Carriage of Neisseria meningitidis in newly enlisted young military professionals during the COVID-19 pandemic
Authors:
L. Siráková; I. Hanovcová; J. Smetana
; M. Malíková; R. Chlíbek
Authors place of work:
Katedra epidemiologie, Fakulta vojenského zdravotnictví, Univerzita obrany Hradec Králové
Published in the journal:
Epidemiol. Mikrobiol. Imunol. 71, 2022, č. 4, s. 183-189
Category:
Původní práce
Summary
Aim: Invasive meningococcal disease (IMD) is still a major threat not only to the youngest age group of children but also to adolescents and young adults. Higher rates of meningococcal disease have also been reported in specific at-risk groups, such as secondary and tertiary students and members of the military. Infection occurs after close contact with a clinically ill individual, but most often with an asymptomatic carrier. The aim of our study was to determine the prevalence of carriage of N. meningitidis in young persons newly enlisted in the Army of the Czech Republic (ACR).
Material and methods: During August 2021, persons entering the service in the ACR were asked to participate in the presented study approved by the Ethics Committee. Nasopharyngeal and oropharyngeal swabs were collected from the study participants in August. A questionnaire survey was administered to each of them after signing an informed consent form. The biological samples were cultured on the day of collection and analysed for N. meningitidis. In case of meningococcal detection, the serogroup of N. meningitidis was determined. For most of the study participants, swabs were repeated after 2-3 months, in October and November. Swabs were also collected from additional participants, namely students entering the first year of bachelor and master studies at a military college.
Results: A total of 252 newly recruited young military professionals, 201 males and 51 females, were included in the study. Carriage of N. meningitidis was found in 13 study participants, i.e., 5.2 % of all tested subjects, with a predominance of positive findings in the summer period. All carriers were males while in females, meningococcal carriage was not detected. In carriers, serogroup B was predominant over non-groupable isolates (NG). There was no evidence of carriage of meningococcal groups A, C, W, X, or Y. Meningococcal isolation was significantly more successful from oropharyngeal compared to nasopharyngeal swabs. Only in five of 17 positive findings, meningococci were detected from both the oropharynx and nasopharynx. No isolation was made from the nasopharynx alone.
Conclusion: The lower percentage of meningococcal carriage in young military professionals in the Czech Republic in the study period 2021 as compared to similar reports on military collectives from other countries can be attributed to the current epidemic situation, where the measures taken in connection with the efforts to prevent the spread of COVID-19 resulted in the loss of seasonality of respiratory diseases and also their significantly lower incidence. This correlates with a reduction in carriage in the monitored age category.
Keywords:
carriage – meningococcus – N. meningitidis – invasive meningococcal diseases – military collective
Zdroje
1. Pavelka J, Homola L. Invazivní meningokoková onemocnění. Pediatr praxi, 2017;18:150–154.
2. Chang Q, Tzeng YL, Stephens DS. Meningococcal disease: changes in epidemiology and prevention. Clin Epidemiol, 2012; 4:237–245.
3. Dwilow R, Fanell S. Invasive meningococcal disease in the 21st century- an update for the clinician. Curr Neurol Neurosci Rep, 2015;15:2.
4. Vuocolo S, Balmer P, Gruber WC, et al. Vaccination strategies for the prevention of meningococcal disease. Hum Vaccin Immunother, 2018;14:1203–1215.
5. Křížová P., Musílek M, Okonji Z, et al. Invazivní meningokokové onemocnění v České republice v roce 2020. Zprávy CEM (SZÚ, Praha), 2021;30(2): 51–60.
6. Christensen H, Bowen MM, Hickman M, et al. Meningococcal carriage by age: a systematic review and meta-analysis. Lancet Infect Dis, 2010;10(12):853–861.doi: 10.1016/S1473- 3099(10)70251-6 PMID: 21075057.
7. Caugant DA, Hoiby EA, Magnus P, et al. Asymptomatic carriage of Neisseria meningitidis in a randomly sampled population. J Clin Microbiol, 1994;32(2):323–330 PMID: 8150942.
8. Trotter CL, Gay NJ, Edmunds WJ. The natural history of meningococcal carriage and disease. Epidemiol Infect, 2006;134:556–566. doi: 10.1017/S0950268805005339.
9. Křížová P. Nosičství Neisseria meningitidis. In Křížová P, Rožnovský L. Meningokokové onemocnění. MAXDORF, 2011. ISBN 978-80- 7345-239-1.
10. Edwards EA, Devine LF, Sengbusch GH. Immunological investigations of meningococcal disease. III. Brevity of group C acquisition prior to disease occurrence. Scand J Infect Dis., 1977;9(2):105–110. doi: 10.3109/inf.1977.9.issue-2.09.
11. Havlík J. Infekční onemocnění nervového systému. In: Havlík J et al. Infekční nemoci. Praha: Galén; 2002. ISBN 80-7262-173-4.
12. Habanec T. Hnisavé infekce centrálního nervového systému. In: Bartošová D et al. Dětské infekční nemoci. Praha: Galén; 2003. ISBN 80-7262-206-4.
13. Blackwell CC, Tzanakaki G, Kremastinou J, et al. Factors affecting carriage of Neisseria meningitidis among Greek military recruits. Epidemiol Infect, 1992;108:441–448.
14. Block C, Gdalevich M, Buber R, et al. Factors associated with pharyngeal carriage of Neisseria meningitidis among Israel Defense Force personnel at the end of their compulsory service. Epidemiol. Infect, 1999;122:51–57.
15. Krizova P, Kriz B. Faktory ovlivňující vznik a vývoj invazivního meningokokového onemocnění a vznik nosičství Neisseria meningitidis – výsledky celorepublikové prospektivní dotazníkové studie případů a kontrol. Epidemiol Mikrobiol Imunol, 1999;48:140–152.
16. MacLennan J, Kafatos G, Neal K, et al. Social behavior and meningococcal carriage in British teenagers. Emerg Infect Dis, 2006;12:950–957.
17. Peterson ME, Mile R, Li Y, et al. Meningococcal carriage in high-risk settings: A systematic review. Internat J Infect Dis, 2018;73:109–117. doi: 10.1016/j.ijid.2018.05.022.
18. Tryfinopoulou K, Kesanopoulos K, Xirogianni A, et al. Meningococcal Carriage in Military Recruits and University Students during the pre menB vaccination era in Greece (2014 – 2015). Plos One, 2016;11(12). doi: 10.1371/journal.pone.0167404.
19. Eslami-Nezhad Z, Esmaili M, Saeid Adeli NA, et al. Neisseria meningitidis carrier rate among military recruits in Kerman, southeast of Iran. Arch Iranian Med, 2005;8(4):304–310.
20. Tyski S, Grzybowska W, Dulny G, et al. Phenotypical and genotypical characterization of Neisseria meningitidis carrier strains isolated from Polish recruits i 1998. Eur J Clin Microbial Infect Dis, 2001;20:350–353.
21. Křížová P. Epidemiologické podklady pro očkování proti invazivnímu meningokokovému onemocnění v České republice. XVI. HVD 2021, 30.9.–2.10.2021 Hradec Králové.
22. Kozáková J. Pneumokoková onemocnění-aktuální epidemiologická situace. XVI. HVD 2021, 30.9.–2.10.2021 Hradec Králové.
23. Brueggemann AB, Jansen van Rensburg MJ, Shaw D, et al. Changes in the incidence of invasive disease due to Streptococcus pneumoniae, Haemophilus influenzae, and Neisseria meningitidis during the COVID-19 pandemic in 26 countries and territories in the Invasive Respiratory Infection Surveillance Initiative: a prospective analysis of surveillance data. Lancet Digit Health, 2021;3(6):e360–e370. doi: 10.1016/S2589- 7500(21)00077-7.
24. Křížová P, Musílek M, Okonji Z, et al. Invazivní meningokokové onemocnění v České republice v roce 2021. Zprávy CEM (SZÚ, Praha), 2022;31(4):145–151.
25. Kriz P, Kriz B, Svandova E, et al. Antimeningococcal herd immunity in the Czech Republic – influence of an emerging clone, Neisseria meningitidis ET-15/37. Epidemiol. Infect, 1999;123:193– 200.
26. Maiden MC, Ibarz-Pavón AB, Urwin R, et al. Impact of meningococcal serogroup C conjugate vaccines on carriage and herd immunity. J Infect Dis, 2008;197(5):737–743.
27. Ibarz-Pavón AB, Maclennan J, Andrews NJ, et al. Changes in serogroup and genotype prevalence among carried meningococci in the United Kingdom during vaccine implementation. J Infect Dis, 2011;204:1046–1053. doi: 10.1093/infdis/jir466.
28. MacLennan JM, Rodrigues CMC, Bratcher HB, et al. Meningococcal carriage in periods of high and low invasive meningococcal disease incidence in the UK: comparison of UKMenCar1–4 cross-sectional survey results. Lancet Infect Dis, 2021;21(5):677– 687. doi: 10.1016/S1473-3099(20)30842-2.
29. Yazdankhah SP, Kriz P, Tzanakaki G, et al. Distribution of serogroups and genotypes among disease-associated and carried isolates of Neisseria meningitidis from the Czech Republic, Greece, and Norway. J Clin Microbiol, 2004;42(11):5146–5153.
30. Křížová P, Kalmusová J, Musílek M. Studium hypervirulentních komplexů Neisseria meningitidis metodami molekulární biologie a možnosti prevence jejich výskytu v České republice vakcinací. Epidemiol Mikrobiol Imunol, 2009;58(4):188–196.
31. Watle SV, Caugant DA, Tunheim G, et al. Meningococcal carriage in Norwegian teenagers: strain characterisation and assessment of risk factors. Epidemiol Infect, 2020; 148:e80. doi: 10.1017/ S0950268820000734.
32. Gilca R, de Wals P, Nolan SM, et al. A longitudinal epidemiology study of meningococcal carriage in students 13 to 25 years old in Quebec. mSphere, 2018; 3(6):e00427-18. doi: 10.1128/ mSphere.00427-18.
33. Esposito S, Zampiero A, Terranova L, et al. Comparison of posterior pharyngeal wall and nasopharyngeal swabbing as a means of detecting the carriage of Neisseria meningitidis in adolescents. Eur J Clin Microbiol Infect Dis, 2013;32(9):1129–1133.doi: 10.1007/s10096-013-1856-2.
34. Caugant DA, Tzanakaki G, Kriz P. Lessons from meningococcal carriage studies. FEMS Microbiol Rev, 2007;31(1):52–63. doi: 10.1111/j.1574-6976.2006.00052.x.
35. Roberts J, Greenwood B, Stuart J. Sampling methods to detect carriage of Neisseria meningitidis; literature review. J Infect, 2009;58(2):103–107. doi: 10.1016/j.jinf.2008.12.005.
Štítky
Hygiena a epidemiologie Infekční lékařství MikrobiologieČlánek vyšel v časopise
Epidemiologie, mikrobiologie, imunologie
2022 Číslo 4
- Perorální antivirotika jako vysoce efektivní nástroj prevence hospitalizací kvůli COVID-19 − otázky a odpovědi pro praxi
- Stillova choroba: vzácné a závažné systémové onemocnění
- Diagnostický algoritmus při podezření na syndrom periodické horečky
- Jak souvisí postcovidový syndrom s poškozením mozku?
Nejčtenější v tomto čísle
- Nosičství Neisseria meningitidis u nastupujících mladých vojenských profesionálů v období pandemie onemocnění covid-19
- Porovnání vývoje epidemiologické situace vybraných sexuálně přenosných infekcí ve třech krajích České republiky v letech 2006–2013
- Akutní poškození ledvin s nutností eliminační léčby jako důsledek infekce Clostridioides difficile u 15letého chlapce
- Molekulární určení genotypu izolátů Streptococcus agalactiae s netypovatelným sérotypem, Česká republika, 2008–2020