Made available in DSpace on 2014-06-11T19:27:22Z (GMT). No. of bitstreams: 0 Previous issue date: 2010-02-25Bitstream added on 2014-06-13T20:56:20Z : No. of bitstreams: 1 barbosa_mmc_me_jabo.pdf: 650496 bytes, checksum: d36cf123ceb16765bef9266b5c12dc6e (MD5) / Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) / Pesquisou-se a ocorrência de E. coli (EPEC, EIEC, EHEC) em água e peixe (pele, trato gastrintestinal e músculo) de pesque-pagues da microbacia do Córrego Rico, Jaboticabal, SP. A amostragem foi realizada entre os meses de abril e junho de 2008 em cinco pesque-pagues. Em cada um, foram colhidos dez exemplares de peixes adultos, e para análise foram colhidas amostras do músculo, do trato gastrintestinal e da superfície corpórea. As amostras de água foram colhidas em cinco pontos distintos de todos os pesque-pague. As colônias com características morfológicas relativas à E. coli isoladas do ágar MacConkey foram submetidas a confirmação bioquímica. Posteriormente, os isolados foram identificados sorologicamente como EPEC, EIEC e EHEC e realizado os testes de susceptibilidade a antimicrobianos e atividade hemolítica. Assim, foram isoladas 115 cepas de E. coli, entre as quais 81 (70%) foram sorogrupadas como EPEC, 5 (4%) como EHEC e 8 (7%) como EIEC. Os sorogrupos mais frenquentes foram O125 (13,9%), O126 (11,3%) e O158 (10,4%). Dentre as amostras testadas, 60 (52%) apresentaram resistência simultânea a dois antimicrobianos. A Análise de Correspondência foi realizada com intuito de verificar as possíveis correspondências envolvendo o local de isolamento, sorogrupos e multirresistência e com isso pode-se observar que o músculo foi o local de isolamento com menor correlação aos demais fatores. Enquanto água, trato e pele apresentaram maior correspondência entre si. Assim, a presença de um alto número de isolados EPEC nesse estudo indica contaminação por enteropatógenos possivelmente advindos de fezes de animais, humanas e/ou águas contaminadas, representando risco à saúde dos frequentadores destes pesque-pagues e consumidores do pescado. / The occurrence of Escherichia coli (EPEC, EIEC, EHEC) in water and fish (skin, gastrointestinal tract and muscle) was surveyed in fee fishing from the stream Rico micro-basin, Jaboticabal, São Paulo/Brazil. Samples were collected between april and june 2008 in five fee fishing. In each fee fishing, ten copies were collected from adult fish and for analysis were sampled muscle, gastrointestinal tract and body surface. Water samples were collected from five different points of all fee fishing. Thus, we isolated colonies from the MacConkey agar with morphological characteristics related to E. coli for biochemical confirmation. Subsequently, the isolates were identified serologically as EPEC, EIEC and EHEC and performed tests of antimicrobial susceptibility and hemolytic activity. It was found that among 115 strains of E. coli isolated, 81 (70%) were serologically classified as EPEC, 5 (4%) as EHEC and 8 (7%) as EIEC. The most common serogroups were O125 (13.9%), O126 (11.3%) e O158 (10.4%). From the 115 bacterial isolates, 60 (52%) were resistant to two antimicrobials. The Correspondence Analysis was performed to verify possible matches involving the location of isolation, serogroup and antimicrobial resistance and that can be observed that the muscle had lower correlation to other factors. While water and tract and skin had correlation with each other. Probably, the isolation of EPEC serogroups in this study indicates contamination by pathogens coming from animals, human and/or contaminated water, constituting a potential risk to the consumer health of these fee fishing.

Made available in DSpace on 2014-06-11T19:27:22Z (GMT). No. of bitstreams: 0 Previous issue date: 2007-05-28Bitstream added on 2014-06-13T19:35:18Z : No. of bitstreams: 1 rangel_pm_me_jabo.pdf: 202160 bytes, checksum: 7b5c8c75d2c9df10071428271f91da55 (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / A um longo tempo a mastite tem sido reconhecida como a doença que provoca as maiores perdas econômicas nos rebanhos leiteiros. De fevereiro a novembro de 2004, 670 amostras de leite mastítico bovino, provenientes de dois estados brasileiros foram coletadas, das quais foram isoladas 231 cepas de Escherichia coli. Estas cepas foram analisadas para a detecção dos genes de produção de Shiga toxina (stx 1 e stx 2) e do gene da intimina (eae). Vinte cepas (8,6%) foram detectadas através de PCR contendo os genes da Shiga toxina (8 stx 1, 12 stx 2 e nenhuma delas ambos os genes). Duas cepas (0,8%) de E. coli eram eae positivo não produtoras de Shiga toxina. As cepas de E. coli foram também examinadas para detectar a resistência a 12 agentes antimicrobianos. As resistências mais comuns foram para tetraciclina (92,2%), estreptomicina (90,4%), ácido nalidíxico (88,3%), amicacina (86,5%) e cefalotina (84,8%). A resistência a múltiplas drogas foi encontrada em 152 cepas (65,8%). . Entre os sorogrupos determinados, O111, O26, O158 e O125 foram os mais comuns, todos sorogrupos EPEC clássicos. / Mastitis has been recognized for some time as the most costly disease in dairy herds. From February to November 2004, 670 samples of bovine mastitic milk were collected from two Brazilian states, from which 231 Escherichia coli strains were isolated. These strains were screened for the presence of Shiga toxin-producing (stx 1 and stx 2) and intimin (eae) genes. Twenty (8.6%) strains were detected by PCR to harbor the Shiga toxin genes (8 the stx 1 gene, 12 the stx 2 gene and none both of them) Two (0.8%) of the E. coli strains studied were eae positive non Shiga toxin-producing. The E coli strains were also examined for resistance to 12 antimicrobial agents. The most commonly observed resistance was to tetracycline (92.2%), streptomycin (90.4%), nalidixic acid (88.3%), amikacin (86.5%) and cephalothin (84.8%). Multidrug resistance was found among 152 isolates (65.8%). Among the serogroups determined O111, O26, O158 and O125 were the most commonly, all of them classic EPEC serogroups.

A Periodontite Agressiva (PA), que atualmente pertence ao grupo das Periodontites estágios 3 e 4, distingue-se dos demais tipos de doença periodontal por seu início precoce, agregação familiar dos casos e por afetar pacientes sistemicamente saudáveis. Além disso, pode ser subclassificada em duas formas, localizada (PAL) e generalizada (PAG), em função de sua extensão. Muitas vezes, os depósitos de biofilme bacteriano são desproporcionais à quantidade de destruição óssea e perda de inserção que o paciente apresenta, independente da subclassificação. O microrganismo mais relacionado à etiopatogênese da doença é o Aggregatibacter actinomycetemcomitans (A. actinomycetemcomitans), incluindo os seus principais sorotipos a, b e c, amplamente estudados. Associado a estas condições, A. actinomycetemcomitans apresenta alguns fatores de virulência como uma leucotoxina, principalmente ligada ao sorotipo b - clone JP2 (que é altamente leucotóxico) e proteínas de membrana externa (OMPs), especialmente Omp29. A resposta de imunoglobulina G (IgG) sérica contra este patógeno foi anteriormente associada à ambas as formas de PA, porém, são escassos os estudos que avaliaram longitudinalmente a resposta sérica frente a variáveis como estas. Dessa maneira, o objetivo desse estudo foi avaliar a resposta sérica, de 27 pacientes com PA e 10 pacientes periodontalmente saudáveis, contra Omp29 e sorotipos de A. actinomycetemcomitans, através de um ensaio ELISA, correlacionando com o número de cópias de JP2 (obtidos por qPCR em tempo real) e parâmetros clínicos, a partir de dados anteriormente coletados por nosso grupo. Todos os dados foram obtidos antes do início do tratamento e um ano após seu término. O tratamento consistiu de orientações de higiene bucal, tratamento mecânico e antibioticoterapia. Os dados resultantes do estudo mostraram que em ambas as formas de PA houve uma redução significativa na profundidade clínica de sondagem (PCS)(p<0,001), nível clínico de inserção (NCI)(p<0,001) e na resposta sérica contra Omp29 e sorotipo c de A. actinomycetemcomitans(p>0,005). Após 1 ano, os valores de densidade óptica (D.O.) normalizados para Omp29 e sorotipos de A. actinomycetemcomitans, bem como o número de cópias do clone JP2 tornaram-se similares aos níveis encontrados nos controles. A redução no número de cópias do clone JP2 foi correlacionada com redução da PCS em PAL(r=0.80,p=0.0042) e valores de D.O. normalizados de Omp29 em PAG(r=0.66,p=0.005). O estudo concluiu que o tratamento periodontal foi eficaz em alterar a resposta sérica contra Omp29 e sorotipos de A. actinomycetemcomitans, além de reduzir o número de cópias do clone JP2 e melhorar os parâmetros clínicos. / Aggressive Periodontitis (AP), which currently belongs to the group of Periodontites stages 3 and 4, is distinguished from other types of periodontal disease due to its early onset, familial aggregation of cases and to affect systemically healthy patients. In addition, it can be sub classified into two forms, localized (PAL) and generalized (PAG), depending on its extent. Often, bacterial biofilm deposits are disproportionate to the amount of bone destruction and loss of insertion that the patient presents, regardless of sub classification. The most important microorganism related to the etiopathogenesis of the disease is Aggregatibacter actinomycetemcomitans (A. actinomycetemcomitans), including its main serotypes a, b and c, widely studied. Associated with these conditions, A. actinomycetemcomitans presents some virulence factors such as leukotoxin, mainly linked to serotype b - clone JP2 (which is highly leukotoxic) and outer membrane proteins (Omp\'s), especially Omp29. Serum immunoglobulin G (IgG) response against this pathogen was previously associated with both forms of BP; however, there are few studies that longitudinally evaluated the serum response to variables such as these. Thus, the objective of this study was to evaluate the serum response of 27 patients with AP and 10 periodontally healthy patients against Omp29 and A. actinomycetemcomitans serotypes by an ELISA, correlating with the number of copies of JP2 (obtained by qPCR in real time) and clinical parameters, from data previously collected by our group. All data were obtained prior to initiation of treatment and one year after its completion. The treatment consisted of oral hygiene guidelines, mechanical treatment and antibiotic therapy. Data from the study showed that in both forms of BP there was a significant reduction in clinical depth of sampling (PCS) (p<0,001),, clinical level of insertion (NCI)(p<0,001) and serum response against Omp29 and serotype c of A. actinomycetemcomitans(p>0,005). After 1 year, normalized optical density (O.D.) values for Omp29 and A. actinomycetemcomitans serotypes, as well as the number of copies of clone JP2 became similar to the levels found in the controls. The reduction in copy number of clone JP2 was correlated with reduction of PCS in PAL(r=0.80,p=0.0042) and O.D. normalized from Omp29 to PAG(r=0.66,p=0.005). The study concluded that periodontal treatment was effective in altering the serum response against Omp29 and A. actinomycetemcomitans serotypes, in addition to reducing the number of copies of clone JP2 and improving clinical parameters.

Neisseria meningitidis is a gram negative, and sometimes encapsulated, diplococcus that causes devastating disease worldwide. For the worldwide genetic surveillance of N. meningitidis, the gold standard for profiling the bacterium uses genetic loci found around the genome. Unfortunately, the software for analyzing the data for these profiles is difficult to use for a variety of reasons. This thesis shows my suite of tools called the Meningococcus Genome Informatics Platform for the analysis of these profiling data. To better understand N. meningitidis, the CDC Meningitis Laboratory and other world class laboratories have adopted a whole genome approach. To facilitate this approach, I have developed a computational genomics assembly and annotation pipeline called the CG-Pipeline. It assembles a genome, predicts locations of various features, and then annotates those features. Next, I developed a comparative genomics browser and database called NBase. Using CG-Pipeline and NBase, I addressed two open questions in N. meningitidis research. First, there are N. meningitidis isolates that cause disease but many that do not cause disease. What is the genomic basis of disease associated versus asymptomatically carried isolates of N. meningitidis? Second, some isolates' capsule type cannot be easily determined. Since isolates are grouped into one of many serogroups based on this capsule, which aids in epidemiological studies and public health response to N. meningitidis, often an isolate cannot be grouped. Thus the question is what is the genomic basis of nongroupability? This thesis addresses both of these questions on a whole genome level.

Neisseria meningitidis causes 500,000 cases of meningitis and septicaemia annually worldwide, with a mortality rate of approximately 10%. Most disease in developed countries is caused by serogroup B infection, against which there is no universal vaccine. Opa proteins are major meningococcal outer membrane proteins, and a limited number of Opa variants have been associated with hyperinvasive serogroup B meningococci, suggesting their use as a potential novel vaccine. Immunisation of mice with recombinant Opa elicited high levels of meningococcal-specific serum bactericidal antibody (SBA), demonstrating proof in principle of this approach. Opa proteins mediate bacterial adherence to host cells and modulate human cellular immunity, and there are conflicting data regarding their effects on CD4⁺ T cells. opa genes from N. meningitidis strain H44/76 were cloned into the plasmid vector pBluescript, disrupted using antibiotic resistance cassettes and transformed into H44/76 to sequentially disrupt the four opa genes. This produced a unique panel of 15 isogenic Opa-deficient strains, including an Opa-negative strain, which enabled investigation of the immunomodulatory role of surface-expressed Opa proteins. There was no consistent effect of Opa expressed on the surface of OMVs and inactivated bacteria on CD4⁺ T cells, with significant heterogeneity of responses between individuals. The rate of Opa phase variation was between 10^-3 and 10^-4, and increased 180-fold following transformation of bacteria with unrelated DNA. These data support further investigation of Opa as a potential meningococcal vaccine component, and highlight the importance of host and bacterial factors in the development of OMV vaccines.

Diss. (sammanfattning) Uppsala : Uppsala universitet, 2007. / Härtill 4 uppsatser.

N. meningitidis is a common commensal of the human upper respiratory tract and a leading cause of bacterial meningitis and septicemia worldwide. The classical pathway of complement (C) is essential for both naturally acquired and vaccine induced immunity against N. meningitidis. Qualitative and/or quantitative differences in anti-meningococcal antibodies (Abs) in serum is one reason for variations in C-dependent bactericidal Ab activity among individuals. I showed that IgG isolated from select individuals could block killing of group B meningococci by Abs that were otherwise bactericidal. Ligand overlay immunoblots revealed that these blocking IgG Abs were directed against a meningococcal antigen called H.8, Killing of meningococci in reactions containing bactericidal mAbs and human blocking Abs was restored when blocking Ab binding to meningococci was inhibited (or competed for) using either synthetic peptides corresponding to H.8 or a non-blocking mAb against H.8. Further, genetic deletion of H.8 from target organisms abrogated blocking. The Fc region of the blocking IgG was required for blocking because F(ab)2 fragments alone generated by pepsin treatment were ineffective. Blocking required IgG glycosylation; deglycosylation of blocking IgG with peptide:N-glycanase (PNGase) eliminated blocking. C4 deposition mediated by a bactericidal mAb directed against a meningococcal vaccine candidate, called factor H-binding protein (fHbp), was reduced by blocking Ab. Anti-fHbp-mediated C4 deposition was unaffected, however, by deglycosylated blocking IgG. Although preliminary, our data suggests blocking of serum bactericidal activity by human anti-H.8 blocking antibody may require mannan-binding lectin (MBL), which itself is a complement activator. Also, whether MBL recruits a complement inhibitor(s) that facilitates blocking remains to be determined. In conclusion, we have identified H.8 as a meningococcal target for novel blocking antibodies that are commonly found in human serum. Blocking Ab may reduce the efficacy of meningococcal vaccines. We propose that outer membrane vesicle-containing meningococcal vaccines may be more efficacious if purged of subversive immunogens such as H.8.

Les arboviroses représentent un fardeau sanitaire considérable et croissant à l’échelle mondiale. La complexité des facteurs biotiques et abiotiques qui interviennent dans la transmission de ces arbovirus pose un défi de taille aux scientifiques qui tentent de comprendre, de modéliser ou d’anticiper leur transmission ainsi qu’aux intervenants de santé publique qui ont la responsabilité de surveiller, d’évaluer et gérer le risque que posent les arbovirus pour la santé des populations. Cette étude visait à estimer et caractériser le risque d’exposition à plusieurs arbovirus suspectés d’être actifs et émergents au Québec mais dont la distribution avait peu ou n’avait pas été étudiée au Québec : le virus du Nil occidental (VNO), le virus de l’encéphalite équine de l’est (VEEE) et deux virus du sérogroupe de la Californie (VSGC), le virus de Jamestown Canyon (VJC) et le virus du lièvre d’Amérique (VLA). Basée notamment sur l’hypothèse selon laquelle les animaux d’espèces différentes qui partagent un environnement commun partagent également un risque environnemental commun, cette étude visait également à évaluer si les populations d’animaux de compagnie pouvaient aider à estimer et caractériser le risque d’infection arbovirale chez l’humain. L’échantillonnage sérologique de populations humaines, canines et équines du sud-ouest du Québec a permis d’évaluer et de comparer la séroprévalence aux arbovirus étudiés chez chacune de ces trois espèces. Les estimations de séroprévalence ont révélé un niveau d’activité arbovirale significative pour chacun des arbovirus. Des différences ont été remarquées quant au pourcentage de sujets séropositifs chez chacune des espèces. Les facteurs environnementaux ayant une influence sur le risque d’infection par le VEEE ont été modélisés à partir de données sérologiques et cliniques chez les chevaux. Les milieux humides boisés ont été identifiés comme les principaux environnements à risque pour le VEEE au Québec alors que les zones agricoles ont été identifiées comme des environnements protecteurs. Les facteurs environnementaux ayant un impact sur le risque d’infection par le VNO ont été modélisés à partir des données sérologiques chez le chien et des données cliniques agrégées chez l’humain. Cette modélisation a suggéré un risque singulièrement plus élevé en zone agricole chez le chien et un risque plus faible en zone forestière chez l’humain, des facteurs rarement identifiés dans la littérature Nord-Américaine. Les facteurs environnementaux et individuels ayant un impact sur le risque d’infection par les VSGC chez l’humain et le chien ont par la suite été modélisés à partir des données sérologiques chez ces deux espèces. D’après nos modèles, le risque d’infection par ces virus serait supérieur en zone forestière et le degré d’exposition aux piqures de moustiques serait un facteur déterminant du risque d’infection chez les deux espèces. Cette étude a permis de bonifier de façon substantielle le portrait de l’activité arbovirale au Québec. Elle a permis de caractériser la distribution du risque et a fourni des données probantes pouvant soutenir la recherche ainsi que la planification des interventions en santé publique. La méthodologie utilisée dans le cadre de cette étude supporte la pertinence de l’approche « One Health » pour l’étude des maladies vectorielles émergentes. / Arboviral infections represent a considerable and growing health burden globally. The complexity of biotic and abiotic factors involved in the transmission of these arboviruses pose a challenge to scientists trying to understand, model or anticipate arboviral transmission as well as to public health authorities who have the responsibility to monitor, assess and manage the public health risk posed by arboviruses. This study aimed at estimating and characterizing the risk of exposure to several arboviruses suspected of being active and emerging in Québec but whose distribution had not been studied thoroughly in Québec: West Nile virus (WNV), eastern equine encephalitis virus (EEEV) and two viruses of the California serogroup (CSG), Jamestown Canyon virus (JCV) and Snowshoe hare virus (SHV). Based on the assumption that animals of different species sharing a common environment also share similar environmental risk, this study also aimed to assess whether some populations of domestic animals could help to estimate and characterize the risk of arboviral infection in humans. Serological sampling of human, canine and equine populations from southwestern Québec was used to evaluate and compare the seroprevalence to the selected arboviruses in each of these three species. Seroprevalence estimates showed a significant level of arboviral activity for all arboviruses. Differences were noted in the percentage of seropositive individuals in each species. Environmental factors that influence the risk of infection by EEEV were modeled based on serological and clinical data in horses. Wooded wetlands were identified as the main risk environments for EEEV in Québec while agricultural areas were identified as protective environments. Environmental factors affecting the risk of WNV infection were modeled based on serological data in dogs and aggregated clinical data in humans. These models suggested a higher risk in agricultural areas in dogs and a lower risk in forest areas in humans, two factors rarely identified in the North American literature. Environmental and individual factors affecting the risk of infection by CSGV in humans and dogs have subsequently been modeled based on serological data in these two species. According to our models, the risk of infection with these viruses would be higher in forested areas and the degree of exposure to mosquito bites would be a risk factor for infection in both species. This study substantially enhanced the comprehension of arboviral activity in Québec. It allowed for characterizing the distribution of risk and provided evidence that may support research and planning of public health interventions. The methodology used in this study supports the relevance of the "One Health" approach for the study of emerging vector-borne diseases.

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No. of bitstreams: 2 Dissertação - Lísia Gomes Martins de Moura Tomich - 2016.pdf: 2901743 bytes, checksum: 22cd41bfc4499cfd4754d856635357af (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2016-08-15 / Conselho Nacional de Pesquisa e Desenvolvimento Científico e Tecnológico - CNPq / INTRODUCTION: Routine infant immunization with meningococcal C conjugate vaccine (MenC-V) started in Brazil in November 2010, administered at three, five and 12 months of age with no catch-up for older age-groups. However, by March 2010, a vaccination campaign with MenC-V was performed in Salvador in individuals under five years-old, and from 10 to 24 yearsold. In São Paulo state, the outbreaks occurred in teenagers and young adults prompting one-time vaccination campaign from 2010 to 2014 targeting these age-groups. OBJECTIVE: To assess the direct and indirect impact (herd effect) of vaccination on invasive meningococcal disease (MD) for capsular group C (MenC) four years after the introduction of MenC-V in three scenarios: i) Brazil as a whole (routine vaccination in childhood only); ii) Brazil except for Salvador (vaccination campaign with teenagers during the year of MenC-V introduction); and iii) São Paulo state (vaccination campaign for adolescents and young adults during 2010-2014 to control outbreaks). METHODS: We performed an ecological quasi-experimental design from 2008 to 2014 using data from the National Reference Laboratory for Meningitis, and data from the National Information System for Notifiable Diseases. A deterministic linkage was performed between the two databases to improve the accuracy of the detection of MD, especially in capsular groups. An interrupted time-series analysis was conducted using the Holt-Winters technique to control for pre-existing trends and seasonal variations. The MenC vaccination impact was evaluated as the percentage of reduction in the incidence rates of MenC in the post-vaccination period (2012 to 2014), using the pre-vaccination period (2008 to 2010) to estimate what would be expected on the post-vaccination period, whether the vaccination had not been introduced. For Salvador, we analyzed the effect of the vaccination on the number of MenC cases. RESULTS: A total of 18,136 invasive MD cases were analyzed. For Brazil as a whole, the vaccination reduced 67.4% (lower 95%CI 42.5%) the rates for MenC for infants under 12 months, 92.3% (lower 95%CI 77.7%) for the age-group 12-23 months, and 65.7% (lower 95%CI 28%) for children aged 2-4 years. Indirect impact (20-24.7%) was observed in the age-group 5-19 years. When excluding Salvador from the analysis of Brazil, the indirect impact was observed only for children in the age-group 5-9 years. In the scenario of São Paulo state, similarly to Brazil, significant impact was observed in the target age-groups, in addition to indirect impact in the age group 5-9 years. In Salvador, in addition to the effect on the vaccinated population a sharp and sustainable decline of MenC cases was observed in all age-groups not target for vaccination. Overall, 1,170 cases of MenC were averted in Brazil after the introduced of Men-C vaccination. CONCLUSION: The strategy of catch-up for adolescents and young adults, especially during the year of MenC-V introduction may lead to rapid and sustainable herd effect. / A vacina meningocócica conjugada contra o grupo capsular C (MenC-V) foi introduzida no calendário de imunização infantil brasileiro em novembro de 2010, sendo administrada aos três, cinco e 12 meses de idade sem catch-up para os demais grupos etários. Entretanto, em março de 2010, uma campanha de vacinação com MenC-V foi realizada em Salvador para indivíduos menores de cinco anos de idade e de 10 a 24 anos. No estado de São Paulo os surtos ocorreram em adolescentes e adultos jovens, determinando campanhas de vacinações de bloqueio nessa faixa etária nos anos de 2010 a 2014. OBJETIVO: Avaliar o impacto direto e indireto (rebanho) da vacinação nas taxas de incidência de doença meningocócica (DM) invasiva pelo grupo capsular C (MenC) após quatro anos da introdução da MenC-V em três cenários: i) Brasil como um todo (imunização de rotina somente de crianças); ii) Brasil exceto Salvador (campanha de vacinação em adolescentes no ano de introdução da MenCV); e iii) estado de São Paulo (vacina de rotina na infância e vacinações de bloqueio em adolescentes e adultos jovens para controlar surtos). MÉTODOS: Foi realizado um estudo ecológico quasi-experimental para avaliar o impacto da vacinação em série histórica de 2008 a 2014 usando os bancos de dados do Laboratório Nacional de Referência para Meningites Bacterianas, Instituto Adolfo Lutz (IAL) e o Sistema de Informação de Agravos de Notificação (Sinan). Um processo de vinculação (linkage) determinístico entre as duas bases foi realizado para melhorar a acurácia da detecção de casos de DM, especialmente de grupo capsulares. Uma análise de série temporal interrompida foi conduzida utilizando a técnica de Holt-Winters para controlar por tendência pré-existente e variações sazonais. O desfecho foi taxa de MenC. O impacto da vacinação foi avaliado pelo percentual de redução da incidência de MenC no período pós-vacinal (2012 a 2014), utilizando o período pré-vacinal (2008 a 2010) para estimar o que seria esperado no período pós-vacinal, caso a vacinação não tivesse sido introduzida. Para Salvador foi analisado o efeito da MenC-V no número de casos de MenC. RESULTADOS: Um total de 18.136 casos de DM invasiva foram analisados. Para o Brasil como um todo, a vacinação reduziu significativamente a DM por MenC na faixa etária alvo, com redução de 67,4% (limite inferior do IC95% 42,5%) em menores de 12 meses, 92,3% (limite inferior do IC95% 77,7%) para faixa etária de 12-23 meses e 65,7% (limite inferior do IC95% 28%) em crianças de 2-4 anos, e efeito rebanho foi observado na faixa etária de 5 a 19 anos com 20-24,7%. Quando se exclui Salvador na análise do Brasil, impacto indireto significativo foi observado somente em crianças de 5-9 anos. No cenário São Paulo, semelhante ao Brasil, observou-se impacto estatisticamente significante nas faixas etárias alvo do PNI, além do efeito rebanho na faixa etária de 5-9 anos de idade. Para Salvador, o impacto da vacinação apresentou um declínio acentuado e sustentável em todas as faixas etárias fora do alvo da vacinação. Ao todo, 1.170 casos de MenC foram evitados no período estudado. CONCLUSÃO: A estratégia de vacinação de catch-up em adolescentes e adultos jovens, especialmente no ano de introdução da MenC-V, promoveu um rápido e sustentável rebanho.