Division of Infectious Diseases, Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, Ohio, USA.
Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.
Clin Infect Dis. 2022 Jul 6;74(12):2159-2165. doi: 10.1093/cid/ciab824.
Cross-protective immunity between Neisseria meningitidis (Nm) and Neisseria gonorrhoeae (Ng) may inform gonococcal vaccine development. Meningococcal serogroup B (MenB) outer membrane vesicle (OMV) vaccines confer modest protection against gonorrhea. However, whether urethral Nm infection protects against gonorrhea is unknown. We examined gonorrhea risk among men with US Nm urethritis clade (US_NmUC) infections.
We conducted a retrospective cohort study of men with urethral US_NmUC (n = 128) between January 2015 and April 2018. Using diagnosis date as the baseline visit, we examined Ng status at return visits to compute urethral Ng risk. We compared these data to 3 referent populations: men with urethral Ng (n = 253), urethral chlamydia (Ct) (n = 251), and no urethral Ng or Ct (n = 255). We conducted sensitivity analyses to assess varied approaches to censoring, missing data, and anatomical site of infection. We also compared sequences of protein antigens in the OMV-based MenB-4C vaccine, US_NmUC, and Ng.
Participants were primarily Black (65%) and heterosexual (82%). Over follow-up, 91 men acquired urethral Ng. Men with urethral US_NmUC had similar Ng risk to men with prior urethral Ng (adjusted hazard ratio [aHR]: 1.27; 95% CI: .65-2.48). Men with urethral US_NmUC had nonsignificantly increased Ng risk compared with men with urethral Ct (aHR: 1.51; 95% CI: .79-2.88), and significantly increased Ng risk compared with men without urethral Ng or Ct (aHR: 3.55; 95% CI: 1.27-9.91). Most of the protein antigens analyzed shared high sequence similarity.
Urethral US_NmUC infection did not protect against gonorrhea despite substantial sequence similarities in shared protein antigens.
脑膜炎奈瑟菌（Nm）和淋病奈瑟菌（Ng）之间的交叉保护免疫可能为淋病疫苗的开发提供信息。脑膜炎 B 群（MenB）外膜囊泡（OMV）疫苗对淋病提供适度的保护。然而，尿道 Nm 感染是否能预防淋病尚不清楚。我们研究了美国奈瑟菌尿道型（US_NmUC）感染男性中淋病的风险。
我们对 2015 年 1 月至 2018 年 4 月期间患有尿道 US_NmUC 的男性进行了一项回顾性队列研究（n = 128）。以诊断日期为基线就诊，我们在复诊时检查了 Ng 状态，以计算尿道 Ng 风险。我们将这些数据与 3 个参照人群进行了比较：尿道 Ng 感染男性（n = 253）、尿道沙眼衣原体（Ct）感染男性（n = 251）和无尿道 Ng 或 Ct 感染男性（n = 255）。我们进行了敏感性分析，以评估不同的随访截止、缺失数据和感染解剖部位的方法。我们还比较了 OMV 为基础的 MenB-4C 疫苗、US_NmUC 和 Ng 中的蛋白抗原序列。
参与者主要为黑人（65%）和异性恋者（82%）。随访期间，91 名男性感染了尿道 Ng。与有既往尿道 Ng 感染的男性相比，有尿道 US_NmUC 的男性的 Ng 风险相似（调整后的危险比 [aHR]：1.27；95%置信区间：.65-2.48）。与有尿道 Ct 感染的男性相比，有尿道 US_NmUC 的男性的 Ng 风险无显著增加（aHR：1.51；95%置信区间：.79-2.88），但与无尿道 Ng 或 Ct 感染的男性相比，有尿道 US_NmUC 的男性的 Ng 风险显著增加（aHR：3.55；95%置信区间：1.27-9.91）。分析的大多数蛋白抗原具有高度的序列相似性。
尽管尿道 US_NmUC 感染和共享蛋白抗原具有高度的序列相似性，但它并没有预防淋病。
