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M - - . Neisseria meningitidis (-), Gram . - 13 . - , . - - . .
- -, . , - -. - , 10% - , 11-19% - , ,
- . - - , . , - - , C, Y W. C - . , - . - . , - . , 4 - - .
M
-
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, 2004-2014: - -
- - . - - . - , , b - , Gram (-) [1,2]. , - b 75% - 90% [1]. - -
, - . , - 50 ( ) [2]. , , - - , - [1,2]. - . , -, , 10% 25%
[3].
- , - . ( ). , . () (, ), , -, , . 30-60% . - >5 , , , , , .
-, Brudzinski Kernig . - 30%. - , . . (
-
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. - , , - . . - , , (occult bacteremia). - , - , . -, - . , , .
-, . - PCR. O -, , , - . - - Y W135. H - - . . 6-10% - , -, , , , ,
. - - . 10%. - 11-19% - , -, , .
, - ( ) -. - , - , . - - (, .) (EKAM), . , - . - , (, , ), - . ,
, , -, , -, , - .
2004-2014 863 - , 55 108 0,71 100.000 ( 1). , - - 2007 2010 [4]
.
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1. - , , 2004-2014
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0,20
0,40
0,60
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100
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2. (-/100.000 ) , 2004-2014
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- 2004-2014, - - 92,1% (795/863). - - 76,1% (657/863) /
Neisseria meningitidis, 572/657
(87,1%) (A, B, C, W135, Y) - . 77% (505/657) - , - , - , 2 C (
3).
3. , , 2004-2014
2%
77%
5%
2%1%
13%
ABCYW135N. Gr.
, , - . - , . (Polymerase Chain Reaction, PCR), , - - , -- - . -
1998 (multiplex PCR) -
[5,6]. - (: 44.4% (1998), 94% (2014). , - (82%) - PCR, -
(18%).
Neisseria meningitidis , 11 (2004-2014), C, - 1997-1998, - .
,W-135 ( 4), - . - (2009-2012) [7,8].
-
6
4. N.meningitidis , , 2004-2014
- (sequencing) . - :
1. (Multilocus Sequence Typing, MLST)
N. meningitidis - -.
PCR, - , - -. MLST (sequence types, ST) 2004-2014 ST-269
(14,7%), ST-32 (10,5%), ST-162 (5,7%), ST 41/44 (5,6%) ( 5) ST-269,
ST 41/44 ST-32 - - (4CmenB) [9].
5. (Sequence types) N. meningitidis, , 2004-2014
-
7
2. porA.
porA, - , - -. , 19-1, 15-11 36 1, 2 , o N. meningitidis . - -,
.
3. (Variable Tandem Repeat Analysis- VNTR)
DNA - (tandem repeats). (motif) - - - N. meningitidis, - . , , -
, - , - , [10, 11].
4. (fHbp, NHBA, NadA).
: fHbp (factor H binding protein ),
-, - , NHBA: Neisserial heparin-binding antigen - ), , - , ,
NadA: (eisserial adhesion A), - . , MATS (Meningococcal Typing
System), - 78,4% - NHBA, 52,7% fHbp (0,7%) NadA. - , - - 89,2%.
[12].
5. Whole Genome Sequencing (WGS). DNA (next generation
sequencing -NGS), (-) DNA - - - DNA, (Whole Genome Sequencing -WGS)
. - () -. Neisseria meningitidis - - , , [13]. - Neisseria
meningitides - , -, - - [14].
-
8
- 2004-2014 49 , 5,68%. - 2012 (11,11%), 2011 (1,82%). 2004-2014
0,40 - 100000 .
- - 3 , . - () < 0,1g/ml, . 0,1 g/ml, 3 . - - , -. ( 64
g/ml). , -, 2-3% . - . -, - shock , - , . - - . , b , - .
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>8 .
( /, , , , ).
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, . : A, B, C, Y W135.
.
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.
.
- - - . - - -, - . (outer membrane proteins), , Men B. -
(reverse vaccinology). -
-
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-, . fHbp (factor H binding protein) Nad A (Neisserial adhesin
A) (Neisseria Heparin Bind-ing protein A) z Por A. MATS
(Meningococcal Antigen Typing System), - (), -. , -
-, . - . (2, 4, 6 + 1 ). . -. FDA - fHBP 10-25 . - .
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: , ,
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3. () , , - 01/01/2015 31/01/2015 ( : , : ).
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(EHF), . , .
.
-
17
1. Meningococcal serogroup Y emergence in Europe High importance
in some European regions in 2012:Michael Brker, Suzana Bukovski,
Davor Culic, Susanne Jacobsson, Maria Koliou, Markku Kuusi, Maria
Joo Simes, Anna Skoczynska, Maija Toropainen, Muhamed-Keir Taha,
Georgina Tzanakaki.Human Vaccines & Immunotherapeutics 10:6,
14; June 2014
O M , , 13 , , , C, W135 . . , - , , [1]. , - C , 4 A, C, W
Y.
2. Diversity of Greek meningococcal serogroup B isolates and
estimated coverage of the 4CMenB meningococcal vaccine.Tzanakaki G,
Hong E, Kesanopoulos K, Xirogianni A, Bambini S, Orlandi L,
Comanducci M, Muzzi A, Taha MK.BMC Microbiol. 2014 Apr 29;14:1
4CMenB . , NadA, fHbp PorA - . , . 4CMenB , . 148 MATS
(Meningococcal Antigen Typing System) [2]. NHBA , fHbp (52,7%),
PorA (8,1%) NadA (0,7%). - ST-162, 44,6% - e 86.4 %.
http://www.ncbi.nlm.nih.gov/pubmed/24779381http://www.ncbi.nlm.nih.gov/pubmed/24779381
-
18
3. Molecular and serological diversity of Neisseria meningitidis
carrier strains isolated from Italian students aged 14 to 22
years.Gasparini R, Comanducci M, Amicizia D, Ansaldi F, Canepa P,
Orsi A, Icardi G, Rizzitelli E, De Angelis G, Bambini S, Moschioni
M, Comandi S, Simmini I, Boccadifuoco G, Brunelli B, Giuliani MM,
Pizza M, Panatto D.J Clin Microbiol. 2014 Jun;52(6):1901-10
4CMenB, . Gasparini . - 14 22 -, , PorA, fHbp, NHBA NadA 4CMenB
[3]., 18,5% , , 5 . (34.4%) - - , 28.1% . Fhbp NHBA - NadA 5% . .
4CMenB , .
B , ,
http://www.ncbi.nlm.nih.gov/pubmed/24648565http://www.ncbi.nlm.nih.gov/pubmed/24648565http://www.ncbi.nlm.nih.gov/pubmed/24648565
-
19
.
() 0,50 / 100000 , , . , 10 - 1000 100000 (WHO 1998).
.
8% 20% (Stephens, 2007). , . - , .
.
-. (Overturf, 2003). , . , D (Cs-C9) (Raun, 2010). .
. . . , .
-
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H , .
. IV . , .
.
. . (Brouwer 2010). .
.
(Rosenstein, 2001). 1% 700 1000 . 1 1000 (Feigin, 2009). .
.
, . . 10-20% . (Feigin 2009). . .
.
, . (Coen, 2006). .
-
21
.
, . .
- 2005 - - -.
2005 C (MCC). (MCV4) A, C, W135 . , Bexsero (4CMenB).O .
- .
. (MCC, MCV4) . , Bexsero (4CMen B) . .
1. K A M ().
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4. Stephens DS. Conquering the meningococcus. FEMS Microbiol
Rev. 31(1):3-14. Review (2007).
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2003.
6. Coen PG, Tally I, Stuart JM, Ashby D, Viner RM, Booy R. Is it
exposure to cigarette smoke or to smokers which increases the risk
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2006.
7. Brouwer MC, Mcintyre P, de Gans J, Prasad K, van de Beek D.
Corticosteroids for acute bacterial meningitis. Cochrane Database
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, - ,
-
22
2015
17-21, 2015
: 16 : : -
: : : Abu Dhabi National Exhibition Centre : +33 1 44 32 03 60:
http://www.wctoh.org/
30- 3, 2015
: 25 & : ; ;
: ...: : Manchester Grand Hyatt : +785-865-9402:
http://www.healthpromotionconference.com
,
-
23
2015
Ebola [1] Ebola . 25 - 2015 23729 (, , ), - 9604 , , , , (, ), ,
, , , . ( ).
MERS [1, 2] 26 2015, 1030 MERS-CoV, 381 . .
(79) [1, 2] 2013 23 2015 602 -, 227 . - . .
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(GAR). : http://www.who.int/csr/disease/ [ 1 2015]
2. European Centre for Disease Control and Prevention (ECDC).
Communicable disease threats report. :
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