Abstract
BackgroundNeisseria meningitidis (Nm) pharyngeal carriage is a necessary condition for invasive disease. We present the first carriage study in children in Buenos Aires, Argentina, considering 2017 as a transition year. Aims: to assess the rate of Nm carriage, to determine genogroup, clonal complex and outer membrane protein distribution, to determine carriage risk factors by age.MethodsCross-sectional study including children 1–17 yrs, at Ricardo Gutiérrez Children’s Hospital in Buenos Aires 2017. Oro-pharyngeal swabs were taken and cultured within a short time after collection. Genogroup was determined by PCR and clonal complex by MLST. Categorical variables were analyzed.ResultsA total of 1,751 children were included. Group 1: 943 children 1–9 yrs, 38 Nm were isolated; overall carriage 4.0%. Genogroup distribution: B 26.3%, W 5.3%, Y 2.6%, Z 5.3%, other groups 7.9% and capsule null (cnl) 52.6%. Participating in extracurricular activities was the only independent predictor of Nm carriage. Group 2: 808 children 10–17 yrs, 76 Nm were isolated; overall carriage 9.4%. Genogroup distribution: B 19.7%, C 5.3%, W 7.9%, Y 9.2%, Z 5.3%, other groups 7.9% and cnl 44.7%. Independent predictors of carriage: attending pubs/night clubs and passive smoking (adjusted OR: 0.55, 95%CI = 0.32–0.93; p = 0.025).ConclusionsOverall carriage was higher in 10–17 yrs. The isolates presenting the cnl locus were prevalent in both age groups and genogroup B was the second most frequent.
Highlights
Neisseria meningitidis (Nm) is a leading cause of invasive diseases such as meningitis and septicaemia
While humans are the only known reservoir of Nm, meningococci are generally commensal organisms colonizing the nasopharynx, a phenomenon known as carriage, which can be transient or evolve into invasive meningococcal disease (IMD)
Carriage prevalence increases with age, rates ranging from 4.5% in children to 23.7% in adolescents have been reported worldwide; children over 10 years of age, adolescents and young adults are the main reservoirs of Nm and are mostly responsible for transmission [7,8]
Summary
Neisseria meningitidis (Nm) is a leading cause of invasive diseases such as meningitis and septicaemia. Twelve different serogroups have been defined based on chemical composition and immunological specificity of capsular polysaccharides (A, B, C, E, H, I, K, L, W, X, Y, Z); most cases of invasive disease are caused by serogroups A, B, C, W, X and Y. Better understanding of factors influencing carriage is crucial to clarify disease dynamics like occur with conjugate polysaccharide vaccines, that can impact carriage and contribute to population immunity. Neisseria meningitidis (Nm) pharyngeal carriage is a necessary condition for invasive disease. Aims: to assess the rate of Nm carriage, to determine genogroup, clonal complex and outer membrane protein distribution, to determine carriage risk factors by age
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