Invasive infections due to Streptococcus pyogenes in the Czech Republic. Results of the active surveillance.
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Biomedical subjects
Publications and source records attributed to P Kriz.
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Previous studies found that the majority of Neisseria meningitidis isolates from either patients or carriers in Greece do not react with the monoclonal antibodies used at present in the whole-cell ELISA (WCE) for determination of serotype and subtype antigens. A new monoclonal antibody designated '22' produced by the National Meningococcal Reference Laboratory in the Czech Republic was assessed in the whole-cell ELISA with 257 non-typable meningococcal strains from both patients (52) and carriers (205). The carrier strains included 34 non-typable isolates from two immigrant populations: ethnic Greeks who have immigrated from Russia since 1989 (19/75) and Kurdish refugees (15/34). Approximately 10% of the meningococcal strains isolated from patients and 11.7% of the carrier strains reacted with the reagent. Although the majority of meningococcal isolates from resident Greeks were not typable with the antibody, 11/19 (57.9%) of the carrier strains from Russian immigrants and 4/15 (20%) of those from the Kurdish refugees reacted with the new reagent.
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Vaccination against Neisseria meningitidis is not part of routine immunization schemes in any country; instead, targeted vaccination of groups at the highest risk is recommended during outbreaks and epidemics. After a long period of sporadic occurrence of meningococcal invasive disease, a new clone of Neisseria meningitidis C:2a:P1.2, ET-15/37, occurred in the Czech Republic, and caused local outbreaks in two neighbouring districts, Olomouc and Bruntal, in spring 1993. In Olomouc, a mass campaign was conducted during which 6191 students were vaccinated (5.6% of the total population of this locality and 96% of all students in the age group 15-19) within 2 weeks in June 1993. In Bruntal district, no such campaign was organized. In Olomouc, the incidence of invasive disease caused by Neisseria meningitidis C in the age group 10-24 decreased from 57 to 0 per 100,000 (P < 0.001) during the post-vaccination period (July 1993-August 1994), but no such decrease was observed in Bruntal. Although other factors can affect the frequency of disease, these results support the current recommendations of targeted vaccination in outbreaks of meningococcal disease.
This report discusses the following issues related to typing of group A streptococci (GAS): The development and use of the 5' emm variable region sequencing (emm typing) in relation to the existing serologic typing system; the designation of emm types in relation to M types; a system for validation of new emm types; criteria for validation of provisional M types to new M-types; a list of reference type cultures for each of the M-type or emm-type strains of GAS; the results of the first culture exchange program for a quality control testing system among the national and World Health Organization collaborating centers for streptococci; and dissemination of new approaches to typing of GAS to the international streptococcal community.