; 20(4): 243-7, 2001 Apr.
Article in English | MEDLINE | ID: mdl-11399013

ABSTRACT

The aim of this study was to investigate the genetic relationships among strains belonging to Neisseria meningitidis serotype 22 recovered in Poland from 1995 to 1998. Phenotypical characterisation of meningococcal strains isolated from patients with meningococcal disease has been performed since 1995. Strains belonging to Neisseria meningitidis type 22 were most frequently recovered from severe cases of meningitis and septicaemia. The type 22 strains were separated into clusters by serosubtyping and DNA analyses by pulsed-field gel electrophoresis and ribotyping. However, the grouping according to serosubtypes was quite different from that obtained by ribotyping and pulsed-field gel electrophoresis. Furthermore, the two genotyping methods seldom identified the same clusters, nor were clusters identified among 26 Neisseria meningitidis type 22 strains recovered from patients hospitalised in five cities. Determination of the susceptibility to penicillin showed that a single strain was resistant (MIC, 2 mg/l) and that one-third (24/71) of the strains tested had reduced susceptibility (MIC range, 0.1-1 mg/l).


Subject(s)
Neisseria meningitidis/classification , Adult , Child, Preschool , Cluster Analysis , Genotype , Humans , Infant , Infant, Newborn , Microbial Sensitivity Tests , Neisseria meningitidis/drug effects , Neisseria meningitidis/genetics , Poland , Serotyping
8.
Scand J Infect Dis ; 32(5): 527-31, 2000.
Article in English | MEDLINE | ID: mdl-11055659

ABSTRACT

Through a 14-months extended surveillance of meningococcal disease in Denmark, all 322 notified cases were investigated for possible connection with a military camp where 3 cohorts of recruits (n = 1069) were studied prospectively for meningococcal carriage. One case occurred in a recruit who was a constant non-carrier during the preceding 3 months. The invasive Neisseria meningitidis B:1:P1.1,7 strain was isolated from the pharynx only in 3 out of 17 room-mates (18%); the strains were identical as assessed by genotyping (PFGE and ribotyping). Two civilian cases outside the camp had direct contact with 2 recruits, but neither these 2 nor other recruits in the relevant divisions carried the invasive strains on any occasion. Six civilian cases had marginal relationship with the camp, but no contact with the recruits. In conclusion, pheno- and genotyping concordantly demonstrated a high carriage rate of the invasive strain among the room-mates to a recruit with meningococcal disease. Transmission to the patient most likely occurred shortly before onset of illness. The extended surveillance did, however, not identify any unexpected epidemiological links and restriction of antibiotic chemoprophylaxis to household/sleeping/kissing contacts in sporadic cases of meningococcal disease seems appropriate and relevant.


Subject(s)
Carrier State/epidemiology , Meningococcal Infections/epidemiology , Military Personnel , Neisseria meningitidis/isolation & purification , Population Surveillance , Adult , Carrier State/microbiology , Child, Preschool , Denmark/epidemiology , Electrophoresis, Gel, Pulsed-Field , Female , Genotype , Humans , Male , Meningococcal Infections/microbiology , Middle Aged , Neisseria meningitidis/classification , Neisseria meningitidis/genetics , Pharynx/microbiology , Phenotype , Prospective Studies , Ribotyping
9.
Epidemiol Infect ; 121(1): 85-94, 1998 Aug.
Article in English | MEDLINE | ID: mdl-9747759

ABSTRACT

Three cohorts of Danish male military recruits (n = 1069) were studied for pharyngeal meningococcal carriage during 3 months at different seasons: 39-47% of entrants were meningococcal carriers and the carriage rate remained constant over time and season. However, individual changes in the carrier state occurred frequently, and after 3 months 34% had changed carrier state on one or more occasions. Initially, a loss of carriage predominated; on the other hand almost 20% of non-carriers had acquisition of meningococci within the first month. The serological phenotypes of the 670 carrier strains were compared with those of 261 invasive strains recovered concurrently from patients with meningococcal disease country-wide. Both carrier strains and invasive strains were phenotypically heterogeneous. Almost 60% of the invasive strains belonged to three phenotypes: B:15:P1.7, 16, C:2a:P1.2, 5 and C:2b:P1.2, 5. In contrast, these phenotypes only amounted to 3.2% of the carrier strains, among which no phenotype was found with a prevalence above 4.9%. However, 30% of the carrier strains had serological phenotypes identical to those of 80% of the invasive strains. Our results indicated that the transmission rate of potential pathogenic carrier strains did not differ from that of other carrier strains.


Subject(s)
Carrier State/epidemiology , Meningococcal Infections/epidemiology , Military Personnel , Neisseria meningitidis/isolation & purification , Denmark/epidemiology , Drug Resistance, Microbial , Humans , Longitudinal Studies , Male , Meningococcal Infections/microbiology , Microbial Sensitivity Tests , Neisseria meningitidis/classification , Neisseria meningitidis/drug effects , Pharynx/microbiology , Phenotype , Seasons , Serotyping
10.
Clin Diagn Lab Immunol ; 4(3): 345-51, 1997 May.
Article in English | MEDLINE | ID: mdl-9144375

ABSTRACT

In order to improve the surveillance of serogroup B and C meningococcal diseases, enzyme-linked immunosorbent assays (ELISAs) specific for anti-B immunoglobulin M (IgM) and anti-C IgM and IgG antibodies were developed. The tests were evaluated by using paired sera from 122 patients with and 101 patients without laboratory evidence of meningococcal disease. Fifty-three of 67 patients (79%) with culture-confirmed serogroup B disease had an anti-B IgM antibody response; anti-B IgM levels waned rapidly in children < or = 4 years of age. Twenty-four of 25 patients (96%) with culture-confirmed serogroup C disease had an anti-C IgM and/or IgG antibody response (IgM, 92%; IgG, 68%). In patients without evidence of meningococcal disease, 19% of children < or = 4 years of age and 69% of those > 4 years of age had intermediate anti-B IgM titers. In contrast, only 1 and 5% of these patients had intermediate titers of anti-C IgM and anti-C IgG, respectively. The ELISAs were shown to be powerful tools for discriminating between serogroup B and C diseases in 96 to 100% of culture-confirmed cases. For 90% of patients with culture-negative meningococcal disease, a serogroup-specific diagnosis could be established by examination of paired sera in the ELISAs. As serogroup B and C meningococci account for practically all cases of meningococcal disease in industrialized countries, the availability of these tests may improve surveillance and prevention.


Subject(s)
Antibodies, Bacterial/analysis , Antigens, Bacterial , Enzyme-Linked Immunosorbent Assay/methods , Meningitis, Meningococcal/immunology , Neisseria meningitidis/immunology , Polysaccharides, Bacterial/immunology , Adolescent , Adult , Aged , Antibodies, Bacterial/blood , Bacterial Capsules , Child , Child, Preschool , Denmark/epidemiology , Humans , Immunoglobulin G/blood , Immunoglobulin M/blood , Infant , Meningitis, Meningococcal/epidemiology , Meningococcal Infections/epidemiology , Meningococcal Infections/immunology , Middle Aged , Neisseria meningitidis/classification , Serotyping
11.
Scand J Infect Dis ; 25(3): 331-9, 1993.
Article in English | MEDLINE | ID: mdl-8362229

ABSTRACT

An outbreak involving 20 cases of serogroup C meningococcal disease, predominantly among teenagers, occurred over a 7-month period in the Randers area of Denmark. The cases were caused by serogroup C:2a:P1.2 sulphonamide-resistant strains. The available evidence was against the transmission being related to particular schools. The outbreak was experienced as 3 clusters. At 2 schools involved in the first and the third cluster of the outbreak, 351 students were examined regarding pharyngeal carriage of meningococci, 282 of whom were tested again 17 weeks later; 308 students attending two similar schools in a nearby area were examined once. The majority of strains isolated from group C carriers in the high-risk area were serologically indistinguishable from the outbreak strain (13/14 = 95%), but less often sulphonamide-resistant (5/13 = 38%). In both areas, the overall rate (30%), the overall group C rate (3%), the carrier rate for the outbreak strain (1%) were the same. The attack rate for the outbreak strain differed significantly: 1/40 in the high-risk area versus 1/2,500 in the normal risk area. No conditions that might explain this difference were revealed. Immediately after recognition of the first and the third cluster, 780 and 13,300 students, respectively, were vaccinated with meningococcal polysaccharide vaccine A+C. It was concluded that the definition of target groups for vaccination should be liberal, because the "at risk" population may be difficult to recognize at the onset of an outbreak.


Subject(s)
Carrier State/epidemiology , Disease Outbreaks , Meningococcal Infections/epidemiology , Neisseria meningitidis/isolation & purification , Pharynx/microbiology , Adolescent , Adult , Carrier State/microbiology , Cluster Analysis , Denmark/epidemiology , Female , Humans , Incidence , Male , Meningococcal Infections/microbiology
12.
Epidemiol Infect ; 108(1): 19-30, 1992 Feb.
Article in English | MEDLINE | ID: mdl-1547836

ABSTRACT

Epidemiological features of an outbreak of group B:15:P1.16 meningococcal disease (MD) in Frederiksborg county, Denmark, 1987-9, were investigated. The study comprised 149 cases notified during the outbreak and the two preceding years; 115 were confirmed by the isolation of Neisseria meningitidis. In 1989 the incidence had increased to 14.1 per 100,000 population. Among group B strains, B:15:P1.16 accounted for 80% (77/97). The overall mortality rate was 10% (15/149). Regarding cases due to group B:15:P1.16 strains a significant time-space clustering, which exclusively occurred within the 10-19 years age group, was demonstrated. The link between cases within clusters was indirect or unknown, except for ten patients with contact to one particular school. The prophylactic measures used included administration of rifampicin to household contacts. During the outbreak the proportion of secondary cases was high (6-15%). All secondary cases occurred outside the household indicating that the household had been protected.


Subject(s)
Disease Outbreaks/statistics & numerical data , Meningococcal Infections/epidemiology , Adolescent , Adult , Age Factors , Bacteremia/epidemiology , Bacteremia/mortality , Bacteremia/prevention & control , Child , Child, Preschool , Cluster Analysis , Denmark/epidemiology , Female , Humans , Infant , Male , Meningitis, Meningococcal/epidemiology , Meningitis, Meningococcal/mortality , Meningitis, Meningococcal/prevention & control , Meningococcal Infections/mortality , Meningococcal Infections/prevention & control , Neisseria meningitidis/classification , Neisseria meningitidis/isolation & purification , Prevalence , Rifampin/therapeutic use , Seasons , Serotyping , Sex Factors , Suburban Population
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