Knudtson Eric J, Lytle Mike L, Vavricka Beverly A, Skaggs Valerie S, Peck Jennifer D, Elimian Andrew E
Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, The University of Oklahoma Health Sciences Center, PO Box 26901, WP 2470, Oklahoma City, OK 73160, USA.
J Negat Results Biomed. 2010 Aug 11;9:6. doi: 10.1186/1477-5751-9-6.
Neisseria meningitidis is the second leading cause of invasive meningitis. A prerequisite for infection is colonization of the nasopharynx, and asymptomatic carrier rates are widely reported in the range of 10-15%. Recent reports have indicated an increased likelihood that a pediatric admission for Neisseria meningitidis will have a mother who is pregnant in the home. We hypothesized that this association may relate to immunologic changes in pregnancy leading to higher carrier rates.We compared the carrier status by performing nasopharyngeal swabs for Neisseria meningitidis in 100 pregnant and 99 non-pregnant women.Average age of the participants was 28.9 +/- 6.7 years. The average gestational age at specimen collection was 27.5 +/- 9.4 weeks. Non pregnant women were significantly more likely to use tobacco (38% vs 24%, p < 0.0001). In the entire 199 patients, only one pregnant patient tested positive for Neisseria meningitidis (0.5%; 95% CI: 0.01%-2.8%).The meningococcal carrier rate in our population is well below what is widely reported in the literature. Assuming a 1% carrier rate in the pregnant group and a 0.5% carrier rate in the non pregnant group, 4,763 patients would be required to detect a difference of this magnitude, given 80% power and an alpha of 0.05.
脑膜炎奈瑟菌是侵袭性脑膜炎的第二大主要病因。感染的一个先决条件是鼻咽部定植，并且无症状携带率普遍报道在10%-15%的范围内。最近的报告表明，因脑膜炎奈瑟菌而入院的儿童家中有怀孕母亲的可能性增加。我们假设这种关联可能与孕期免疫变化导致更高的携带率有关。我们通过对100名孕妇和99名非孕妇进行脑膜炎奈瑟菌鼻咽拭子检测来比较携带状态。参与者的平均年龄为28.9±6.7岁。采集标本时的平均孕周为27.5±9.4周。非孕妇吸烟的可能性显著更高（38%对24%，p<0.0001）。在全部199名患者中，只有一名孕妇的脑膜炎奈瑟菌检测呈阳性（0.5%；95%置信区间：0.01%-2.8%）。我们人群中的脑膜炎球菌携带率远低于文献中广泛报道的水平。假设孕妇组携带率为1%，非孕妇组携带率为0.5%，在检验效能为80%且α为0.05的情况下，需要4763名患者才能检测到这种程度的差异。
