Abstract
We assessed the characteristics of Neisseria meningitidis pharyngeal carriage in a cohort of ‘men having sex with men’, including patients with pharyngeal Neisseria gonorrhoeae infection. In the period 2017-2019, among all the oropharyngeal samples tested for gonorrhoea from MSM attending a STI Clinic in Bologna (Italy), we randomly selected 244 N. gonorrhoeae-positive samples and 403 negatives (n=647). Pharyngeal specimens were tested for N. meningitidis presence, by the detection of sodC gene. N. meningitidis-positive samples were further grouped by PCR tests for the major invasive genogroups (i.e., A, B, C, W, and Y). A molecular assay, targeting capsule transporter gene, was used to determine meningococcal capsular status. Overall, 75.8% (491/647) of samples tested positive for sodC gene, indicating a pharyngeal meningococcal carriage. Meningococcal colonisation was significantly more frequent in younger subjects (P=0.009), with no association with HIV infection. Non-groupable meningococci represented most of pharyngeal carriages (about 71%). The commonest N. meningitidis serogroup was B (23.6%), followed by C (2.1%), Y (1.8%) and W (1.1%). Meningococci were often characterized by the genetic potential of capsule production. Interestingly, a negative association between N. meningitidis and N. gonorrhoeae was found: pharyngeal gonorrhoea was significantly more present in patients without meningococcal carriage (P=0.03). Although preliminary, our data added knowledge on the epidemiology of meningococcal carriage in MSM communities at high risk of gonococcal infections, gaining new insights into the interactions/dynamics between N. meningitidis and N. gonorrhoeae.
Highlights
Neisseria meningitidis (NM) and Neisseria gonorrhoeae (GC) are two closely related Gram-negative coccoid bacteria (80-90% genetic homology), expressing different pathogenicity and responsible of different clinical conditions (Tinsley and Nassif, 1996).NM is usually a commensal microorganism, able to colonize the nasopharyngeal niche without affecting the host (Gentile et al, 2021)
No significant difference was observed between the mean age of GC-positive vs negative subjects (32.6 ± 9.3 vs 33.5 ± 10.1 years; P=0.28)
HIVpositive men who have sex with men’ (MSM) were significantly older than HIV-negative ones (38.4 ± 9.7 vs 31.9 ± 9.4; P
Summary
Neisseria meningitidis (NM) and Neisseria gonorrhoeae (GC) are two closely related Gram-negative coccoid bacteria (80-90% genetic homology), expressing different pathogenicity and responsible of different clinical conditions (Tinsley and Nassif, 1996).NM is usually a commensal microorganism, able to colonize the nasopharyngeal niche without affecting the host (Gentile et al, 2021). Neisseria meningitidis (NM) and Neisseria gonorrhoeae (GC) are two closely related Gram-negative coccoid bacteria (80-90% genetic homology), expressing different pathogenicity and responsible of different clinical conditions (Tinsley and Nassif, 1996). NM can invade normally sterile sites (e.g., bloodstream, cerebrospinal fluid), causing an invasive meningococcal disease, characterized by meningitis and/or sepsis (Igidbashian et al, 2020). Disease progress is usually acute and severe, with a high mortality rate (10%-15%) and a significant risk of long-term sequelae (60%) (CDC, 2015). GC is the causative agent of gonorrhoea, one of the most common bacterial sexually transmitted infections (STIs) worldwide, with a significant clinical and public health impact (ECDC, 2020). Gonococcal genital infections (e.g., urethritis and cervicitis) can be associated with serious complications such as pelvic inflammatory disease, infertility, and ectopic pregnancy (Morgan and Decker, 2016)
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