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Walsh L, Clark SA, Derrick JP, Borrow R. Beyond the usual suspects: Reviewing infections caused by typically-commensal Neisseria species. J Infect 2023; 87:479-489. [PMID: 37797844 DOI: 10.1016/j.jinf.2023.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 07/27/2023] [Accepted: 09/22/2023] [Indexed: 10/07/2023]
Abstract
OBJECTIVE Few data outside of individual case reports are available on non-meningococcal, non-gonococcal species of Neisseria as causative agents of invasive disease. This review collates disease, organism and patient information from case reports on the topic. METHODS A literature search was performed examining articles describing diseases caused by non-meningococcal and non-gonococcal Neisseria. FINDINGS Neisseria present as opportunistic pathogens causing a wide variety of diseases including serious presentations, endocarditis being the most common condition described and N. mucosa the most commonly presenting pathogen overall. Disease may occur in otherwise healthy patients, although risk factors for infection include recent surgery, an immunocompromised state, poor oral health, and intravenous drug use. CONCLUSIONS Commensal Neisseria infections are rare but can present serious invasive diseases. Further research is required to determine why some species cause disease more than others or why some are inclined towards particular manifestations.
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Affiliation(s)
- Lloyd Walsh
- Meningococcal Reference Unit, UK Health Security Agency, Manchester M13 9WL, United Kingdom.
| | - Stephen A Clark
- Meningococcal Reference Unit, UK Health Security Agency, Manchester M13 9WL, United Kingdom
| | - Jeremy P Derrick
- School of Biological Sciences, Faculty of Biology, Medicine, and Health, University of Manchester, Manchester M13 9PL, United Kingdom
| | - Ray Borrow
- Meningococcal Reference Unit, UK Health Security Agency, Manchester M13 9WL, United Kingdom
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Belachew T, Assefa M, Tefera Z, Fenta A, Biset S. Colonization Rate and Associated Factors of Non-Pathogenic Neisseria Species, and Moraxella catarrhalis Among Healthy School Children in Gondar, Northwest Ethiopia. Infect Drug Resist 2023; 16:369-378. [PMID: 36714354 PMCID: PMC9879043 DOI: 10.2147/idr.s395343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 01/11/2023] [Indexed: 01/23/2023] Open
Abstract
Background Although commensal Neisseria species inhabiting mucosal surfaces in the upper respiratory tract (URT) are rarely associated with infections, their presence in the area has been linked to the development of immunity against N. meningitidis and the source of antibiotic resistance determinants in pathogenic species. M. catarrhalis in the oropharynx of children is also a predisposing factor for otitis media. As a result, determining the oropharyngeal carriage rate of these commensal species and associated factors among healthy schoolchildren is substantial. Materials and Methods This community-based cross-sectional study was conducted in Gondar, Northwest Ethiopia, from January to April 2019. A multi-stage and simple random sampling technique were used to select schools and participants, respectively. A total of 524 oropharyngeal swabs were collected using cotton swabs. Modified Thayer-Martin media was used for primary bacterial isolation, and battery of biochemical tests was performed to identify species. For frequencies, descriptive statistics were computed and the logistic regression model was used to see the relationship between dependent and independent variables. Results A total of 524 healthy schoolchildren with a mean age of 12.2 ± 2.74 years participated in this study. The overall oropharyngeal carriage rate was 21.8% (114/524). Of these, N. meningitidis, N. lactamica, N. sicca, and M. catarrhalis were identified in 53 (46.5%), 14 (12.3%), 11 (9.6%), and 36 (31.6%) children, respectively. The culture positivity rate was higher at a younger age, which was 8.1%, 11.3%, and 14.9% in ages between 15-18, 11-14, and 7-10, respectively. The oropharyngeal carriage was significantly associated with the number of students per class (>40). Conclusion There is a higher proportion of carriers of commensal N. lactamica and M. catarrhalis in Gondar town schoolchildren. The oropharyngeal carriage rate was associated with a crowded classroom. The characterization of non-pathogenic Neisseria species and M. catarrhalis in the study area can support the diagnosis of patients suspected of having N. meningitis infections.
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Affiliation(s)
- Teshome Belachew
- Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Muluneh Assefa
- Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | | | | | - Sirak Biset
- Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia,Correspondence: Sirak Biset, Tel +251-911-598-568, Email
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Baerentsen R, Tang CM, Exley RM. Et tu, Neisseria? Conflicts of Interest Between Neisseria Species. Front Cell Infect Microbiol 2022; 12:913292. [PMID: 35811666 PMCID: PMC9263626 DOI: 10.3389/fcimb.2022.913292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 05/27/2022] [Indexed: 11/24/2022] Open
Abstract
Neisseria meningitidis and Neisseria gonorrhoeae are two obligate human pathogens that have evolved to be uniquely adapted to their host. The meningococcus is frequently carried asymptomatically in the nasopharynx, while gonococcal infection of the urogenital tract usually elicits a marked local inflammatory response. Other members of the Neisseria genus are abundant in the upper airway where they could engage in co-operative or competitive interactions with both these pathogens. Here, we briefly outline the potential sites of contact between Neisseria spp. in the body, with emphasis on the upper airway, and describe the growing yet circumstantial evidence for antagonism from carriage studies and human volunteer challenge models with Neisseria lactamica. Recent laboratory studies have characterized antagonistic mechanisms that enable competition between Neisseria species. Several of these mechanisms, including Multiple Adhesin family (Mafs), Two Partner Secretion Systems, and Type VI secretion system, involve direct contact between bacteria; the genetic organisation of these systems, and the domain structure of their effector molecules have striking similarities. Additionally, DNA from one species of Neisseria can be toxic to another species, following uptake. More research is needed to define the full repertoire of antagonistic mechanisms in Neisseria spp., their distribution in strains, their range of activity, and contribution to survival in vivo. Understanding the targets of effectors could reveal how antagonistic relationships between close relatives shape subsequent interactions between pathogens and their hosts.
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Shao Y, Chen M, Luo J, Li D, Yuan L, Yang X, Wang M, Chen M, Guo Q. Serogroup Y Clonal Complex 23 Meningococcus in China Acquiring Penicillin Resistance from Commensal Neisseria lactamica Species. Antimicrob Agents Chemother 2022; 66:e0238321. [PMID: 35652645 PMCID: PMC9211434 DOI: 10.1128/aac.02383-21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 05/16/2022] [Indexed: 11/20/2022] Open
Abstract
Invasive meningococcal disease (IMD) due to serogroup Y Neisseria meningitidis (NmY) is rare in China; recently, an invasive NmY isolate, Nm512, was discovered in Shanghai with decreased susceptibility to penicillin (PenNS). Here, we investigated the epidemiology of NmY isolates in Shanghai and explored the potential commensal Neisseria lactamica donor of the PenNS NmY isolate. A total of 491 N. meningitidis and 724 commensal Neisseria spp. isolates were collected. Eleven NmY isolates were discovered from IMD (n = 1) and carriers (n = 10), including two PenNS isolates with five-key-mutation-harboring (F504L-A510V-I515V-H541N-I566V) penA genes. Five of the eight ST-175 complex (CC175) isolates had a genotype [Y:P1.5-1,2-2:F5-8:ST-175(CC175)] identical to that of the predominant invasive clone found in South Africa. Only one invasive NmY CC23 isolate (Nm512) was discovered; this isolate carried a novel PenNSpenA832 allele, which was identified in commensal N. lactamica isolates locally. Recombination analysis and transformation of the penA allele highlighted that N. meningitidis Nm512 may acquire resistance from its commensal donor; this was supported by the similar distribution of transformation-required DNA uptake sequence variants and the highly cognate receptor ComP between N. meningitidis and N. lactamica. In 2,309 NmY CC23 genomes from the PubMLST database, isolates with key-mutation-harboring penA genes comprised 12% and have been increasing since the 1990s, accompanied by recruitment of the blaROB-1 and/or quinolone resistance allele. Moreover, penA22 was predominant among genomes without key mutations in penA. These results strongly suggest that Nm512 is a descendant of the penA22-harboring CC23 isolate from Europe and acquired its penicillin resistance locally from commensal N. lactamica species by natural transformation.
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Affiliation(s)
- Youxing Shao
- Institute of Antibiotics, Huashan Hospital, Fudan University, Shanghai, People’s Republic of China
- Key Laboratory of Clinical Pharmacology of Antibiotics, National Heath Commission of the People’s Republic of China, Shanghai, People’s Republic of China
| | - Mingliang Chen
- Department of Microbiology, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, People’s Republic of China
- Department of Microbiology, Shanghai Institutes of Preventive Medicine, Shanghai, People’s Republic of China
| | - Jiayuan Luo
- Department of Microbiology, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, People’s Republic of China
| | - Dan Li
- Department of Microbiology, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, People’s Republic of China
| | - Lingyue Yuan
- Department of Microbiology, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, People’s Republic of China
| | - Xiaoying Yang
- Institute of Antibiotics, Huashan Hospital, Fudan University, Shanghai, People’s Republic of China
- Key Laboratory of Clinical Pharmacology of Antibiotics, National Heath Commission of the People’s Republic of China, Shanghai, People’s Republic of China
| | - Minggui Wang
- Institute of Antibiotics, Huashan Hospital, Fudan University, Shanghai, People’s Republic of China
- Key Laboratory of Clinical Pharmacology of Antibiotics, National Heath Commission of the People’s Republic of China, Shanghai, People’s Republic of China
| | - Min Chen
- Department of Microbiology, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, People’s Republic of China
| | - Qinglan Guo
- Institute of Antibiotics, Huashan Hospital, Fudan University, Shanghai, People’s Republic of China
- Key Laboratory of Clinical Pharmacology of Antibiotics, National Heath Commission of the People’s Republic of China, Shanghai, People’s Republic of China
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Clark SA, Gray S, Finn A, Borrow R. Colistin Sensitivity and Factor H-Binding Protein Expression among Commensal Neisseria Species. mSphere 2021; 6:e0017521. [PMID: 34133203 PMCID: PMC8265630 DOI: 10.1128/msphere.00175-21] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 05/28/2021] [Indexed: 11/20/2022] Open
Abstract
Many bacterial carriage studies utilize colistin-containing media to select for Neisseria meningitidis among the diverse human pharyngeal milieu. These studies commonly report the isolation of Neisseria commensal species, with carriage rates of around 1% or less typically observed. Here, we describe the isolation of N. cinerea and N. polysaccharea from pharyngeal swabs using nonselective agar and confirm they are unable to grow on colistin-containing media. We also demonstrated colistin sensitivity among archived Neisseria commensal strains, including N. cinerea, N. polysaccharea, N. mucosa, and N. subflava. The distribution of lptA among these strains indicated that, while the phosphoethanolamine (PEA) transferase encoded by this gene confers colistin resistance, other mechanisms may lead to reduced susceptibility in some lptA-deficient strains. The majority of the N. cinerea and N. polysaccharea isolates expressed medium to very high levels of factor H-binding protein (fHbp), an important meningococcal vaccine antigen. Sequence analysis showed that the commensal fHbp peptide variants were similar in sequence to fHbp variants typically observed among invasive meningococci. Altogether, these results not only suggest that Neisseria commensal strains could be carried at much higher rates than previously reported but also raise questions about the impact of protein-based meningococcal vaccines on these unencapsulated commensals. IMPORTANCE This study highlights the need for further work to accurately determine the pharyngeal carriage prevalence of Neisseria commensal bacteria (e.g., N. cinerea and N. polysaccharea) among the general population. Previous studies have clearly demonstrated the suppressive effect these commensal species can have on meningococcal colonization, and so the carriage prevalence of these species could be an important factor in the spread of meningococci through the population. Furthermore, the surface expression of the meningococcal vaccine antigen factor H-binding protein by many of these commensal strains could have important implications for the use of fHbp-containing vaccines. Carriage of these commensal species may influence the immune response to these vaccines, or conversely, the immune response elicited by vaccination may induce clearance of these potentially important members of the pharyngeal niche.
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Affiliation(s)
- Stephen A. Clark
- Meningococcal Reference Unit (MRU), Public Health England (PHE), Manchester, United Kingdom
| | - Steve Gray
- Meningococcal Reference Unit (MRU), Public Health England (PHE), Manchester, United Kingdom
| | - Adam Finn
- School of Cellular and Molecular Medicine, University of Bristol, Bristol, United Kingdom
| | - Ray Borrow
- Meningococcal Reference Unit (MRU), Public Health England (PHE), Manchester, United Kingdom
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Takei H, Takeuchi N, Hoshino T, Ohkusu M, Segawa S, Murata S, Ishiwada N. Bacteriological analysis of Neisseria lactamica isolated from the respiratory tract in Japanese children. J Infect Chemother 2020; 27:65-69. [PMID: 32873462 DOI: 10.1016/j.jiac.2020.08.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 08/07/2020] [Accepted: 08/14/2020] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Neisseria lactamica is a commensal bacterium of the upper respiratory tract in humans and is closely related to Neisseria meningitidis. N. lactamica colonization may contribute to preventing N. meningitidis colonization and invasive meningococcal disease. However, the transference of antimicrobial resistance genes from N. lactamica to N. meningitidis has been reported. METHODS In this study, we aimed to identify N. lactamica using matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) and performed multilocus sequence typing of seven N. lactamica strains isolated from Japanese children. We also analyzed the antimicrobial susceptibility of these strains and the mutations in their antimicrobial resistance genes (penA, gyrA, and parC). RESULTS All the N. lactamica strains could be identified using MALDI-TOF MS. All strains were of different sequence types (STs), including five new STs. Five strains had intermediate susceptibility, two were resistant to ampicillin, and all had five out of the five known PBP2 mutations. Six strains were resistant to levofloxacin. Among the quinolone-resistant strains, three had GyrA mutations, and three had both ParC and GyrA mutations. CONCLUSIONS N. lactamica STs may vary in Japanese children, and penicillin- and quinolone-resistant strains may be prevalent. We should pay attention not only to the drug resistance of N. meningitidis but also to the drug susceptibility of N. lactamica whose drug-resistance genes may transfer to N. meningitidis.
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Affiliation(s)
- Haruka Takei
- Department of Infectious, Immune and Allergic Diseases, Saitama Children's Medical Center, Japan; Department of Pediatrics, Chiba University Graduate School of Medicine, Japan
| | - Noriko Takeuchi
- Department of Infectious Diseases, Medical Mycology Research Center, Chiba University, Japan.
| | - Tadashi Hoshino
- Division of Infectious Diseases, Chiba Children's Hospital, Japan
| | - Misako Ohkusu
- Department of Infectious Diseases, Medical Mycology Research Center, Chiba University, Japan
| | - Shunsuke Segawa
- Division of Clinical Laboratory, Chiba University Hospital, Japan
| | - Shota Murata
- Division of Clinical Laboratory, Chiba University Hospital, Japan
| | - Naruhiko Ishiwada
- Department of Infectious Diseases, Medical Mycology Research Center, Chiba University, Japan
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Abstract
PURPOSE OF REVIEW Nonpathogenic commensal Neisseria are rarely considered in the clinical setting despite evidence that they can cause invasive opportunistic infections. In contrast, they may offer protection against pathogenic Neisseria, and such relationships are being actively explored in experimental studies. RECENT FINDINGS Recent case reports are presented of invasive infection caused by nonpathogenic Neisseria in patients on novel biologic therapies. On the other hand, Neisseria lactamica, a nonpathogenic commensal, has been shown in human challenge studies to inhibit colonization by Neisseria meningitidis. Experimental mouse models have also explored the inhibitory effects of nonpathogenic Neisseria on Neisseria gonnhoreae infection. Cutting-edge advances in metagenomics and microbiomics are being used to understand the mechanisms underpinning these effects. SUMMARY Clinicians should have increased awareness of nonpathogenic Neisseria. First, as new immunomodulating therapies become licenced, the interactions that maintain balance between commensals and their human hosts may be altered. Second, these bacteria are showing promise in their capacity to exclude pathogenic Neisseria species from their anatomical niches.
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Shen Y, Chen M. Prevalence, sequence type, and quinolone resistance of Neisseria lactamica carried in children younger than 15 years in Shanghai, China. J Infect 2019; 80:61-68. [PMID: 31586462 DOI: 10.1016/j.jinf.2019.08.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2019] [Revised: 07/29/2019] [Accepted: 08/24/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVE Neisseria lactamica has an important influence on carriage and antimicrobial susceptibility of N. meningitidis, a major pathogen of septicemia and meningitis. In China, quinolone resistance is highly prevalent in N. meningitidis but unknown in N. lactamica. This study investigates the carriage rate, sequence type, and ciprofloxacin resistance of N. lactamica in children in China. METHODS During 2014-2016, throat swabs were collected from 2,239 children in Shanghai. The ciprofloxacin minimum inhibitory concentrations of the isolates were determined by the agar dilution method. RESULTS The overall carriage rate of N. lactamica was higher (8.9%) than that of N. meningitidis (0.9%) and peaked at two years (37.1%). The resistance frequency of N. lactamica to ciprofloxacin was 98.5% (197/200). There were 65 sequence types (STs). Clonal complex (cc) 640 (45.5%) dominated, while ST-14031 was predominant (37%, 74/200). All isolates possessed a GyrA mutation; 17 isolates (8.5%) harbored additionally a ParC mutation. Assigned to 39 different alleles, the gyrA sequences from these N. lactamica isolates formed an N. lactamica cluster, which also included eight alleles from N. meningitidis. CONCLUSION The N. lactamica isolates in China showed distinct characteristics with lower genetic diversity and a much higher prevalence of quinolone resistance than in other countries.
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Affiliation(s)
- Yinfang Shen
- Department of Pediatrics, Jinshan Hospital, Fudan University, Shanghai, China
| | - Mingliang Chen
- Department of Microbiology, Shanghai Municipal Center for Disease Control and Prevention, 1380 West ZhongShan Road, Shanghai, 200336, China; Department of Microbiology, Shanghai Institutes of Preventive Medicine, Shanghai, China.
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Diallo K, MacLennan J, Harrison OB, Msefula C, Sow SO, Daugla DM, Johnson E, Trotter C, MacLennan CA, Parkhill J, Borrow R, Greenwood BM, Maiden MCJ. Genomic characterization of novel Neisseria species. Sci Rep 2019; 9:13742. [PMID: 31551478 PMCID: PMC6760525 DOI: 10.1038/s41598-019-50203-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Accepted: 09/04/2019] [Indexed: 12/11/2022] Open
Abstract
Of the ten human-restricted Neisseria species two, Neisseria meningitidis, and Neisseria gonorrhoeae, cause invasive disease: the other eight are carried asymptomatically in the pharynx, possibly modulating meningococcal and gonococcal infections. Consequently, characterizing their diversity is important for understanding the microbiome in health and disease. Whole genome sequences from 181 Neisseria isolates were examined, including those of three well-defined species (N. meningitidis; N. gonorrhoeae; and Neisseria polysaccharea) and genomes of isolates unassigned to any species (Nspp). Sequence analysis of ribosomal genes, and a set of core (cgMLST) genes were used to infer phylogenetic relationships. Average Nucleotide Identity (ANI) and phenotypic data were used to define species clusters, and morphological and metabolic differences among them. Phylogenetic analyses identified two polyphyletic clusters (N. polysaccharea and Nspp.), while, cgMLST data grouped Nspp isolates into nine clusters and identified at least three N. polysaccharea clusters. ANI results classified Nspp into seven putative species, and also indicated at least three putative N. polysaccharea species. Electron microscopy identified morphological differences among these species. This genomic approach provided a consistent methodology for species characterization using distinct phylogenetic clusters. Seven putative novel Neisseria species were identified, confirming the importance of genomic studies in the characterization of the genus Neisseria.
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Affiliation(s)
- Kanny Diallo
- Centre pour les Vaccins en Développement, Bamako, Mali. .,Department of Zoology, University of Oxford, Oxford, UK.
| | | | | | - Chisomo Msefula
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, College of Medicine, University of Malawi, Blantyre, Malawi
| | - Samba O Sow
- Centre pour les Vaccins en Développement, Bamako, Mali
| | | | - Errin Johnson
- Electron Microscopy Facility, Sir William Dunn School of Pathology, University of Oxford, Oxford, UK
| | - Caroline Trotter
- Department of Veterinary Medicine, University of Cambridge, Cambridge, UK
| | - Calman A MacLennan
- Jenner Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | | | - Ray Borrow
- Vaccine Evaluation Unit, Public Health England, Manchester, UK
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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 2018; 24:143-154. [PMID: 30461138 PMCID: PMC7380001 DOI: 10.1111/tmi.13185] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [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)
| | - Abraham Aseffa
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | | | - Kanny Diallo
- Department of Bacteriology, Noguchi Memorial Research Institute, University of Legon, Accra, Legon
| | | | | | - James M Stuart
- London School of Hygiene & Tropical Medicine, London, UK
| | - Caroline L Trotter
- Department of Veterinary Medicine, University of Cambridge, Cambridge, UK
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Moura ARSS, Kretz CB, Ferreira ÍE, Nunes AMPB, de Filippis I, de Moraes JC, Reis MG, McBride AJA, Wang X, Campos LC. Epidemiology and molecular characterization of Neisseria lactamica carried in 11-19 years old students in Salvador, Brazil. Int J Med Microbiol 2018; 308:454-458. [PMID: 29605532 DOI: 10.1016/j.ijmm.2018.03.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Revised: 02/20/2018] [Accepted: 03/21/2018] [Indexed: 11/29/2022] Open
Abstract
Neisseria lactamica is a nonpathogenic commensal bacterium that is potentially associated with the development of natural immunity against N. meningitidis. However, the genetic variation present in natural populations of N. lactamica has not been fully investigated. To better understand its epidemiology and genetic variation, we studied N. lactamica carriage in 1200 students aged 11-19 years old in Salvador, Brazil. The carriage prevalence was 4.5% (54/1200), with no statistical difference among sex and age, although we observed a trend towards higher carriage prevalence among 11-year-old individuals. Whole genome sequence analysis revealed a high genetic diversity among the isolates, with the presence of 32 different STs, 28 (87.5%) of which were new. A total of 21/50 (42%) isolates belonged to three different clonal complexes. While none of the isolates contained nadA or fHpb alleles, we detected 21 FetA variants, 20 NhbA variants and two variants of PorB. The data provide detailed information on circulating N. lactamica isolates in adolescents in Brazil and are complementary to studies in other countries.
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Affiliation(s)
- Ana Rafaela Silva Simões Moura
- Laboratório de Patologia e Biologia Molecular, Instituto Gonçalo Moniz, FIOCRUZ-BAHIA, Rua Waldemar Falcão 121, 40296-710, Salvador BA, Brazil
| | - Cécilia Batmalle Kretz
- Meningitis and Vaccine Preventable Diseases Branch, Division of Bacterial Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta GA 30333, USA
| | - Ítalo Eustáquio Ferreira
- Laboratório de Patologia e Biologia Molecular, Instituto Gonçalo Moniz, FIOCRUZ-BAHIA, Rua Waldemar Falcão 121, 40296-710, Salvador BA, Brazil
| | - Amélia Maria Pithon Borges Nunes
- Laboratório de Patologia e Biologia Molecular, Instituto Gonçalo Moniz, FIOCRUZ-BAHIA, Rua Waldemar Falcão 121, 40296-710, Salvador BA, Brazil
| | - Ivano de Filippis
- Instituto Nacional de Controle de Qualidade em Saúde - INCQS, FIOCRUZ, 21040-900, Rio de Janeiro RJ, Brazil
| | - José Cássio de Moraes
- Faculdade de Ciências Médicas da Santa Casa de São Paulo, 01220200, São Paulo SP, Brazil
| | - Mitermayer Galvão Reis
- Laboratório de Patologia e Biologia Molecular, Instituto Gonçalo Moniz, FIOCRUZ-BAHIA, Rua Waldemar Falcão 121, 40296-710, Salvador BA, Brazil
| | - Alan John Alexander McBride
- Laboratório de Patologia e Biologia Molecular, Instituto Gonçalo Moniz, FIOCRUZ-BAHIA, Rua Waldemar Falcão 121, 40296-710, Salvador BA, Brazil; Núcleo de Biotecnologia, Centro de Desenvolvimento Tecnológico, Universidade Federal de Pelotas, Campus Universitário s/n, 96160-000, Pelotas RS, Brazil
| | - Xin Wang
- Meningitis and Vaccine Preventable Diseases Branch, Division of Bacterial Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta GA 30333, USA
| | - Leila Carvalho Campos
- Laboratório de Patologia e Biologia Molecular, Instituto Gonçalo Moniz, FIOCRUZ-BAHIA, Rua Waldemar Falcão 121, 40296-710, Salvador BA, Brazil.
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Household transmission of Neisseria meningitidis in the African meningitis belt: a longitudinal cohort study. LANCET GLOBAL HEALTH 2018; 4:e989-e995. [PMID: 27855873 DOI: 10.1016/s2214-109x(16)30244-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Revised: 07/28/2016] [Accepted: 09/23/2016] [Indexed: 01/25/2023]
Abstract
BACKGROUND Information on transmission of meningococcal infection in the African meningitis belt is scarce. We aimed to describe transmission patterns of Neisseria meningitidis (meningococcus) in households in the African meningitis belt. METHODS Cross-sectional carriage surveys were done in seven African meningitis belt countries (Chad, Ethiopia, Ghana, Mali, Niger, Nigeria, and Senegal) between Aug 1, 2010, and Oct 15, 2012. Meningococcal carriers identified in these surveys and all available people in their households were recruited into this longitudinal cohort study. We took pharyngeal swabs at first visit and took further swabs twice a month for 2 months and then monthly for a further 4 months. We used conventional bacteriological and molecular techniques to identify and characterise meningococci. We estimated the rates of carriage acquisition and recovery using a multi-state Markov model. FINDINGS Meningococci were isolated from 241 (25%) of 980 members of 133 households in which a carrier had been identified in the cross-sectional survey or at the first household visit. Carriage was detected subsequently in another household member who was not an index carrier in 75 households. Transmission within a household, suggested by detection of a further carrier with the same strain as the index carrier, was found in 52 of these 75 households. Children younger than 5 years were the group that most frequently acquired carriage from other household members. The overall individual acquisition rate was 2·4% (95% CI 1·6-4·0) per month, varying by age and household carriage status. The mean duration of carriage was 3·4 months (95% CI 2·7-4·4). INTERPRETATION In the African meningitis belt, transmission of meningococci within households is important, particularly for young children, and periods of carriage are usually of short duration. FUNDING Bill & Melinda Gates Foundation, Wellcome Trust.
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Wang C, Luo J, Wang H, Amer S, Ding H, Dong Y, He H. Isolation and characterization of a Neisseria sp. from the captive wild goose (Anser anser). Integr Zool 2016; 11:128-33. [PMID: 26767581 DOI: 10.1111/1749-4877.12181] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The present study investigated 15 dead cases of captive wild goslings (Anser anser), which were bred in a small poultry farm in Shandong Province, China. The examined cases presented diverse clinical signs accompanied with neurological manifestations and fatal outcomes. Bacterial culture identified the gram-negative Neisseria sp. from the brain homogenate of most examined cases (10/15, 66.7%). The isolated bacteria were identified based on morphologic characteristics, biochemical tests and 16S rDNA typing. Results proved that 1 identical bacterial strain (BNO09-3) was isolated from the positive cases. The phylogeny based on the 16S rDNA gene sequences indicated that this isolate has a close relationship with various strains of genus Neisseria sp. isolated from liver and feces of duck. This is the first report of Neisseria sp. causing fatality in captive wild geese in China.
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Affiliation(s)
- Chengmin Wang
- National Research Center For Wildlife Born Diseases, Key Laboratory of Animal Ecology and Conservation Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing, China
| | - Jing Luo
- National Research Center For Wildlife Born Diseases, Key Laboratory of Animal Ecology and Conservation Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing, China
| | - Haijing Wang
- National Research Center For Wildlife Born Diseases, Key Laboratory of Animal Ecology and Conservation Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing, China
| | - Said Amer
- National Research Center For Wildlife Born Diseases, Key Laboratory of Animal Ecology and Conservation Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing, China.,Department of Zoology, Faculty of Science, Kafr El Sheikh University, Kafr El Sheikh, Egypt
| | - Hua Ding
- Department of Infectious Diseases, Hangzhou Center for Disease Control and Prevention, Hangzhou, China
| | - Ying Dong
- Department of Medical Oncology, the Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Hongxuan He
- National Research Center For Wildlife Born Diseases, Key Laboratory of Animal Ecology and Conservation Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing, China
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14
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Bårnes GK, Kristiansen PA, Beyene D, Workalemahu B, Fissiha P, Merdekios B, Bohlin J, Préziosi MP, Aseffa A, Caugant DA. Prevalence and epidemiology of meningococcal carriage in Southern Ethiopia prior to implementation of MenAfriVac, a conjugate vaccine. BMC Infect Dis 2016; 16:639. [PMID: 27814682 PMCID: PMC5097444 DOI: 10.1186/s12879-016-1975-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Accepted: 10/26/2016] [Indexed: 01/07/2023] Open
Abstract
Background Neisseria meningitidis colonizes humans and transmits mainly by asymptomatic carriage. We sought to determine the prevalence and epidemiology of meningococcal carriage in Ethiopia prior to the introduction of MenAfriVac, a serogroup A meningococcal conjugate vaccine. Methods A cross-sectional meningococcal carriage study was conducted in Arba Minch, southern Ethiopia. A total of 7479 oropharyngeal samples were collected from 1 to 29 year old volunteers, between March and October, 2014. The swabs were cultured for N. meningitidis and Neisseria lactamica in Ethiopia. N. meningitidis isolates were confirmed and characterized by their serogroup, sequence type (ST) and PorA:FetA profile in Norway. Results Overall carriage prevalence was 6.6 %. There was no significant difference in overall carriage between male (6.7 %) and female (6.4 %) participants. Highest carriage prevalence (10.9 %) for females was found in the 15–19 years of age, while prevalence among males was highest (11.3 %) in the 20–24 age group. Non-groupable isolates dominated (76.4 %), followed by serogroups X (14.0 %) and W (5.9 %) isolates. No serogroup A was found. Most non-groupable isolates were ST-192. Serogroup W isolates were assigned to the ST-11 clonal complex, and serogroup X isolates to the ST-181 and ST-41/44 clonal complexes. Overall carriage prevalence of N. lactamica was 28.1 %. Carriage of N. meningitidis and N. lactamica varied depending on age and geographic area, but there was no association between carriage of the two species. Conclusions Epidemic strains of serogroups W and X were circulating in this area of Ethiopia. As no serogroup A was found among the carriage isolates the immediate impact of mass-vaccination with MenAfriVac on transmission of N. meningitidis in this population is expected to be marginal.
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Affiliation(s)
- Guro K Bårnes
- WHO Collaborating Center for Reference and Research on Meningococci, Norwegian Institute of Public Health, Oslo, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Paul A Kristiansen
- WHO Collaborating Center for Reference and Research on Meningococci, Norwegian Institute of Public Health, Oslo, Norway
| | | | | | | | - Behailu Merdekios
- College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Jon Bohlin
- Department of Methodology Research and Analysis, Norwegian Institute of Public Health, Oslo, Norway
| | | | - Abraham Aseffa
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Dominique A Caugant
- WHO Collaborating Center for Reference and Research on Meningococci, Norwegian Institute of Public Health, Oslo, Norway. .,Faculty of Medicine, University of Oslo, Oslo, Norway.
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15
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Diallo K, Trotter C, Timbine Y, Tamboura B, Sow SO, Issaka B, Dano ID, Collard JM, Dieng M, Diallo A, Mihret A, Ali OA, Aseffa A, Quaye SL, Bugri A, Osei I, Gamougam K, Mbainadji L, Daugla DM, Gadzama G, Sambo ZB, Omotara BA, Bennett JS, Rebbetts LS, Watkins ER, Nascimento M, Woukeu A, Manigart O, Borrow R, Stuart JM, Greenwood BM, Maiden MCJ. Pharyngeal carriage of Neisseria species in the African meningitis belt. J Infect 2016; 72:667-677. [PMID: 27018131 PMCID: PMC4879866 DOI: 10.1016/j.jinf.2016.03.010] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Revised: 03/14/2016] [Accepted: 03/16/2016] [Indexed: 12/29/2022]
Abstract
Objectives Neisseria meningitidis, together with the non-pathogenic Neisseria species (NPNs), are members of the complex microbiota of the human pharynx. This paper investigates the influence of NPNs on the epidemiology of meningococcal infection. Methods Neisseria isolates were collected during 18 surveys conducted in six countries in the African meningitis belt between 2010 and 2012 and characterized at the rplF locus to determine species and at the variable region of the fetA antigen gene. Prevalence and risk factors for carriage were analyzed. Results A total of 4694 isolates of Neisseria were obtained from 46,034 pharyngeal swabs, a carriage prevalence of 10.2% (95% CI, 9.8–10.5). Five Neisseria species were identified, the most prevalent NPN being Neisseria lactamica. Six hundred and thirty-six combinations of rplF/fetA_VR alleles were identified, each defined as a Neisseria strain type. There was an inverse relationship between carriage of N. meningitidis and of NPNs by age group, gender and season, whereas carriage of both N. meningitidis and NPNs was negatively associated with a recent history of meningococcal vaccination. Conclusion Variations in the prevalence of NPNs by time, place and genetic type may contribute to the particular epidemiology of meningococcal disease in the African meningitis belt. A prevalence of 10.2% of Neisseria infection was observed during the study. Five Neisseria species were identified in nasopharyngeal samples. High level of genetic diversity was observed in carried isolates. Inverse relationship between carriage of Neisseria meningitidis and non-pathogenic Neisseria.
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Affiliation(s)
- Kanny Diallo
- Centre pour les Vaccins en Développement, Bamako, Mali; Department of Zoology, University of Oxford, Oxford, UK.
| | - Caroline Trotter
- Department of Veterinary Medicine, University of Cambridge, Cambridge, UK
| | | | | | - Samba O Sow
- Centre pour les Vaccins en Développement, Bamako, Mali
| | - Bassira Issaka
- Centre de Recherche Médicale et Sanitaire, Niamey, Niger
| | - Ibrahim D Dano
- Centre de Recherche Médicale et Sanitaire, Niamey, Niger
| | | | - Marietou Dieng
- Institut de Recherche pour le Développement, Dakar, Senegal
| | | | - Adane Mihret
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Oumer A Ali
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Abraham Aseffa
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | | | | | - Isaac Osei
- Navrongo Health Research Centre, Navrongo, Ghana
| | | | | | | | | | | | | | | | | | | | | | - Arouna Woukeu
- London School of Hygiene & Tropical Medicine, London, UK
| | | | - Ray Borrow
- Vaccine Evaluation Unit, Public Health England, Manchester, UK
| | - James M Stuart
- London School of Hygiene & Tropical Medicine, London, UK
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16
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Wörmann ME, Horien CL, Johnson E, Liu G, Aho E, Tang CM, Exley RM. Neisseria cinerea isolates can adhere to human epithelial cells by type IV pilus-independent mechanisms. MICROBIOLOGY-SGM 2016; 162:487-502. [PMID: 26813911 DOI: 10.1099/mic.0.000248] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
In pathogenic Neisseria species the type IV pili (Tfp) are of primary importance in host-pathogen interactions. Tfp mediate initial bacterial attachment to cell surfaces and formation of microcolonies via pilus-pilus interactions. Based on genome analysis, many non-pathogenic Neisseria species are predicted to express Tfp, but aside from studies on Neisseria elongata, relatively little is known about the formation and function of pili in these organisms. Here, we have analysed pilin expression and the role of Tfp in Neisseria cinerea. This non-pathogenic species shares a close taxonomic relationship to the pathogen Neisseria meningitidis and also colonizes the human oropharyngeal cavity. Through analysis of non-pathogenic Neisseria genomes we identified two genes with homology to pilE, which encodes the major pilin of N. meningitidis. We show which of the two genes is required for Tfp expression in N. cinerea and that Tfp in this species are required for DNA competence, similar to other Neisseria. However, in contrast to the meningococcus, deletion of the pilin gene did not impact the association of N. cinerea to human epithelial cells, demonstrating that N. cinerea isolates can adhere to human epithelial cells by Tfp-independent mechanisms.
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Affiliation(s)
- Mirka E Wörmann
- Sir William Dunn School of Pathology, University of Oxford, Oxford OX1 3RE, UK
| | - Corey L Horien
- Sir William Dunn School of Pathology, University of Oxford, Oxford OX1 3RE, UK
| | - Errin Johnson
- Sir William Dunn School of Pathology, University of Oxford, Oxford OX1 3RE, UK
| | - Guangyu Liu
- Sir William Dunn School of Pathology, University of Oxford, Oxford OX1 3RE, UK
| | - Ellen Aho
- Department of Biology, Concordia College, Moorhead, MN, USA
| | - Christoph M Tang
- Sir William Dunn School of Pathology, University of Oxford, Oxford OX1 3RE, UK
| | - Rachel M Exley
- Sir William Dunn School of Pathology, University of Oxford, Oxford OX1 3RE, UK
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17
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Karch A, Vogel U, Claus H. Role of penA polymorphisms for penicillin susceptibility in Neisseria lactamica and Neisseria meningitidis. Int J Med Microbiol 2015; 305:729-35. [DOI: 10.1016/j.ijmm.2015.08.025] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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18
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Shen H, Zhu B, Wang S, Mo H, Wang J, Li J, Zhang C, Zeng H, Guan L, Shi W, Zhang Y, Ma X. Association of targeted multiplex PCR with resequencing microarray for the detection of multiple respiratory pathogens. Front Microbiol 2015; 6:532. [PMID: 26074910 PMCID: PMC4446546 DOI: 10.3389/fmicb.2015.00532] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Accepted: 05/14/2015] [Indexed: 11/24/2022] Open
Abstract
A large number of viral and bacterial organisms are responsible for community-acquired pneumonia (CAP) which contributes to substantial burden on health management. A new resequencing microarray (RPM-IVDC1) associated with targeted multiplex PCR was recently developed and validated for multiple respiratory viruses detection and discrimination. In this study, we evaluated the capability of RPM-IVDC1 for simultaneous identification of multiple viral and bacterial organisms. The nasopharyngeal aspirates (NPAs) of 110 consecutive CAP patients, aged from 1 month to 96 years old, were collected from five distinct general hospitals in Beijing during 1-year period. The samples were subjected to the RPM-IVDC1 established protocol as compared to a real-time PCR (qRT-PCR), which was used as standard. The results of virus detection were consistent with those previously described. A total of 37 of Streptococcus pneumoniae, 14 of Haemophilus influenzae, 10 of Mycoplasma pneumoniae, two of Klebsiella pneumoniae and one of Moraxella catarrhalis were detected by RPM-IVDC1. The sensitivities and specificities were compared with those of qRT-PCR for S. pneumoniae (100, 100%, respectively), H. influenzae (92.3, 97.9%, respectively), M. pneumoniae (69.2, 99.0%, respectively), K. pneumoniae (100, 100%, respectively), and M. catarrhalis (100, 100%, respectively). Additional 22 of Streptococcus spp., 24 of Haemophilus spp. and 16 of Neisseria spp. were identified. In addition, methicillin-resistant and carbapenemases allele were also found in nine of Staphylococcus spp. and one of K. pneumoniae, respectively. These results demonstrated the capability of RPM-IVDC1 for simultaneous detection of broad-spectrum respiratory pathogens in complex backgrounds and the advantage of accessing to the actual sequences, showing great potential use of epidemic outbreak investigation. The detection results should be carefully interpreted when introducing this technique in the clinical diagnostics.
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Affiliation(s)
- Hongwei Shen
- Key Laboratory of Medical Virology, Ministry of Health, Chinese Center for Disease Control and Prevention, National Institute for Viral Disease Control and Prevention Beijing, China ; Futian District Center for Disease Control and Prevention Shenzhen, China
| | - Bingqing Zhu
- State Key Laboratory for Infectious Disease Prevention and Control, Chinese Center for Disease Control and Prevention, National Institute for Communicable Disease Control and Prevention Beijing, China
| | - Shulian Wang
- Third Hospital of Beijing Armed Police Corps Laboratory Beijing, China
| | - Haolian Mo
- Futian District Center for Disease Control and Prevention Shenzhen, China
| | - Ji Wang
- Key Laboratory of Medical Virology, Ministry of Health, Chinese Center for Disease Control and Prevention, National Institute for Viral Disease Control and Prevention Beijing, China
| | - Jin Li
- Key Laboratory of Medical Virology, Ministry of Health, Chinese Center for Disease Control and Prevention, National Institute for Viral Disease Control and Prevention Beijing, China
| | - Chen Zhang
- Key Laboratory of Medical Virology, Ministry of Health, Chinese Center for Disease Control and Prevention, National Institute for Viral Disease Control and Prevention Beijing, China
| | - Huashu Zeng
- Futian District Center for Disease Control and Prevention Shenzhen, China
| | - Li Guan
- Key Laboratory of Medical Virology, Ministry of Health, Chinese Center for Disease Control and Prevention, National Institute for Viral Disease Control and Prevention Beijing, China
| | - Weixian Shi
- Beijing Center for Disease Control and Prevention, Institute for Infectious Disease and Endemic Disease Control Beijing, China
| | - Yong Zhang
- Futian District Center for Disease Control and Prevention Shenzhen, China
| | - Xuejun Ma
- Key Laboratory of Medical Virology, Ministry of Health, Chinese Center for Disease Control and Prevention, National Institute for Viral Disease Control and Prevention Beijing, China
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19
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Yadav S, Manglani MV, Narayan DA, Sharma S, Ravish HS, Arora R, Castells VB, Arya S, Oster P. Safety and immunogenicity of a quadrivalent meningococcal conjugate vaccine (MenACYW-DT): a multicenter, open-label, non-randomized, phase III clinical trial. Indian Pediatr 2015; 51:451-6. [PMID: 24986280 DOI: 10.1007/s13312-014-0435-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To assess the safety and immunogenicity of a quadrivalent meningococcal (groups A,C,Y,W) polysaccharide diphtheria toxoid conjugate vaccine (MenACYW-DT) in India. DESIGN Open-label, descriptive, non-randomized study. SETTING Three medical college hospitals, one each in New Delhi, Bengaluru and Mumbai, India. PARTICIPANTS 300 healthy, vaccine-naïve participants (100 children aged 2-11 years, 100 adolescents aged 12-17 years, and 100 adults aged 18-55 years). INTERVENTION One dose (0.5 mL) of MenACYW-DT administered intramuscularly. MAIN OUTCOME MEASURES Serum bactericidal antibody titers against A, C, Y, and W were measured before and after MenACWY-DT vaccination. Safety data were also collected. RESULTS Thirty days post-vaccination, geometric mean titers rose across all serogroups. Most participants had protective titers >8 (1/dil) across the four serogroups. The percentage (95% CI) achieving >8 (1/dil) in the Adolescent Group was typical - A: 96.9% (91.2%; 99.4%); C: 96.9% (91.2%; 99.4%); Y:100% (96.3%; 100%); W:100% (96.3%; 100%). In general, solicited reactions were mild and short-lived. Unsolicited events were uncommon and unrelated to vaccination. CONCLUSIONS MenACYW-DT was well tolerated and elicited a robust and protective immune response 30 days post-vaccination against meningococcal serogroups A, C, Y, and W-135 in the Indian study participants aged 2-55 years.
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Affiliation(s)
- Sangeeta Yadav
- Departments of Pediatrics, Maulana Azad Medical College and Lok Nayak Hospital, New Delhi, India; #Lokmanya Tilak Municipal Medical College and General Hospital; Mumbai, India; Community Medicine, Kempegowda Institute of Medical Sciences (KIMS), Bangalore, India; Sanofi Pasteur India Pvt Ltd, Mumbai, India; and Sanofi Pasteur, Lyon, France. Correspondence to: Dr Rohit Arora, Sanofi Pasteur India Pvt Ltd, 54/A, Sir Mathuradas Vasanji Road, Andheri East, Mumbai 400 093, India.
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20
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Kristiansen PA, Ba AK, Ouédraogo AS, Sanou I, Ouédraogo R, Sangaré L, Diomandé F, Kandolo D, Saga IM, Misegades L, Clark TA, Préziosi MP, Caugant DA. Persistent low carriage of serogroup A Neisseria meningitidis two years after mass vaccination with the meningococcal conjugate vaccine, MenAfriVac. BMC Infect Dis 2014; 14:663. [PMID: 25472422 PMCID: PMC4267149 DOI: 10.1186/s12879-014-0663-4] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Accepted: 11/24/2014] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND The conjugate vaccine against serogroup A Neisseria meningitidis (NmA), MenAfriVac, is currently being introduced throughout the African meningitis belt. In repeated multicentre cross-sectional studies in Burkina Faso we demonstrated a significant effect of vaccination on NmA carriage for one year following mass vaccination in 2010. A new multicentre carriage study was performed in October-November 2012, two years after MenAfriVac mass vaccination. METHODS Oropharyngeal samples were collected and analysed for presence of N. meningitidis (Nm) from a representative selection of 1-29-year-olds in three districts in Burkina Faso using the same procedures as in previous years. Characterization of Nm isolates included serogrouping, multilocus sequence typing, and porA and fetA sequencing. A small sample of invasive isolates collected during the epidemic season of 2012 through the national surveillance system were also analysed. RESULTS From a total of 4964 oropharyngeal samples, overall meningococcal carriage prevalence was 7.86%. NmA prevalence was 0.02% (1 carrier), significantly lower (OR, 0.05, P = 0.005, 95% CI, 0.006-0.403) than pre-vaccination prevalence (0.39%). The single NmA isolate was sequence type (ST)-7, P1.20,9;F3-1, a clone last identified in Burkina Faso in 2003. Nm serogroup W (NmW) dominated with a carriage prevalence of 6.85%, representing 87.2% of the isolates. Of 161 NmW isolates characterized by molecular techniques, 94% belonged to the ST-11 clonal complex and 6% to the ST-175 complex. Nm serogroup X (NmX) was carried by 0.60% of the participants and ST-181 accounted for 97% of the NmX isolates. Carriage prevalence of serogroup Y and non-groupable Nm was 0.20% and 0.18%, respectively. Among the 20 isolates recovered from meningitis cases, NmW dominated (70%), followed by NmX (25%). ST-2859, the only ST with a serogroup A capsule found in Burkina Faso since 2004, was not found with another capsule, neither among carriage nor invasive isolates. CONCLUSIONS The significant reduction of NmA carriage still persisted two years following MenAfriVac vaccination, and no cases of NmA meningitis were recorded. High carriage prevalence of NmW ST-11 was consistent with the many cases of NmW meningitis in the epidemic season of 2012 and the high proportion of NmW ST-11 among the characterized invasive isolates.
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Affiliation(s)
- Paul A Kristiansen
- WHO Collaborating Center for Reference and Research on Meningococci, Norwegian Institute of Public Health, Oslo, Norway.
| | - Absatou Ky Ba
- Laboratoire National de Santé Public, Ouagadougou, Burkina Faso.
| | | | - Idrissa Sanou
- Centre Hospitalier Universitaire Souro Sanou, Bobo-Dioulasso, Burkina Faso.
- Centre Hospitalier Universitaire Yalgado, Ouagadougou, Burkina Faso.
| | - Rasmata Ouédraogo
- Centre Hospitalier Universitaire Pédiatrique Charles de Gaulle, Ouagadougou, Burkina Faso.
| | - Lassana Sangaré
- Centre Hospitalier Universitaire Yalgado, Ouagadougou, Burkina Faso.
| | - Fabien Diomandé
- WHO Inter Country Support Team, Ouagadougou, Burkina Faso.
- Centers for Disease Control and Prevention, Atlanta, USA.
| | - Denis Kandolo
- WHO Inter Country Support Team, Ouagadougou, Burkina Faso.
| | - Inger Marie Saga
- WHO Collaborating Center for Reference and Research on Meningococci, Norwegian Institute of Public Health, Oslo, Norway.
| | - Lara Misegades
- Centers for Disease Control and Prevention, Atlanta, USA.
| | - Thomas A Clark
- Centers for Disease Control and Prevention, Atlanta, USA.
| | - Marie-Pierre Préziosi
- Meningitis Vaccine Project, Ferney, France.
- WHO Initiative for Vaccine Research, Geneva, Switzerland.
| | - Dominique A Caugant
- WHO Collaborating Center for Reference and Research on Meningococci, Norwegian Institute of Public Health, Oslo, Norway.
- Faculty of Medicine, University of Oslo, Oslo, Norway.
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