A Multi-country Evaluation of Neisseria meningitidis Serogroup B Factor H-Binding Proteins and Implications for Vaccine Coverage in Different Age Groups

作者：Hoiseth Susan K; Murphy Ellen; Andrew Lubomira; Vogel Ulrich; Frosch Matthias; Hellenbrand Wiebke; Abad Raquel; Vazquez Julio A; Borrow Ray; Findlow Jamie; Taha Muhamed Kheir; Deghmane Ala Eddine; Caugant Dominique A; Kriz Paula; Musilek Martin; Mayer Leonard W; Wang Xin; MacNeil Jessica R; York Laura; Tan Charles Y; Jansen Kathrin U; Anderson Annaliesa S^*

来源：Pediatric Infectious Disease Journal, 2013, 32(10): 1096-1101.

DOI：10.1097/INF.0b013e31829aa63b

• factor H-binding protein
• meningococcal
• serogroup B vaccine
• epidemiology

Background: Recombinant vaccines containing factor H-binding protein (fHBP) have been developed for the purpose of protection from invasive meningococcal serogroup B disease. Neisseria meningitidis fHBP sequences can be divided into 2 genetically and immunologically distinct subfamilies (A and B); thus, cross protection is conferred within but not between subfamilies. A comprehensive understanding of fHBP epidemiology is required to accurately assess the potential vaccine impact when considering different vaccination implementation strategies. %26lt;br%26gt;Methods: Systematically collected invasive meningococcal serogroup B isolates from England, Wales, Northern Ireland, the United States, Norway, France and the Czech Republic were previously characterized for fHBP sequence. This study expanded the evaluation with additional meningococcal serogroup B disease isolates from Spain (n = 346) and Germany (n = 205). This expanded set (n = 1841), collected over a 6-year period (2001 to 2006), was evaluated for fHBP sequence and fHBP subfamily relative to patient age. %26lt;br%26gt;Results: All 1841 isolates contained fhbp. fHBP sequences from Spain and Germany fell within the previously described subfamilies, with 69% of isolates belonging to subfamily B and 31% to subfamily A; prevalent sequence variants were also similar. Stratification of data by age indicated that disease in infants %26lt;1 year of age was caused by a significantly higher proportion of isolates with fHBP subfamily A variants than that seen in adolescents and young adults 11-25 years (47.7% versus 19.5%, P %26lt; 0.0001, respectively). %26lt;br%26gt;Conclusions: These observations highlight a difference in epidemiology of fHBP subfamilies in different age groups, with fHBP subfamily A strains causing more disease in vulnerable populations, such as infants, than in adolescents.

• 出版日期2013-10