a Pediatric Highly Intensive Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano , Milano , Italy.
b Pediatric Clinic, Department of Surgical and Biomedical Sciences , Università degli Studi di Perugia , Perugia , Italy.
Hum Vaccin Immunother. 2018 May 4;14(5):1070-1074. doi: 10.1080/21645515.2018.1450121. Epub 2018 May 9.
Recently, two vaccines against meningococcal serogroup B (MenB) have been developed. They are prepared according to the reverse vaccinology approach and contain 4 (4CMenB) and 2 (MenB-FHbp) cross-reactive surface proteins. In Italy 4CMenB vaccine has been included in the official vaccination schedule only recently and recommended only for infants and toddlers, whereas MenB-FHbp is not licensed. In order to collect information about the present carriage of Neisseria meningitidis serogroup B (MenB) in Italian adolescents and to evaluate the potential protection offered by the presently available MenB vaccines, 2,560 otherwise healthy, high school students aged 14-21 years (907 males, 35.4%, median age 16.2 years) were enrolled in Milan, Italy. A swab to collect posterior pharynx secretions was collected from each subject and meningococcal identification, serogrouping, multilocus sequence typing analysis, sequence alignments and phylogenetic analysis were performed. A total of 135 (5.3%) adolescents were meningococcal carriers. Strains belonging to serogroup B were the most common (n = 58; 2.3%), followed by MenY (n = 32; 1.2%), MenC (n = 7; 0.3%), MenW (n = 6; 0.3%) and MenX (n = 5; 0.2%). The remaining bacteria were not capsulated. The identified MenB strains belonged to eleven clonal complexes (CCs): ST-162 CC (n = 12; 20.7%), ST-865 CC (n = 12; 20.7%), ST-41/44/Lin.3 CC (n = 11; 19.0%), ST-35 CC (n = 6; 10.3%), ST-32/ET-5 CC (n = 4; 6.9%), ST-269 CC (n = 3; 5.2%), ST-213 CC (n = 2; 3.4%), ST-198 CC (n = 1; 1.7%), ST-461 CC (n = 1; 1.7%), ST-549 CC (n = 1; 1.7%), and ST-750 CC (n = 1; 1.7%). This study showed that MenB was the most commonly carried meningococcal serogroup found in adolescents living in Milan, Italy. The MenB vaccines presently licensed could have theoretically induced the production of antibodies effective against the greatest part of the identified MenB strains (100% in the case of 4CMenB and 95% in case of MenB-FHbp) Monitoring carriage remains essential to evaluate MenB circulation, but further studies are necessary to evaluate the effect on carriage and the final efficacy of both new MenB vaccines.
最近，已经开发出两种针对脑膜炎奈瑟菌 B 群（MenB）的疫苗。它们是根据反向疫苗学方法制备的，包含 4 种（4CMenB）和 2 种（MenB-FHbp）交叉反应表面蛋白。在意大利，4CMenB 疫苗最近才被纳入官方免疫接种计划，仅推荐用于婴儿和幼儿，而 MenB-FHbp 尚未获得许可。为了收集有关意大利青少年中目前脑膜炎奈瑟菌 B 群（MenB）携带情况的信息，并评估目前可用的 MenB 疫苗提供的潜在保护作用，我们从意大利米兰招募了 2560 名 otherwise healthy、年龄在 14-21 岁的高中生（907 名男性，35.4%，中位年龄 16.2 岁）。从每个受试者中采集咽后拭子进行脑膜炎奈瑟菌鉴定、血清群分型、多位点序列分型分析、序列比对和系统发育分析。共有 135 名（5.3%）青少年是脑膜炎奈瑟菌携带者。属于 B 群的菌株最为常见（n = 58；2.3%），其次是 MenY（n = 32；1.2%）、MenC（n = 7；0.3%）、MenW（n = 6；0.3%）和 MenX（n = 5；0.2%）。其余细菌未被囊化。鉴定的 MenB 菌株属于 11 个克隆复合体（CC）：ST-162 CC（n = 12；20.7%）、ST-865 CC（n = 12；20.7%）、ST-41/44/Lin.3 CC（n = 11；19.0%）、ST-35 CC（n = 6；10.3%）、ST-32/ET-5 CC（n = 4；6.9%）、ST-269 CC（n = 3；5.2%）、ST-213 CC（n = 2；3.4%）、ST-198 CC（n = 1；1.7%）、ST-461 CC（n = 1；1.7%）、ST-549 CC（n = 1；1.7%）和 ST-750 CC（n = 1；1.7%）。本研究表明，MenB 是意大利米兰青少年中最常见的脑膜炎奈瑟菌血清群。目前许可的 MenB 疫苗理论上可以诱导产生针对大部分鉴定出的 MenB 菌株有效的抗体（4CMenB 为 100%，MenB-FHbp 为 95%）。监测携带情况仍然是评估 MenB 传播的关键，但需要进一步研究来评估这两种新的 MenB 疫苗对携带情况和最终疗效的影响。
