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Prevalence and persistence of Neisseria meningitidis carriage in Swedish university students. Epidemiol Infect 2023; 151:e25. [PMID: 36775828 PMCID: PMC9990396 DOI: 10.1017/s0950268823000018] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023] Open
Abstract
The bacterium Neisseria meningitidis causes life-threatening disease worldwide, typically with a clinical presentation of sepsis or meningitis, but can be carried asymptomatically as part of the normal human oropharyngeal microbiota. The aim of this study was to examine N. meningitidis carriage with regard to prevalence, risk factors for carriage, distribution of meningococcal lineages and persistence of meningococcal carriage. Throat samples and data from a self-reported questionnaire were obtained from 2744 university students (median age: 23 years) at a university in Sweden on four occasions during a 12-month period. Meningococcal isolates were characterised using whole-genome sequencing. The carriage rate among the students was 9.1% (319/3488; 95% CI 8.2-10.1). Factors associated with higher carriage rate were age ≤22 years, previous tonsillectomy, cigarette smoking, drinking alcohol and attending parties, pubs and clubs. Female gender and sharing a household with children aged 0-9 years were associated with lower carriage. The most frequent genogroups were capsule null locus (cnl), group B and group Y and the most commonly identified clonal complexes (cc) were cc198 and cc23. Persistent carriage with the same meningococcal strain for 12 months was observed in two students. Follow-up times exceeding 12 months are recommended for future studies investigating long-term carriage of N. meningitidis.
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Neisseria meningitidis carriage rate, antibiotic susceptibility profile, and associated factors among prisoners at Jimma zonal correction facility in Jimma Town, Southwestern Ethiopia: a cross-sectional study. Trop Med Health 2022; 50:67. [PMID: 36114580 PMCID: PMC9479249 DOI: 10.1186/s41182-022-00462-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Accepted: 09/07/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Neisseria meningitidis causes severe life-threatening meningococcal disease with a case fatality rate of 10–15% even with proper treatment. In Ethiopia, particularly in our study area, inadequate information is found on meningococcal disease. So, this study aimed to assess N. meningitidis carriage rate, antibiotic susceptibility profile, and associated factors among prisoners in Jimma Town, Southwestern Ethiopia.
Methods
A cross-sectional study was conducted in Jimma town, Southwest Ethiopia, from May to October 2019. A stratified sampling technique was used and proportional allocation was done. A total of 550 oropharyngeal swabs were collected, processed, isolated, and identified N. meningitidis using standard microbiological techniques. Antibiotics susceptibility test was done for isolates using the disk diffusion method. Data on demographic and associated factors for carriage were collected using a structured questionnaire. Data were summarized using frequency, percentage, graph, and table. A logistic regression model was used to see the association between the dependent and independent variables. Variables with a p-value < 0.25 during bivariate analysis were included in multivariate analysis to identify factors significantly associated with the meningococcal carriage and, a p-value < 0.05 was considered statistically significant.
Result
Out of the 550 study participants, 76(13.8%) with (CI: 7.20–18.20) were found carriers of N meningitidis. The predominant isolates were non-serogroupable 26(34.2%) and serogroup W/Y 22(28.9%), respectively. N. meningitidis isolates showed highest sensitivity to chloramphenicol 74(97.4%). Meningococcal carriage rate was significantly associated with being age group of 16–20 years; having respiratory symptoms within 3 months and active cigarette smoking within 3 months.
Conclusions
The majority of participants harbor most of the serogroups responsible for invasive cases of meningococcal disease. Respiratory symptoms, active cigarette smoking, and age group of 16–20 years increased the risk of N. meningitidis pharyngeal carriage rate. This study suggests providing better health education to control respiratory symptoms, smoking, and providing antibiotic prophylaxis for prisoners.
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Kizil MC, Kilic O, Ceyhan M, Iseri Nepesov M, Karbuz A, Kurugol Z, Hacimustafaoglu M, Celebi S, Dinleyici M, Carman KB, Bayhan C, Balliel Y, Sutcu M, Kuyucu N, Kondolot M, Kara SS, Ocal Demir S, Cay U, Gayretli Aydin ZG, Kaya M, Dinleyici EC. Nasopharyngeal Meningococcal Carriage among Children and Adolescents in Turkey in 2018: An Unexpected High Serogroup X Carriage. CHILDREN-BASEL 2021; 8:children8100871. [PMID: 34682136 PMCID: PMC8534370 DOI: 10.3390/children8100871] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 09/18/2021] [Accepted: 09/26/2021] [Indexed: 12/03/2022]
Abstract
Meningococcal carriage studies and transmission modeling can predict IMD epidemiology and used to define invasive meningococcal disease (IMD) control strategies. In this multicenter study, we aimed to evaluate the prevalence of nasopharyngeal Neisseria meningitidis (Nm) carriage, serogroup distribution, and related risk factors in Turkey. Nasopharyngeal samples were collected from a total of 1267 children and adolescents and were tested with rt-PCR. Nm carriage was detected in 96 participants (7.5%, 95% CI 6.1–9.0), with the peak age at 13 years (12.5%). Regarding age groups, Nm carriage rate was 7% in the 0–5 age group, was 6.9%in the 6–10 age group, was 7.9% in the 11–14 age group, and was 9.3% in the 15–18 age group. There was no statistically significant difference between the groups (p > 0.05). The serogroup distribution was as follows: 25% MenX, 9.4% MenA, 9.4% MenB, 2.1% MenC, 3.1% MenW, 2.1% for MenY, and 48.9% for non-groupable. The Nm carriage rate was higher in children with previous upper respiratory tract infections and with a high number of household members, whereas it was lower in children with antibiotic use in the last month (p < 0.05 for all). In this study, MenX is the predominant carriage strain. The geographical distribution of Nm strains varies, but serogroup distribution in the same country might change in a matter of years. Adequate surveillance and/or a proper carriage study is paramount for accurate/dynamic serogroup distribution and the impact of the proposed vaccination.
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Affiliation(s)
- Mahmut Can Kizil
- Division of Pediatric Infectious Diseases, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir 26040, Turkey; (M.C.K.); (O.K.); (M.I.N.)
| | - Omer Kilic
- Division of Pediatric Infectious Diseases, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir 26040, Turkey; (M.C.K.); (O.K.); (M.I.N.)
| | - Mehmet Ceyhan
- Division of Pediatric Infectious Diseases, Faculty of Medicine, Hacettepe University, Ankara 06230, Turkey;
| | - Merve Iseri Nepesov
- Division of Pediatric Infectious Diseases, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir 26040, Turkey; (M.C.K.); (O.K.); (M.I.N.)
| | - Adem Karbuz
- Tascioglu City Hospital Division of Pediatric Infectious Diseases, Istanbul 34000, Turkey;
| | - Zafer Kurugol
- Division of Pediatric Infectious Diseases, Faculty of Medicine, Ege University, Izmir 35000, Turkey;
| | - Mustafa Hacimustafaoglu
- Division of Pediatric Infectious Diseases, Faculty of Medicine, Uludag University, Bursa 16059, Turkey; (M.H.); (S.C.)
| | - Solmaz Celebi
- Division of Pediatric Infectious Diseases, Faculty of Medicine, Uludag University, Bursa 16059, Turkey; (M.H.); (S.C.)
| | - Meltem Dinleyici
- Division of Social Pediatrics, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir 26040, Turkey;
| | - Kursat Bora Carman
- Division of Pediatric Neurology, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir 26040, Turkey;
| | - Cihangul Bayhan
- Division of Pediatric Infectious Diseases, Gulhane Training and Research Hospital, Ankara 06300, Turkey;
| | - Yasemin Balliel
- Antalya Muratpaşa Çaybaşı No:1 Family Health Center, Antalya 07000, Turkey;
| | - Murat Sutcu
- Division of Pediatric Infectious Diseases, Faculty of Medicine, Istinye University, Istanbul 34010, Turkey;
| | - Necdet Kuyucu
- Division of Pediatric Infectious Diseases, Faculty of Medicine, Mersin University, Mersin 33343, Turkey;
| | - Meda Kondolot
- Division of Social Pediatrics, Faculty of Medicine, Erciyes University, Kayseri 38039, Turkey;
| | - Soner Sertan Kara
- Division of Pediatric Infectious Diseases, Faculty of Medicine, Aydin Adnan Menderes University, Aydin 09010, Turkey;
| | - Sevliya Ocal Demir
- Division of Pediatric Infectious Diseases, Faculty of Medicine, Istanbul Medeniyet University, Istanbul 34000, Turkey;
| | - Ummuhan Cay
- Division of Pediatric Infectious Diseases, Faculty of Medicine, Cukurova University, Adana 01330, Turkey;
| | - Zeynep Gokce Gayretli Aydin
- Division of Pediatric Infectious Diseases, Faculty of Medicine, Karadeniz Technical University, Trabzon 61080, Turkey;
| | | | - Ener Cagri Dinleyici
- Department of Pediatrics, Faculty of Medicine, Ener Cagri Dinleyici, Eskisehir Osmangazi University, Eskisehir 26040, Turkey
- Correspondence:
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Sharma S, Acharya J, Caugant DA, Aryal S, Banjara MR, Ghimire P, Singh A. Meningococcal Carriage among Household Contacts of Patients with Invasive Meningococcal Disease in Kathmandu, Nepal: A Longitudinal Study. Pathogens 2021; 10:pathogens10070781. [PMID: 34206153 PMCID: PMC8308540 DOI: 10.3390/pathogens10070781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 06/11/2021] [Accepted: 06/15/2021] [Indexed: 11/24/2022] Open
Abstract
Because asymptomatic carriers are key source of transmission, information on meningococcal carriage in the community provides a scientific basis for appropriate preventive/control strategies. This longitudinal study (January 2017–December 2019) aimed to estimate carriage rate of meningococci among household contacts of meningococcal meningitis cases within Kathmandu Valley, Nepal. Throat swab samples were collected at first visit from each person in households, twice a month for up to 2 months and subsequently on a monthly basis for a further 4 months. Altogether, 1125 throat samples were processed by conventional culture for the identification of meningococci. To the best of our knowledge, this is the first longitudinal study on meningococcal carriage in Nepal. The meningococcal carriage rate among household contacts was 15%. All carriers were aged 19 years or older. There was no statistically significant gender difference. The duration of carriage was 60 days. Twenty of 36 isolates belonged to serogroup A, and 16 were non-serogroupable (NG). Serogroups isolated from the same individuals did not change within the follow-up period. All meningococcal isolates over the past 38 years in Nepal that have been reported in previous studies have belonged to serogroup A. The detection of NG meningococcal isolates in apparently healthy household contacts clearly indicates the importance of vigilance through surveillance and periodic in-depth studies.
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Affiliation(s)
- Supriya Sharma
- Central Department of Microbiology, Tribhuvan University, Kirtipur, Kathmandu 44600, Nepal; (M.R.B.); (P.G.); (A.S.)
- Correspondence: ; Tel.: +977-98-4150-8496
| | - Jyoti Acharya
- National Public Health Laboratory, Teku, Kathmandu 44600, Nepal;
| | - Dominique A. Caugant
- WHO Collaborating Centre for Reference and Research on Meningococci, Norwegian Institute of Public Health, 0213 Oslo, Norway;
| | | | - Megha Raj Banjara
- Central Department of Microbiology, Tribhuvan University, Kirtipur, Kathmandu 44600, Nepal; (M.R.B.); (P.G.); (A.S.)
| | - Prakash Ghimire
- Central Department of Microbiology, Tribhuvan University, Kirtipur, Kathmandu 44600, Nepal; (M.R.B.); (P.G.); (A.S.)
| | - Anjana Singh
- Central Department of Microbiology, Tribhuvan University, Kirtipur, Kathmandu 44600, Nepal; (M.R.B.); (P.G.); (A.S.)
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Tefera Z, Mekonnen F, Tiruneh M, Belachew T. Carriage rate of Neisseria meningitidis, antibiotic susceptibility pattern and associated risk factors among primary school children in Gondar town, Northwest Ethiopia. BMC Infect Dis 2020; 20:358. [PMID: 32434569 PMCID: PMC7238561 DOI: 10.1186/s12879-020-05080-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 05/11/2020] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Globally, in 2012, about 1.2 million estimated cases were reported with ~ 135,000 deaths annually. In Ethiopia, specifically in our study area, limited information is found on the oropharyngeal carriage, antimicrobial resistance pattern, and associated risk factors for N. meningitidis among school children. So, the aim of this study was to assess oropharyngeal carriage rate of N. meningitidis, antibiotic susceptibility pattern and associated risk factors among primary school children in Gondar town, Northwest Ethiopia. METHODS A cross sectional study was conducted from January to April, 2019 in Gondar town. Multi stage simple random sampling technique was used. A total of 524 oropharyngeal swabs were collected using sterile plastic cotton swabs. Modified Thayer Martin media was used for primary isolation. Antimicrobial susceptibility pattern was done based on Kirby-Bauer method on Muller-Hinton agar supplemented with 5% sheep blood. Multidrug resistance was defined as resistance of an isolate to two or more antimicrobial classes tested. Logistic regression model was used to see the association between dependent variables (Carriage rate of Neisseria meningitidis, Serogroups of Neisseria meningitidis and Antimicrobial susceptibility patterns) and independent variables (Socio-demographic data and risk factors). Variables with a P- value ≤0.2 during bivariable analysis was taken to multivariable analysis to check significant association of meningococcal carriage with risk factors. Finally, a P-value < 0.05 was considered as statistically significant. Data was summarized using numbers, percentages and tables. RESULTS A total of 53(10.1%) (CI: 7.6-12.8) N. meningitidis isolates were identified. Serogroup A 13 (24.5%) was the most prevalent followed by Y/W135 11(20.7%) whereas serogroup B 4(7.6%) was the least identified serotype. Meningococcal isolates were resistant to ciprofloxacin (45.3%) and trimethoprim-sulfamethoxazole (73.6%). Overall, most of meningococcal isolates showed about 32(60.4%) multidrug resistance. Meningococcal carriage rate was significantly associated with family size, tonsillectomy, passive smoking, number of students per class, sharing utensils, history of visiting healthcare institutions, and indoor kitchen. CONCLUSION This study highlights the need for reinforcement of case-based, laboratory confirmed surveillance of N. meningitidis carriage in Ethiopian elementary school students to enable mapping of distribution of serotypes of the causative organisms across the country and determine the current potential necessity of vaccination.
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Affiliation(s)
| | - Feleke Mekonnen
- Department of Medical Microbiology, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Moges Tiruneh
- Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Teshome Belachew
- Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
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Neisseria meningitidis carriage in indigenous peoples of Amazonas State, Brazil. J Infect 2020; 80:671-693. [PMID: 32035938 DOI: 10.1016/j.jinf.2020.01.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 01/30/2020] [Accepted: 01/31/2020] [Indexed: 11/20/2022]
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Seifert HS. Location, Location, Location-Commensalism, Damage and Evolution of the Pathogenic Neisseria. J Mol Biol 2019; 431:3010-3014. [PMID: 30986425 DOI: 10.1016/j.jmb.2019.04.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 02/19/2019] [Accepted: 04/03/2019] [Indexed: 10/27/2022]
Abstract
The 10 human-restricted Neisseria species all colonize mucosal surfaces, but show a spectrum of pathogenicity. The commensal Neisseria do not normally cause pathology, while the two pathogenic species, Neisseria meningitidis and Neisseria gonorrhoeae, straddle the border between commensalism and pathogenicity. Why the pathogenic Neisseria continue to mediate host damage after thousands of years of co-evolution with their human host, and why the commensal species have not acquired the ability to damage the host, if this capability provides a selective advantage, is not understood. One way the pathogenic species are different from the commensal species is by their ability to induce PMN inflammation, which is dependent on the site of colonization. I discuss how the site of colonization dictates whether copious inflammation occurs with both pathogenic species. I put forth a model that posits that an ancestor of both pathogenic species changed colonization site from the oral cavity to the genital tract of a human or humanoid and had to evolve multiple, new traits - to induce PMN inflammation and avoid adaptive immunity - to allow efficient sexual transmission. This model predicts that PMN inflammation produces the serious sequelae of gonorrhea and increases the probability that N. meningitidis might exit the oral cavity to produce systemic disease. In both cases, the pathology produced by these host-adapted species is an unintended by product of the inflammation but host damage does not provide any selective advantage for these organisms.
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Affiliation(s)
- H Steven Seifert
- Department of Microbiology-Immunology, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA.
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Greenwood BM, Aseffa A, Caugant DA, Diallo K, Kristiansen PA, Maiden MCJ, Stuart JM, Trotter CL. Narrative review of methods and findings of recent studies on the carriage of meningococci and other Neisseria species in the African Meningitis Belt. Trop Med Int Health 2019; 24:143-154. [PMID: 30461138 PMCID: PMC7380001 DOI: 10.1111/tmi.13185] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To review the findings of studies of pharyngeal carriage of Neisseria meningitidis and related species conducted in the African meningitis belt since a previous review published in 2007. METHODS PubMed and Web of Science were searched in July 2018 using the terms 'meningococcal OR Neisseria meningitidis OR lactamica AND carriage AND Africa', with the search limited to papers published on or after 1st January 2007. We conducted a narrative review of these publications. RESULTS One hundred and thirteen papers were identified using the search terms described above, 20 of which reported new data from surveys conducted in an African meningitis belt country. These papers described 40 surveys conducted before the introduction of the group A meningococcal conjugate vaccine (MenAfriVacR ) during which 66 707 pharyngeal swabs were obtained. Carriage prevalence of N. meningitidis varied substantially by time and place, ranging from <1% to 24%. The mean pharyngeal carriage prevalence of N. meningitidis across all surveys was 4.5% [95% CI: 3.4%, 6.8%] and that of capsulated N. meningitidis was 2.8% [95% CI: 1.9%; 5.2%]. A study of households provided strong evidence for meningococcal transmission within and outside households. The introduction of MenAfriVac® led to marked reductions in carriage of the serogroup A meningococcus in Burkina Faso and Chad. CONCLUSIONS Recent studies employing standardised methods confirm the findings of older studies that carriage of N. meningitidis in the African meningitis belt is highly variable over time and place, but generally occurs with a lower prevalence and shorter duration than reported from industrialised countries.
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Affiliation(s)
| | | | | | - Kanny Diallo
- Department of BacteriologyNoguchi Memorial Research InstituteUniversity of LegonAccraLegon
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