1%) showed VR2 4, with nine of them belonging to cc41/44. The percentage of PorA VR2 4 in the other European Countries was about 20%, higher than in Greece. The most common fHbp variant in Greece was variant 1 (66.9%) Selleckchem CYT387 followed by variant 2 (24.3%) and variant 3 (8.8%). Among the fHbp peptides the most common was 1.15 (41/148, 27.7%) followed by peptide 2.21 (25/148, 16.9%) and 1.1, corresponding to the specific genotype included in the 4CMenB vaccine (16/148, 10.8%). This differed from the Copanlisib manufacturer EURO-5 study, in which peptide 1.4 (16.2%) was the most frequent and peptides 1.15 and 2.21 were identified only in 11.4% and 2% of isolates, respectively, whereas the percentage of fHbp-1.1 was quite comparable

[23]. The NHBA peptide 20 (63/148, 42.6%), 21 (33/148, 22.3%) and 2 (15/148, 10.1%) accounted for more than 75% of the strains. This also differed from the Euro-5 study [23] where the peptide 2 was the most frequent (24.7%) and the peptide 20 was represented by 5% of the isolates. NHBA peptide 20 was predominant in Greece as a consequence of the prevalence of cc162. For

NadA, Selleckchem STI571 18 of 148 (12%) isolates harbored nadA gene (22.3% in the EURO-5 study), including one cc41/44 isolate, one cc212 isolate and all cc32 isolates. The remaining isolates were devoid of nadA gene. The nadA gene presence was slightly lower in Greece than in the rest of Europe. Estimated 4CMenB coverage The analysis of Greek strains revealed that the coverage by at least one antigen (fHbp, NHBA, NadA or PorA) predicted by MATS was 89.2% (63.5%-98.6%) CI0.95 by at least one antigen (Table  1). This prediction is similar to the coverage predicted by MATS-PBT for only the 52 strains that were collected in Greece during 2008–2010, which was 88% (60%-96%)

CI0.95. The predicted coverage for each of the clonal complexes is shown in Table  2. The highest predicted coverage was shown among the strains belonging to cc32/ET-5 (100%), followed by cc269 (97% (57.6%-100%) CI0.95), cc41/44/lineage3 (94.4% (72.2%-100%)CI0.95) Niclosamide and cc162 (86.4% (63.6%-100%) CI0.95). Table 1 Contribution of each antigen and their combination to MATS PBT predicted coverage Antigen Combination No of strains % coverage of each antigen combination % coverage of combined antigen groups No antigen 16 10.8% 10.8% fHbp 14 9.5%   NadA 1 0.7% 44.7% NHBA 50 33.8%   PorA 1 0.7%   fHbp + NHBA 55 37.1%   PorA + NHBA 2 1.3% 44.5% PorA + fHbp + NHBA 9 6.1%   Table 2 MATS-PBT predicted coverage by clonal complex Clonal Complex No of Strains Predicted coverage ST-162 66 86.4% (63.6%-100%)CI0.95 ST-269 33 97.0% (57.6%-100%)CI0.95 ST-41/44/lineage 3 18 94.4% (72.2%-100%) CI0.95 ST-32/ET-5 16 100% The contribution of each antigen to coverage was variable across the clonal complexes (Figure  3).