Meningococcal Carriage in Military Recruits and University Students during the Pre MenB Vaccination Era in Greece (2014-2015).

Kyriaki Tryfinopoulou,Athanasia Xirogianni,Georgina Tzanakaki,Vassiliki Papaevangelou,Maria Tsolia,Nektarios Marmaras,Aftab Jasir,Anastasia Papandreou,Konstantinos Kesanopoulos,Caroline L Trotter

doi:10.1371/journal.pone.0167404

Abstract

PurposeThe aim of the study was to estimate the meningococcal carriage rate and to identify the genotypic characteristics of the strains isolated from healthy military recruits and university students in order to provide data that might increase our understanding on the epidemiology of meningococcus and obtain information which helps to evaluate the potential effects on control programs such as vaccination.,MethodsA total of 1420 oropharyngeal single swab samples were collected from military recruits and university students on voluntary basis, aged 18–26 years. New York City Medium was used for culture and the suspected N. meningitidis colonies were identified by Gram stain, oxidase and rapid carbohydrate utilization tests. Further characterisation was carried out by molecular methods (multiplex PCR, MLST, WGS).ResultsThe overall carriage rate was of 12.7%; 15% and 10.4% for recruits and university students respectively. MenB (39.4%) was the most prevalent followed by MenY (12.8%) and MenW (4.4%). Among the initial 76 Non Groupable (NG) isolates, Whole Genome Sequence Analysis (WGS) revealed that 8.3% belonged to MenE, 3.3% to MenX and 1.1% to MenZ, while, 53 strains (29.4%) were finally identified as capsule null. Genetic diversity was found among the MenB isolates, with 41/44 cc and 35 cc predominating.ConclusionMeningococcal carriage rate in both groups was lower compared to our previous studies (25% and 18% respectively) with predominance of MenB isolates. These findings, help to further our understanding on the epidemiology of meningococcal disease in Greece. Although the prevalence of carriage seems to have declined compared to our earlier studies, the predominant MenB clonal complexes (including 41/44cc and 35cc) are associated with invasive meningococcal disease.

Highlights

Invasive Meningococcal disease (IMD) is a life threatening illness with annual incidence varying from 1–1000 per 100 000 in different parts of the world
Among the initial 76 Non Groupable (NG) isolates, Whole Genome Sequence Analysis (WGS) revealed that 8.3% belonged to MenE, 3.3% to MenX and 1.1% to MenZ, while, 53 strains (29.4%) were identified as capsule null
Meningococcal carriage rate in both groups was lower compared to our previous studies (25% and 18% respectively) with predominance of MenB isolates

Summary

Introduction

Invasive Meningococcal disease (IMD) is a life threatening illness with annual incidence varying from 1–1000 per 100 000 in different parts of the world. The human naso-pharynx is a known reservoir for meningococcal asymptomatic carriage. Studies performed in Europe have shown that asymptomatic carriage is an age-dependent phenomenon showing low prevalence in the first years of life, with a sharp increase in teenagers and young adults [3] and associated with factors such as active and passive smoking, concomitant viral or bacterial respiratory infections, low socioeconomic status and crowding conditions. In closed and semi-closed populations, such as military recruits and university students, transmission increases and carriage rates may reach higher percentages [1, 4, 5, 6]

Objectives

Methods

Conclusion