新型泌尿生殖道嗜神经奈瑟菌的出现。
Emergence of a novel urogenital-tropic Neisseria meningitidis.
机构信息
The Ohio State University College of Medicine.
Sexual Health Clinic, Columbus Public Health, Columbus, Ohio.
出版信息
Curr Opin Infect Dis. 2021 Feb 1;34(1):34-39. doi: 10.1097/QCO.0000000000000697.
PURPOSE OF REVIEW
Neisseria meningitidis (Nm) is primarily associated with asymptomatic nasopharyngeal carriage and invasive meningococcal disease (sepsis and meningitis), but like N. gonorrhoea (Ng), Nm can colonize urogenital and rectal mucosal surfaces and cause disease. First noted in 2015, but with origins in 2011, male urethritis clusters caused by a novel Nm clade were reported in the USA (the US_NmUC). This review describes research developments that characterize this urogenital-tropic Nm.
RECENT FINDINGS
The US_NmUC evolved from encapsulated Nm serogroup C strains. Loss of capsule expression, lipooligosaccharide (LOS) sialylation, genetic acquisition of gonococcal alleles (including the gonococcal anaerobic growth aniA/norB cassette), antimicrobial peptide heteroresistance and high surface expression of a unique factor-H-binding protein, can contribute to the urethra-tropic phenotype. Loss-of-function mutations in mtrC are overrepresented in clade isolates. Similar to Ng, repeat US_NmUC urethritis episodes can occur. The US_NmUC is now circulating in the UK and Southeast Asia. Genomic sequencing has defined the clade and rapid diagnostic tests are being developed for surveillance.
SUMMARY
The US_NmUC emerged as a cause of urethritis due to acquisition of gonococcal genetic determinants and phenotypic traits that facilitate urogenital tract infection. The epidemiology and pathogenesis of this urogenital-tropic pathogen continues to be defined.
目的综述
脑膜炎奈瑟菌（Nm）主要与无症状鼻咽携带和侵袭性脑膜炎球菌病（败血症和脑膜炎）有关，但与淋病奈瑟菌（Ng）一样，Nm 可定植于泌尿生殖道和直肠黏膜表面并引起疾病。首次于 2015 年报道，但起源于 2011 年，美国（美国_NmUC）报道了一种新型 Nm 分支引起的新型男性尿道炎聚集。本文综述描述了表征这种泌尿生殖道趋向性 Nm 的研究进展。
最新发现
美国_NmUC 是从有荚膜 Nm 血清群 C 菌株进化而来的。荚膜表达缺失、脂寡糖（LOS）唾液酸化、淋球菌等位基因（包括淋球菌厌氧生长 aniA/norB 盒）的遗传获得、抗微生物肽异质性耐药性和独特的因子 H 结合蛋白的高表面表达，可能有助于尿道趋向性表型。功能丧失突变 mtrC 在分支分离物中过度表达。类似于 Ng，重复的美国_NmUC 尿道炎发作可能会发生。美国_NmUC 现在正在英国和东南亚传播。基因组测序定义了该分支，正在开发快速诊断检测方法进行监测。
总结
美国_NmUC 作为尿道炎的病因出现，这是由于获得了促进泌尿生殖道感染的淋球菌遗传决定因素和表型特征。这种泌尿生殖道趋向性病原体的流行病学和发病机制仍在定义中。
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