Microheterogeneity of serogroup A (subgroup III) Neisseria meningitidis during an outbreak in northern Ghana

During a meningitis outbreak in the eastern subdistrict of the Kassena-Nank ana District of the Upper East Region of Ghana, we analysed cerebrospinal f luid from suspected meningitis cases for the most common causative organism s. In 50 of 92 samples analysed, serogroup A Neisseria meningitidis were de tected. The ages of serogroup A N. meningitidis patients ranged from 4 mont hs to 64 years. The case fatality ratio was 20%. Coma or stupor on presenta tion worsened the prognosis. All serogroup A N. meningitidis isolates recov ered revealed the A: 4: P1.9, 20 phenotype characteristic for the subgroup III clonal grouping. No evidence for resistance to penicillin G, chloramphe nicol, cefotaxime, ciprofloxacin, rifampicin or tetracycline was found. All strains were resistant to sulphadiazine. Restriction analysis patterns of opa, iga and ingA genes were characteristic for the majority of N. meningit idis serogroup A subgroup III bacteria isolated in Africa after the 1987 ep idemic in Mecca. Differences in pulsed-field gel electrophoresis patterns o f NheI and SpeI digested DNA revealed microheterogeneity among the Ghanaian isolates.