Infections with Neisseria meningitidis are grave and present
largely in two ways: as meningitis and septicemia. Their
case-fatality rate is high approaching 8% despite existing treatment.
Preventive measures must be swiftly implemented to avoid transmission to
patient relatives and the spread of the germ in the population.
Molecular surveillance by the National Centre for Meningococci (NCM)
is one of the means, together with mandatory disease notification by
physians and laboratories, to timely spot and fight epidemics.
NCM’s activities are carried out at the Bacteriology
Laboratory of the Geneva University Hospitals (HUG).
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The CNM must exercise an alert and expertise mission for
the attention of
the Federal Office of Public Health (FOPH), cantonal administrations,
diagnostic laboratories, the medical corps and hospitals.
In this perspective, the CNM’s objectives are:
- To assist Swiss laboratories with the confirmation of Neisseria
meningitidis and to participate in the dissemination of
scientific information (bacteriological identification,
distribution of serogroups, methods for determining antibiotic
- To monitor antibiotic resistance, particularly to penicillin.
That determination is made by the MIC method (Minimum Inhibitory
Concentration) and by the sequencing of the gene penA, for sensitivity
- To determine serogroups (A, B, C, W135, X), by immunoagglutination.
Certain serogroups imply specific prophylactic measures (chemoprophylaxis
and/or vaccination for the serogroups A, C, Y, W135).
- To identify subtypes by sequencing porA gene (encoding outer membrane
proteins) or gene fetA (encoding outer membrane proteins regulated by iron).
- To analyse additional epidemiologic markers for identification of
clones: Multilocus Sequence Typing (MLST).
- To develop techniques for more rapid diagnosis (PCR from CSF and
blood) or improved genotyping of strains (biochips or microarrays).