a VisMederi Srl , Siena , Italy.
b Department of Life Sciences , University of Siena , Siena , Italy.
Expert Rev Anti Infect Ther. 2017 Jul;15(7):689-701. doi: 10.1080/14787210.2017.1333422. Epub 2017 May 29.
Invasive Meningococcal Disease (IMD) represents a potentially life-threatening condition caused by Neisseria meningitidis. The disease is characterized by a case fatality rate of 5-10% whereas serious clinical sequelae can develop in survivors within 12-24 h from the first symptoms. However, IMD infection only occurs rarely, in fact, most of the interactions established between N. meningitidis and the host are harmless, and an estimated 10% of the population asymptomatically carries the bacterium in the nasopharynx. Meningococcal carriage represents a critical condition for IMD onset since it represents the first step for disease transmission. Furthermore, high levels of carriage can promote genetic recombination among different N. meningitidis strains potentially leading to the development of new pathogenic variants. Areas covered: The present review discusses N. meningitidis carriage, factors able to influence meningococcal carriage and disease and the effect of vaccinations on both conditions, with a particular focus on Italy. Expert commentary: Data regarding the effect of different meningococcal vaccines on N. meningitidis carriage are available, whereas further studies are needed to investigate the positive impact of the two recently licensed vaccines 4CMenB and rLP2086 on meningococcal carriage.
侵袭性脑膜炎奈瑟菌病（IMD）是由脑膜炎奈瑟菌引起的一种潜在危及生命的疾病。该疾病的病死率为 5-10%，而幸存者在出现症状后 12-24 小时内可能会出现严重的临床后遗症。然而，IMD 感染很少发生，事实上，脑膜炎奈瑟菌与宿主之间建立的大多数相互作用是无害的，估计有 10%的人群在鼻咽部无症状携带该细菌。脑膜炎奈瑟菌带菌是 IMD 发病的关键条件，因为它是疾病传播的第一步。此外，高带菌水平可促进不同脑膜炎奈瑟菌菌株之间的基因重组，从而可能导致新的致病变异体的产生。涵盖领域：本综述讨论了脑膜炎奈瑟菌带菌、影响脑膜炎奈瑟菌带菌和疾病的因素，以及疫苗对这两种情况的影响，特别关注了意大利的情况。专家评论：有关不同脑膜炎球菌疫苗对脑膜炎奈瑟菌带菌影响的数据是可用的，然而，还需要进一步研究最近批准的两种疫苗 4CMenB 和 rLP2086 对脑膜炎奈瑟菌带菌的积极影响。
