PDF(Pubmed)
Abstract：
BACKGROUND: Invasive meningococcal disease (IMD) cases declined upon the implementation of non-pharmaceutical interventions (NPI) (social distancing and mask wearing) to control the COVID-19 pandemic but rebounded in 2022 in numbers with genotypical changes of the strains. We explored here associated modifications in the clinical presentations of IMD.
METHODS: We conducted a retrospective descriptive study using the Database of the French National Reference Centre for meningococci and Haemophilus influnezae for IMD cases between 2015 and 2022. We scored serogroups, sex, age groups, clinical presentations and clonal complexes of the corresponding patients and isolates.
RESULTS: Non-meningeal forms of IMD increased significantly upon easing of NPI, such as bacteremic meningococcal pneumonia and bacteremic abdominal forms. They represented 6% and 8% of all IMD forms and were significantly linked to serogroups Y and W respectively, to older adults for bacteremic pneumonia and to young adults for bacteremic abdominal presentations. These forms were significantly associated with more early mortality and clonal complexes 23, 11 and 9316.
CONCLUSIONS: The increase in atypical IMD forms may lead to higher burden of IMD due to delayed diagnosis and management. Updating prevention may be needed through by adapting the current vaccination strategies to epidemiological changes.
METHODS: We conducted a retrospective descriptive study using the Database of the French National Reference Centre for meningococci and Haemophilus influnezae for IMD cases between 2015 and 2022. We scored serogroups, sex, age groups, clinical presentations and clonal complexes of the corresponding patients and isolates.
RESULTS: Non-meningeal forms of IMD increased significantly upon easing of NPI, such as bacteremic meningococcal pneumonia and bacteremic abdominal forms. They represented 6% and 8% of all IMD forms and were significantly linked to serogroups Y and W respectively, to older adults for bacteremic pneumonia and to young adults for bacteremic abdominal presentations. These forms were significantly associated with more early mortality and clonal complexes 23, 11 and 9316.
CONCLUSIONS: The increase in atypical IMD forms may lead to higher burden of IMD due to delayed diagnosis and management. Updating prevention may be needed through by adapting the current vaccination strategies to epidemiological changes.
摘要：
背景：在实施非药物干预措施（NPI）（社交距离和戴口罩）以控制COVID-19大流行后，侵袭性脑膜炎球菌病（IMD）病例有所下降，但在2022年随着菌株的基因型变化而反弹。我们在这里探讨了IMD临床表现中的相关修饰。
方法：我们在2015年至2022年间，使用法国国家脑膜炎球菌和肺炎嗜血杆菌参考中心数据库对IMD病例进行了回顾性描述性研究。我们对血清群进行了评分，性别,年龄组,相应患者和分离株的临床表现和克隆复合物。
结果：非脑膜形式的IMD在NPI缓解后显著增加，如细菌性脑膜炎球菌肺炎和细菌性腹部形式。它们占所有IMD形式的6%和8%，分别与血清群Y和W显著相关，老年人用于细菌性肺炎，年轻人用于细菌性腹部表现。这些形式与更多的早期死亡率和克隆复合物23、11和9316显着相关。
结论：非典型IMD形式的增加可能会由于诊断和治疗的延迟而导致IMD负担增加。可能需要通过使当前的疫苗接种策略适应流行病学变化来更新预防。
方法：我们在2015年至2022年间，使用法国国家脑膜炎球菌和肺炎嗜血杆菌参考中心数据库对IMD病例进行了回顾性描述性研究。我们对血清群进行了评分，性别,年龄组,相应患者和分离株的临床表现和克隆复合物。
结果：非脑膜形式的IMD在NPI缓解后显著增加，如细菌性脑膜炎球菌肺炎和细菌性腹部形式。它们占所有IMD形式的6%和8%，分别与血清群Y和W显著相关，老年人用于细菌性肺炎，年轻人用于细菌性腹部表现。这些形式与更多的早期死亡率和克隆复合物23、11和9316显着相关。
结论：非典型IMD形式的增加可能会由于诊断和治疗的延迟而导致IMD负担增加。可能需要通过使当前的疫苗接种策略适应流行病学变化来更新预防。
