BACKGROUND: This study presents antigenic and genetic characteristics of Neisseria meningitidis strains recovered from invasive meningococcal disease (IMD) in the Czech Republic in 1971-2015. MATERIAL AND METHODS: A total of 1970 isolates from IMD, referred to the National Reference Laboratory for Meningococcal Infections in 1971-2015, were studied. All isolates were identified and characterized by conventional biochemical and serological tests. Most isolates (82.5%) were characterized by multilocus sequence typing method. RESULTS: In the study period 1971-2015, the leading serogroup was B (52.4%), most often assigned to clonal complexes cc32, cc41/44, cc18, and cc269. A significant percentage of strains were of serogroup C (41.4%), with high clonal homogeneity due to hyperinvasive complex cc11, which played an important role in IMD in the Czech Republic in the mid-1990s. Serogroup Y isolates, mostly assigned to cc23, and isolates of clonally homogeneous serogroup W have also been recovered more often over the last years. CONCLUSION: The incidence of IMD and distribution of serogroups and clonal complexes of N. meningitidis in the Czech Republic varied over time, as can be seen from the long-term monitoring, including molecular surveillance data. Data from the conventional and molecular IMD surveillance are helpful in refining the antimeningococcal vaccination strategy in the Czech Republic.

• MeSH
• Incidence MeSH
• Humans MeSH
• Meningococcal Infections diagnosis   epidemiology   microbiology   MeSH
• Multilocus Sequence Typing MeSH
• Neisseria meningitidis genetics   isolation & purification   MeSH
• Serogroup MeSH
• Bacterial Typing Techniques MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Geographicals
• Czech Republic epidemiology   MeSH

Various meningococcal conjugate vaccines exist against serogroups A, C, W and Y. A new protein-based vaccine targeting serogroup B (MenB) is also now available. The potential of such vaccines to drive serogroup replacement is considered a possible public health concern when implementing nationwide routine immunization programmes. The aim of this work was to investigate if and how serogroup replacement may occur following widespread vaccination with a MenB vaccine that may protect against carriage. To that end, we built a dynamic transmission model with age and serogroup stratification, focusing on European settings where most invasive meningococcal disease (IMD) cases are caused by serogroups B and C. For illustration purposes, the model was employed in 2 such settings: UK (England and Wales) and Czech Republic. Preliminary model-based projections suggest that, under strong serogroup competition for colonization, vaccine-induced serogroup replacement may occur even with a relatively low vaccine efficacy against serogroup B carriage (e.g., 20%), with potential subsequent increase in serogroup C IMD. The magnitude and speed of the model-projected serogroup C IMD increase depend on the MenB vaccination strategy, vaccine efficacy against carriage and the extent of any potential cross-protection against other serogroups. These analyses are neither exhaustive nor definitive, and focused on simulating potential population-level trends in IMD post-vaccination, under certain assumptions. Due to present inherent limitations and uncertainties, this study has limited quantitative value and is best regarded as an explorative qualitative modeling approach, to complement and challenge the current status quo, and suggest areas where collecting additional data may be essential.

• Keywords
• dynamic transmission model, invasive meningococcal disease, mathematical modeling, serogroup B meningococcal vaccine, serogroup replacement,
• MeSH
• Child MeSH
• Mass Vaccination MeSH
• Infant MeSH
• Humans MeSH
• Meningitis, Meningococcal microbiology   prevention & control   MeSH
• Meningococcal Vaccines immunology   MeSH
• Adolescent MeSH
• Neisseria meningitidis, Serogroup B immunology   MeSH
• Neisseria meningitidis, Serogroup C immunology   MeSH
• Child, Preschool MeSH
• Antibodies, Bacterial immunology   MeSH
• Models, Theoretical MeSH
• Vaccination MeSH
• Cross Protection immunology   MeSH
• Check Tag
• Child MeSH
• Infant MeSH
• Humans MeSH
• Adolescent MeSH
• Child, Preschool MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH
• Geographicals
• Czech Republic MeSH
• United Kingdom MeSH
• Names of Substances
• Meningococcal Vaccines MeSH
• Antibodies, Bacterial MeSH