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Clinical presentation of invasive disease caused by Neisseria meningitidis serogroup Y in Sweden, 1995 to 2012
Örebro University, School of Medical Sciences. Department of Infectious Diseases, Faculty of Health and Medical Sciences, Örebro University, Örebro, Sweden.ORCID iD: 0000-0003-1999-3383
Örebro University, School of Medical Sciences. Örebro University Hospital. Department of Laboratory Medicine, Örebro University Hospital, Örebro, Sweden.ORCID iD: 0000-0003-4637-8626
Department of Infectious Diseases, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden.
Örebro University, School of Medical Sciences. Örebro University Hospital. Department of Laboratory Medicine, Örebro University Hospital, Örebro, Sweden.
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2017 (English)In: Epidemiology and Infection, ISSN 0950-2688, E-ISSN 1469-4409, Vol. 145, no 10, p. 2137-2143Article in journal (Refereed) Published
Abstract [en]

Over the period 1995-2012, the incidence of invasive meningococcal disease (IMD) caused by Neisseria meningitidis serogroup Y (NmY) increased significantly in Sweden. This is mainly due to the emergence of a predominant cluster named strain type YI subtype 1, belonging to the ST-23 clonal complex (cc). The aim of this study was to examine the clinical picture of patients with invasive disease caused by NmY and to analyse whether the predominant cluster exhibits certain clinical characteristics that might explain the increased incidence. In this retrospective observational study, the medical records available from patients with IMD caused by Nm serogroup Y in Sweden between 1995 and 2012 were systematically reviewed. Patient characteristics, in-hospital findings and outcome were studied and differences between the dominating cluster and other isolates were analysed. Medical records from 175 of 191 patients were retrieved. The median age was 62 years. The all-cause mortality within 30 days of admission was 9% (15/175) in the whole material; 4% (2/54) in the cohort with strain type YI subtype 1 and 11% (12/121) among patients with other isolates. Thirty-three per cent of the patients were diagnosed with meningitis, 19% with pneumonia, 10% with arthritis and 35% were found to have bacteraemia but no apparent organ manifestation. This survey included cases with an aggressive clinical course as well as cases with a relatively mild clinical presentation. There was a trend towards lower mortality and less-severe disease in the cohort with strain type YI subtype 1 compared with the group with other isolates.

Place, publisher, year, edition, pages
Cambridge University Press, 2017. Vol. 145, no 10, p. 2137-2143
Keywords [en]
Invasive meningococcal disease, meningococcal disease, Neisseria meningitidis, Neisseria meningitidis serogroup Y, Sweden
National Category
Infectious Medicine Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:oru:diva-58934DOI: 10.1017/S0950268817000929ISI: 000404243900018PubMedID: 28478773Scopus ID: 2-s2.0-85018441510OAI: oai:DiVA.org:oru-58934DiVA, id: diva2:1134654
Note

Funding Agency:

Region Örebro County Research Committee 

Available from: 2017-08-21 Created: 2017-08-21 Last updated: 2019-03-26Bibliographically approved

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Säll, OlofStenmark, BiancaJacobsson, SusanneFredlund, Hans

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