134 / 150
followed introduction of pneumococcal conjugate vaccines (PCV) into
the UK childhood immunisation program in 2006.
Aim(s)/Objective(s):
To examine the rising incidence of IPD in NEE.
Method(s):
NEE residents with laboratory-confirmed IPD were
reported to the NEE IPD enhanced surveillance system between 1
April 2006 and 31 March 2016. Clinical and demographic data were
obtained from clinicians and primary care; serotypes were obtained
from the Public Health England Respiratory and Vaccine Preventable
Bacteria Reference Unit. Incidence rate ratios (IRR) were estimated
using negative binomial regression.
Results:
Between 1 April 2015 and 31 March 2016, 298 cases of IPD
(11.4/100,000 population) were reported. This was significantly
greater than the previous epidemiological year 2014/2015 (230
cases; 8.8/100,000 population; p = 0.003), significantly greater than
the average during the three epidemiological years covering 2011/
2014 (211 cases; 8.1/100,000 population; p < 0.001) and similar to
2006/
2007 (11.91/100,000
population; p = 0.577).While IPD caused by
13-valent PCV serotypes has remained low, cases due to serotypes
exclusive to 23-valent polysaccharide vaccine (in particular 8, 9N, 12F)
have increased significantly, as have cases caused by non-vaccine type
serotypes 15A, 23A, 35F. Increases are particularly notable in
individuals 5
–
64 years and
≥
65 years.
Discussion and/or Conclusion(s):
This reversal of the declining trend
of IPD is unexpected and merits further study and comparison to
trends observed elsewhere. Investigation of possible underlying
causes may inform public health responses to address the persistent
burden of IPD.
ID: 5100
HIV, hepatitis B and syphilis testing in antenatal clinic attendees at
Bairo Pite Clinic, Timor-Leste
Marc Heymann
1
, Charlotte Hall
2
.
1
Warwick Medical SChool,
2
Bairo Pite
Clinic, Dili, Timor-Leste
Background:
Routine antenatal clinic (ANC) screening in Dili, Timor-
Leste includes hepatitis B (HBV), HIV, and- from late 2014- syphilis
screening. Limited prevalence data suggest antenatal prevalence rates
of 0.52% (syphilis), 0.04% (HIV) and 2.8% (HBV). Bairo Pite Clinic is a
non-governmental health facility in Dili with approximately 100 new
ANC attendees monthly.
Aim(s)/Objective(s):
1.
Service evaluation of syphilis screening programme
2.
Assessment of HIV and HBV prevalence
Method(s):
1.
Evaluation of syphilis screening programme and of ANC consulta-
tions/testing procedures
2.
Prospective evaluation of HIV/HBV/syphilis results of ANC
attendees over one week
3.
Retrospective evaluation of results for ANC attendees in the
preceding month.
Results:
Prevalence data:
1.
prospective cohort: 0/65(0%) HIV, 0/65(0%) syphilis, 1/65(1.5%)
HBV
2.
retrospective cohort: 0/493(0%) HIV, 11/493(2.2%) HBV; syphilis
prevalence unknown (not in midwifery records).
Service evaluation: Syphilis testing was not requested by midwives
(unlike HIV, HBV) but was observed to be performed by laboratory
staff. Other syphilis screening issues: no consistency in screening test
used, no pathway for management of a positive result and no clear
reporting structure.
Discussion and/or Conclusion(s):
This study supports the existing
estimates of HIV and antenatal hepatitis B prevalence. HIV and HBV
testing are well established with clear referral pathways and excellent
coverage. It is encouraging that syphilis testing is occurring given its
recent introduction, but work needs to be done to increase midwives
’
awareness and create a formal consistent testing pathway. Further
prevalence studies for syphilis are needed.
ID: 5112
Genomic surveillance of vaccine antigens in invasive
meningococcal disease in Great Britain and Ireland using Bexsero
®
Antigen Sequence Type (BAST)
Charlene Rodrigues
1
, Carina Brehony
2
, Ray Borrow
3
, Andrew Smith
4
,
Robert Cunney
5
, E Richard Moxon
6
, Martin Maiden
2
.
1
University of
Oxford,
2
Department of Zoology, University of Oxford, South Parks Road,
Oxford, United Kingdom;
3
Public Health England, Meningococcal
Reference Unit, Manchester Royal Infirmary, Manchester, United
Kingdom;
4
Scottish Haemophilus, Legionella, Meningococcus and
Pneumococcus Reference Laboratory, Glasgow Royal Infirmary, Glasgow,
United Kingdom and College of Medical, Veterinary & Life Sciences,
University of Glasgow, Glasgow, United Kingdom;
5
Irish Meningitis and
Meningococcal Reference Laboratory, Temple Street Children
’
s University
Hospital, Dublin, Ireland;
6
Department of Paediatrics, University of
Oxford, John Radcliffe Hospital, Oxford, United Kingdom
Background:
Invasive meningococcal disease (IMD) in the UK is
predominantly due to serogroup B, with the burden of disease among
children under 5 years. In September 2015, the UK implemented a
targeted serogroup B vaccine, Bexsero
®
, into the national childhood
immunisation schedule at 2, 4 and 12 months.
Aim(s)/Objective(s):
To design and implement a genomic scheme for
rapid and scalable surveillance of vaccine antigens in response to this
selection pressure.
Method(s):
All culture-confirmed IMD isolates (n = 2016) from
2010
–
11 to 2013
–
14 from UK (Meningitis Research Foundation
Meningococcus Genome Library) and Republic of Ireland were
included. Whole genome sequences were hosted on PubMLST
Neisseria public database
(http:/ /pubmlst.org/neisseria/). A novel
Bexsero
®
Antigen Sequence Type (BAST) scheme was implemented
and used to analyse the presence of vaccine antigens (fHbp, NadA,
NHBA and PorA).
Results:
There were 1966 isolates for which BAST was determined,
with 647 unique BASTs. The nine most frequently occurring BASTs
accounted for 39.4% of all isolates (n = 775). BAST was strongly
associated with clonal complex (Cramer
’
s V 0.946). BASTs were
largely stable over time, except for the increase in clonal complex 11
associated BAST-2. The 14 most frequent BASTs were present in all
areas, but there was variation in the prevalence of BASTs between
the four geographic regions.
Discussion and/or Conclusion(s):
The Meningitis Research
Foundation Meningococcus Genome Library is a publicly available,
online repository of IMD isolates, facilitating high resolution
analysis of bacterial genomes. The presence of a few predo-
minant BASTs with temporal and geographical stability, suggests
that use of the associated vaccine antigens could provide high vaccine
coverage.
ID: 5114
Bexsero
®
vaccine coverage estimates in Great Britain and Ireland
using genomic surveillance using Bexsero
®
Antigen Sequence Type
(BAST)
Charlene Rodrigues
1
, Carina Brehony
2
, Ray Borrow
3
, Andrew Smith
4
,
Robert Cunney
5
, E Richard Moxon
6
, Martin Maiden
2
.
1
University of
Oxford,
2
Department of Zoology, University of Oxford, South Parks Road,
Oxford, United Kingdom;
3
Public Health England, Meningococcal
Reference Unit, Manchester Royal Infirmary, Manchester, United
Kingdom;
4
Scottish Haemophilus, Legionella, Meningococcus and
Pneumococcus Reference Laboratory, Glasgow Royal Infirmary, Glasgow,
United Kingdom and College of Medical, Veterinary & Life Sciences,
University of Glasgow, Glasgow, United Kingdom;
5
Irish Meningitis and
Meningococcal Reference Laboratory, Temple Street Children
’
s University
Hospital, Dublin, Ireland;
6
Department of Paediatrics, University of
Oxford, John Radcliffe Hospital, Oxford, United Kingdom
Background:
In September 2015, Bexsero
®
, targeted to serogroup B
meningococcus, was introduced into the UK childhood immunisation
Abstracts of FIS/HIS 2016
–
Poster Presentations / Journal of Hospital Infection 94S1 (2016) S24
–
S134
S129