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Journal of Clinical Microbiology, October 2005, p. 5129-5135, Vol. 43, No. 10
0095-1137/05/$08.00+0     doi:10.1128/JCM.43.10.5129-5135.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.

Molecular Epidemiology of Neisseria meningitidis Isolated in the African Meningitis Belt between 1988 and 2003 Shows Dominance of Sequence Type 5 (ST-5) and ST-11 Complexes

Pierre Nicolas,1* Gunnstein Norheim,2 Eric Garnotel,3 Saacou Djibo,4 and Dominique A. Caugant2

French Forces Institute of Tropical Medicine (IMTSSA), WHO Collaborating Centre for Reference and Research on Meningococci, Le Pharo, BP 46, 13998 Marseille, France,1 WHO Collaborating Centre for Reference and Research on Meningococci, Norwegian Institute of Public Health, Oslo, Norway,2 Hôpital d'Instruction des Armées Alphonse Laveran, Marseille, France,3 CERMES, Réseau International des Instituts Pasteur, Ministry of Health, Niamey, Niger4

Received 21 March 2005/ Returned for modification 10 May 2005/ Accepted 29 June 2005

At the two World Health Organization Collaborating Centers for Reference and Research on Meningococci in Marseilles, France, and Oslo, Norway, the multilocus sequence typing technique was used for the characterization of a total of 357 strains of meningococci isolated from meningitis cases in 13 African countries of the meningitis belt between 1988 and 2003. Among these strains, 278 of 357 (77.9%) belonged to the sequence type 5 (ST-5) complex; 23.2% were ST-5 and 53.5% were ST-7. ST-5 was probably introduced in Africa in 1987 and was responsible for most of the meningitis cases between 1988 and 2001. ST-7 emerged in the mid-1990s and has totally replaced ST-5 since 2002. These two STs characterized serogroup A strains and have been responsible for hundreds of thousands of cases. Fifty-two strains (14.3%) belonged to the ST-11 complex. The ST-11 complex was characterized by serogroup W135, which has been responsible for an increasing number of sporadic cases since 2000 and the first W135 epidemic ever seen in Africa (in Burkina Faso in 2002). Identification of W135 ST-11 strains in many countries is a great concern for the region. Apart from these two major clonal complexes, a few other clones, such as ST-2881, ST-181, and ST-751, were sporadically detected. Careful surveys for these clones need to be conducted, but at present they play only a minor role in the overall epidemiology of meningococcal meningitis.

* Corresponding author. Mailing address: Unité du Méningocoque, IMTSSA, Centre Collaborateur OMS, BP 46, le Pharo, 13998 Marseille Armées, France. Phone: 33 4 91 15 01 15. Fax: 33 4 91 59 44 77. E-mail: imtssa.meningo{at}wanadoo.fr.

Journal of Clinical Microbiology, October 2005, p. 5129-5135, Vol. 43, No. 10
0095-1137/05/$08.00+0     doi:10.1128/JCM.43.10.5129-5135.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.



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