Oxford Vaccine Group, Department of Paediatrics, University of Oxford and the NIHR Oxford Biomedical Research Centre, Oxford, UK.
Oxford Vaccine Group, Department of Paediatrics, University of Oxford and the NIHR Oxford Biomedical Research Centre, Oxford, UK.
J Infect. 2015 Jul;71(1):43-52. doi: 10.1016/j.jinf.2015.02.006. Epub 2015 Feb 21.
Recent development of serogroup B meningococcal (MenB) vaccines highlights the importance of pharyngeal carriage data, particularly in adolescents and young adults, to inform implementation strategies. We describe current UK carriage prevalence in this high risk population and compare methods of carriage detection.
In this multisite study, pharyngeal swabs were collected on 3-4 occasions over 6-12 months, from 1040 school and university students, aged 10-25 years. Meningococcal carriage was detected by standard culture combined with seroagglutination or PCR of cultured isolates, or by direct PCR from swab. The factor H binding protein (fHBP) variants present in meningococcal isolates were determined.
Meningococcal serogroups B and Y were most common, with carriage up to 6.5% and 5.5% respectively, increasing throughout adolescence. Identification by seroagglutination was often unreliable, and the sensitivity of direct PCR detection was 66% compared to culture combined with PCR. Of MenB isolates, 89.1% had subfamily A variants of fHBP. The acquisition rate of MenB carriage was estimated at 2.8 per 1000 person-months.
If vaccination is to precede the adolescent rise in MenB carriage, these data suggest it should take place in early adolescence. Studies assessing vaccine impact should use molecular methods to detect carriage.
B 群脑膜炎奈瑟菌（MenB）疫苗的最新发展凸显了咽拭子携带数据的重要性，尤其是在青少年和年轻成年人中，以便为实施策略提供信息。我们描述了该高风险人群中目前英国的携带流行率，并比较了携带检测方法。
在这项多地点研究中，从 1040 名年龄在 10-25 岁的学校和大学生中，在 6-12 个月内分 3-4 次采集咽拭子。通过标准培养结合血清凝集或培养分离物的 PCR，或直接从拭子中进行 PCR 来检测脑膜炎奈瑟菌携带。确定脑膜炎奈瑟菌分离株中存在的因子 H 结合蛋白（fHBP）变体。
B 群和 Y 群脑膜炎奈瑟菌最为常见，分别占携带率的 6.5%和 5.5%，并在整个青春期逐渐增加。血清凝集鉴定通常不可靠，而直接 PCR 检测的灵敏度与培养结合 PCR 相比为 66%。在 MenB 分离株中，89.1%的 fHBP 具有亚家族 A 变体。MenB 携带的获得率估计为每 1000 人-月 2.8 例。
如果要在 MenB 携带率在青少年中上升之前进行疫苗接种，这些数据表明应在青春期早期进行。评估疫苗效果的研究应使用分子方法来检测携带情况。
