Institute of Diagnostics, Department of Medical Microbiology, University of Oulu, Oulu, Finland.
J Clin Microbiol. 2012 Feb;50(2):264-73. doi: 10.1128/JCM.05385-11. Epub 2011 Nov 30.
The relationship between carriage and the development of invasive meningococcal disease is not fully understood. We investigated the changes in meningococcal carriage in 892 military recruits in Finland during a nonepidemic period (July 2004 to January 2006) and characterized all of the oropharyngeal meningococcal isolates obtained (n = 215) by using phenotypic (serogrouping and serotyping) and genotypic (porA typing and multilocus sequence typing) methods. For comparison, 84 invasive meningococcal disease strains isolated in Finland between January 2004 and February 2006 were also analyzed. The rate of meningococcal carriage was significantly higher at the end of military service than on arrival (18% versus 2.2%; P < 0.001). Seventy-four percent of serogroupable carriage isolates belonged to serogroup B, and 24% belonged to serogroup Y. Most carriage isolates belonged to the carriage-associated ST-60 clonal complex. However, 21.5% belonged to the hyperinvasive ST-41/44 clonal complex. Isolates belonging to the ST-23 clonal complex were cultured more often from oropharyngeal samples taken during the acute phase of respiratory infection than from samples taken at health examinations at the beginning and end of military service (odds ratio [OR], 6.7; 95% confidence interval [95% CI], 2.7 to 16.4). The ST-32 clonal complex was associated with meningococcal disease (OR, 17.8; 95% CI, 3.8 to 81.2), while the ST-60 clonal complex was associated with carriage (OR, 10.7; 95% CI, 3.3 to 35.2). These findings point to the importance of meningococcal vaccination for military recruits and also to the need for an efficacious vaccine against serogroup B isolates.
脑膜炎奈瑟菌传播与侵袭性脑膜炎发病之间的关系尚未完全明确。我们调查了 892 名芬兰新兵在非流行期间（2004 年 7 月至 2006 年 1 月）的脑膜炎奈瑟菌带菌情况，并使用表型（血清型和血清型）和基因型（porA 分型和多位点序列分型）方法对获得的所有咽部分离物（n=215）进行了特征描述。为了进行比较，我们还对芬兰在 2004 年 1 月至 2006 年 2 月期间分离的 84 株侵袭性脑膜炎奈瑟菌进行了分析。与入伍时相比，服役期末的带菌率显著更高（18%比 2.2%；P<0.001）。74%的可定型带菌分离株属于 B 群，24%属于 Y 群。大多数带菌分离株属于与带菌相关的 ST-60 克隆复合体。然而，21.5%属于高度侵袭性的 ST-41/44 克隆复合体。与呼吸道感染急性期相比，在新兵入伍体检时和服役期末采集的咽拭子中，分离到 ST-23 克隆复合体的分离株更为常见（比值比 [OR]，6.7；95%置信区间 [95%CI]，2.7 至 16.4）。ST-32 克隆复合体与脑膜炎发病相关（OR，17.8；95%CI，3.8 至 81.2），而 ST-60 克隆复合体与带菌相关（OR，10.7；95%CI，3.3 至 35.2）。这些发现表明，对新兵进行脑膜炎球菌疫苗接种非常重要，同时也需要针对 B 群分离株的有效疫苗。
