Neisseria meningitidis W135 Invasive Infections in children ...

... Chalvon-Demersay, Chami, Chamouilli, Chamoux, Chandesris, Chantelat, Chantepie, Chaplain, Chappet, Charachon, Charara, Chardon, Charras, Charvet,.
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ESPID 2012

Contact information : Jean Gaschignard 14 rue Juge, 75015 Paris Phone : (+33) 6 86 99 54 48 Email : [email protected]

ACT IV

Neisseria meningitidis W135 Invasive Infections in children : epidemiological, clinical and genotypic features in a French national survey J. Gaschignard1,2, C. Levy2,3, A.E. Deghmane4, D. Giorgini4, E. Hong4, R. Cohen2,3, F. Dubos2,E. Bingen1,2, A. Faye1,2, M.K. Taha4 Institute(s): 1Hop Robert Debré, APHP, Université Paris 7 Denis Diderot, Paris-Sorbonne-Cité, 2GPIP, 3ACTIV, 4Institut Pasteur, Paris, France

Introduction

Material and Methods

W135 Invasive Meningococcal Disease (IMD) -1968: first description, -2000s: epidemics in Africa and linked to pilgrimage to Mecca -Case-reports of extra-meningeal presentation -Few pediatric data Aims: -Describe W135 IMD epidemiology in children -Study correlation between genotypes of isolates and clinical manifestations

Two French National Prospective Surveys: 1. French National Reference Center for meningococci (Institut Pasteur) 2. GPIP/ACTIV network of 252 pediatric ward Inclusion criteria: -Children 1 day to 18 years old -W135 IMD = positive culture or PCR for Neisseria meningitidis W135 in a sterile site

Definitions: -Meningitis: positive culture or PCR in the CSF or pleiocytosis (> 10 cells/mm3) with positive culture or PCR in the blood -Arthritis: positive culture or PCR in the articular fluid or monoarthritis with positive culture or PCR in the blood Genotyping by Multi Locus Sequence Typing

Results Figure 1. Diagnosis flowchart (n=119)

119 cases Culture + 100

Figure 2. Age distribution (n=118)

Figure 3. Initial clinical status (n=119)

Number of cases (sex ratio M/F = 1.2)

Culture – 19

Meningococcemia n=25 †3

40 35

Fulminans n=6 †2

30

CSF 56

Blood 39

25

Articlar fluid 5

Arthritis n=10 †0

20

PCR + 19

15 10 5

CSF 12

Meningitis n=78 †2

0

Blood 4

Articlar fluid 3

0

1

2

3

4

5

6

7

8

9 10 11 12 13 14 15 16 17

Age (years)

†number of death / total = 7/119 (6%)

Figure 4. Genotypes distribution (n=99)

Figure 5. Initial clinical status according to clonal complex

*

*

*p = 0.007 for proportion of meningitis between ST-22 and ST-11 Acknowledgments We thank all pediatricians and microbiologists who participated to the study Abdelhadi, Aberrane, Abou Tara, Abrudan, Achkar, Adam, Adamon, Afanetti, Akitani,Alba-Sauviat, Albertini, Aljazayri, Aljumaidi, Allia, Alonso, Altuzarra, Amama, Amira, Amirault, Amsallen, Anastay, Andlauer, Andriantahina, Arlet, Armengaud,Arnault, Aubert, Audry, Aujard, Bachelier, Bajolle, Bandin, Banerjee, Barbier, Barnaud, Baron-Joly, Barrans, Barraud, Barre, Barthez, Bartizel, Baruteau, Bassil, Bayle, Belgaid, Belivier, Ben Ameur, Benabdelmalek, Benchekroun, Benezech, Bengrina, Benmahammed, Benmoulai, Benoist, Benoit, Bensaid, Benseddik, Berche , Bernard, Berrahma, Berterottiere, Berthelot, Berthier, Bertrou, Bessis, Besson-Leaud, Biessy, Billion, Bina, Bineau, Bingen, Bitar, Blanc, Bland, Blondel, Blondin, Boileau, Boivin, Boize, Bolot, Boniface, Bonnin, Boquet, Born, Bosdure, Bost-Bru, Bouderlique, Bouige, Boukezia, Bour, Boussadia, Boutros, Boutte, Bouziges, Bovero, Boyer, Branca, Branger, Bresson, Breuil, Briand, Briffod, Brizard, Brocard, Brouard, Broussine, Bruna, Brunel, Bruyas, Bucur, Buisson-Touati, Caillaux, Callamand, Calvez, Cambonie, Campet, Canis, Canonne, Canzi, Capdeville, Carbajal, Carbonnelle, Carre, Carre-Cavellier, Carriere, Carroger, Cartier, Cartier-Riviere, Cascarigny, Castelnau, Cathenoz, Cattoen, Cau, Cauby, Cavalier, Cecille, Chabrol, Chaix, Chalumeau, Chalvon-Demersay, Chami, Chamouilli, Chamoux, Chandesris, Chantelat, Chantepie, Chaplain, Chappet, Charachon, Charara, Chardon, Charras, Charvet, Chenaud, Chergui, Cheron, Cheuret, Chevallier, Chomienne, Ciupek, Claris, Clergeau, Cointin, Colin Gorski, Collignon, Colombani, Combe, Constanty, Cordier, Cormier, Cosson, Costa, Cottin, Coumenges, Courcol, Courouble, Courtad, Crepet, Croize, Crost , Cuvelier, Cuzzi, D'albignac, Dabernat, Dagorne, Dalmon, Daltroff, Danan, Danekova, Danjean-Deguin, Danjoux, Dao, Dao-Dubremptz, Daoud, Darras, Dassieu, Dauger, David Rubin, De Champs, De Lumley, De Montclos, De Montgolfier, De Ricaud, Debriel, Decoster, Decousser, Deforche, Delacour, Delamare, Delaporte, Delarbre, Delavelle, Delbeke, Delesalle, Deligne, Delisle, Demachy, Demarcq, Demarque, Demarquez, Denis, Desfrere, Despert, Desprez, Dessioux, Desvigne, Deutscher, Devictor, Deville, Devouge, Dhaoui, Dib, Dieckmann, Dolhem, Dorangeon, Doucet-Populaire, Douchain, Dubois, Dubos, Dubourdieu, Duchaine, Dufour, Dumont, Dumoulard, Dupre, Durand, Duval-Arnould, Eb, Eicher, Eitenschenck, Elbez, Elharrif, Emond, Enchery, Escarguel, Estapa, Esteve, Estournet Mathiaud, Estrangin, Etienne, Evers, Evrard, Eyssette-Guerreau, Faibis, Fargeot Espaliat, Farges, Fasquelle, Faul, Favaretto, Faye, Ferroni, Fevre, Fiette, Fihman, Fischbach, Flipo, Flurin, Forget, Fortin, Fos, Foskett, Foucaud, Franc, Frey, Freydiere, Fruchart-Flamenbaum, Furioli, Gagliardone, Gaillard, Gallou, Ganivala, Garandeau, Garbarg-Chenon, Garcera, Gardrat, Garnier, Garrec, Gaschet, Gaudelus, Gauduchon, Gavignet, Gbadamassi, Geffroy, Gendrel, Geraudel, Gilles, Gillet, Girard, Gire, Girier, Glastre, Goldstein, Goudeau, Gougeon, Goumy, Gouraud, Goux, Graff, Graine, Grancher, Granier, Granry, Greco, Gremeaux, Gremillet, Gressier, Grimprel, Grise, Guerin, Guichard, Guiet, Guillaume Baudet, Guillermet-Fromentin, Guillois, Guillot, Guyon, Guyot, Haas, Hachani, Hachart, Hage, Hallalel, Halphen, Hasselmann, Hautefort, Hees, Hefteh, Heidt, Hentgen, Hernandorena, Herve, Heurte, Heusse, Hevin-Martin, Heyman, Hidri, Hoffmann, Hombrouck-Alet, Honore, Horea, Hubert, Hudebine, Huet, Huin, Hureaux, Husson, Huvenne, Ikounga, Imbert, Jacob, Jalloul, Jan, Jaouen, Jarlier, Jaulhac, Jeannoel, Jeannot, Jeny, Jeudy, Jokic, Joly-Guillou, Jomaa, Joram, Julienne, Jullian, Kalach, Khazaal, Kirch, Kitzis, Klein, Kone-Paut, Kozisek, Kretz, Kuntzel, Labbe, Labenne, Laborie, Labrune, Lafargue, Lafendi, Laffort, Lagier, Lahrach, Laidj, Laisney, Lajarrige, Lakhdari, Laluque, Lamarca, Lambert, Landragin, Lanotte, Larchet, Larroque, Launay, Layadi, Le Bail, Le Bideau, Le Gagneur, Le Gall, Le Lorier, Le Luyer, Le Monnier, Le Turdu, Leblanc, Leboucher, Lebrun, Lecarpentier, Lecine, Leclerc, Leclercq, Lecomte, Lecoustumier, Lefrand-Crepin, Legagneur, Lehnert, Lehours, Lelioux, Leluan, Lemari, Lemble, Lemeland, Lemenand, Lenclen, Leneveu, Leotard, Lesage, Lesbros, Lescanne, Levy, Lorrot, Louf, Lounis, Lureau, M'bamba, Maakaroun, Madhi, Magny, Magrhraoui, Malbrunot, Mallet, Mammeri, Mancini, Mangeol, Marani, Marcou, Marie Dit Dinard, Marin, Marmonier, Marmouset, Marret, Martin, Martinat, Martinot, Mas, Mathieu, Maugard, Maurage, Mazataud, Melon, Menget, Menouar, Menouni-Foray, Meunier, Meyer, Mignard, Mignot, Mikail, Milesi, Milh, Milleret-Proyart, Mitanchez, Mondaud, Monier, Monin, Morales-Gineste, Moreau, Moregne, Morice, Moriette, Morin, Morisot, Morville, Motte, Mougin-Joubert, Moulene, Mouly, Mounzer, Mselati, Muller, Nacer, Naudion, Nelson, Nerl Schiavini, Nerome, Netter, Neuwirth, Nordmann, Noulard, Orzechowski, Ould, Oules , Paget, Pangon, Pannecouck, Paon, Parez, Paris, Pateyron, Patoz, Paul, Paul, Paut, Pautard, Pejoan, Pellerin, Pelloux, Penaud, Penel, Peralta, Perez, Perrin, Perroud, Petit, Petitboulanger, Peyraud, Phan, Philippon, Picherot, Pierre, Pierrejean, Pigeon, Pinquier, Plasse, Ploton, Plouvier, Poilane, Poilly, Pollet, Popelard, Porcheret, Poulain, Poynard Vogt, Pradeaux, Priqueler, Py, Queinnec, Questiaux, Quinet Beatrice, Raber, Raffin, Raoult, Raymond, Raynaud, Rebaud, Renaud, Renier, Rennes, Renolleau, Retali, Retornaz, Reynaud, Richardin, Rio, Rivaux, Riviere, Robin, Rodiere, Rolland, Romain, Rossignol, Rottman, Roudaut, Rougier, Roullaud, Roussellier, Roybet, Roze, Sachs, Sadik, Sadki, Saf, Said-Menthon, Saliba, Salomon, Sanchez, Santerne, Sanyas, Sardet, Sarlangue, Sartre, Savoy, Scanvic, Scat, Schaefer, Schneider, Seaume, Sebag, Secher, Sfez, Siegel, Simonin, Siouala, Sirot, Sivadon-Tardy, Smati, Sommabere, Soto, Soumureau, Spicq, Tahiri, Talon, Tchanga, Terki, Texier, Thevenieau, Thevenot, Thibault, Thierry, Thore, Thouvenin, Tiry, Tommasi, Tourrand, Tous, Trioche, Tronc, Turchini, Tytgat, Uzan, Vachee, Vaillant, Valayer, Valensi, Vallee, Van De Perre, Vandenesch, Vanel Contamin, Vasselon-Raina, Vaucel , Venot, Vergnaud, Vergne, Vernet-Garnier, Vervel, Vic, Vignaud, Vigneron, Villemain, Villeneuve L., Vorlet, Voyer, Vray, Vrillon, Vu Thien, Warin, Wasels, Weber, Weisse, Wemeau, Worcel, Yang Ting, Ygout, Ythier, Zaoui, Zarzour, Zehani, Zelinsky-Gurung, Zimmermann, Zumbo, Zupan Simunek. We thank Nathalie Kohn, Sadia Tortorelli, Isabelle Ramay, Manuela Pereira, Michel Boucherat

Conclusion 1. One of the largest series of W135 IMD 2. High proportion of arthritis as initial diagnosis, greater than that usually observed with B and C serogroups 3. ST-22 clonal complex prevailed over ST-11 in W135 IMD 4. ST-22 had a lower neurotopism than ST-11 but identical mortality rate Further investigations of clinical tropism of W135 serogroup isolates and their clonal complexes are warranted.