Meningococcal Carriage in ‘Men Having Sex With Men’ With Pharyngeal Gonorrhoea

Abstract

We assessed the characteristics of Neisseria meningitidis pharyngeal carriage in a cohort of ‘men having sex with men’, including patients with pharyngeal Neisseria gonorrhoeae infection. In the period 2017-2019, among all the oropharyngeal samples tested for gonorrhoea from MSM attending a STI Clinic in Bologna (Italy), we randomly selected 244 N. gonorrhoeae-positive samples and 403 negatives (n=647). Pharyngeal specimens were tested for N. meningitidis presence, by the detection of sodC gene. N. meningitidis-positive samples were further grouped by PCR tests for the major invasive genogroups (i.e., A, B, C, W, and Y). A molecular assay, targeting capsule transporter gene, was used to determine meningococcal capsular status. Overall, 75.8% (491/647) of samples tested positive for sodC gene, indicating a pharyngeal meningococcal carriage. Meningococcal colonisation was significantly more frequent in younger subjects (P=0.009), with no association with HIV infection. Non-groupable meningococci represented most of pharyngeal carriages (about 71%). The commonest N. meningitidis serogroup was B (23.6%), followed by C (2.1%), Y (1.8%) and W (1.1%). Meningococci were often characterized by the genetic potential of capsule production. Interestingly, a negative association between N. meningitidis and N. gonorrhoeae was found: pharyngeal gonorrhoea was significantly more present in patients without meningococcal carriage (P=0.03). Although preliminary, our data added knowledge on the epidemiology of meningococcal carriage in MSM communities at high risk of gonococcal infections, gaining new insights into the interactions/dynamics between N. meningitidis and N. gonorrhoeae.

PriorNeisseria meningitidis(Nm) proctitis does not preventNeisseria gonorrhoeae(Ng) proctitis among men who have sex with men (MSM)

“…Urethral infection with Nm was not found to lower the incidence of subsequent urethral Ng 1. However, a negative association between pharyngeal Nm and pharyngeal Ng has been reported 2. We describe the occurrence of Nm and Ng proctitis in a cohort of men who have sex with men comprising either pre-exposure prophylaxis users or people living with HIV.…”

Continuing genomic evolution of the Neisseria meningitidis cc11.2 urethritis clade, NmUC: a narrative review

“…The asymptomatic nasopharyngeal Nm carriage rate in different populations varies from 5-40 % in an age-dependent manner [11]. Approximately 10 % of adults are asymptomatic nasopharyngeal carriers of Nm in non-epidemic periods [12,13] and this percentage increases in certain populations: 30 % in men who have sex with men (MSM) and 24 % in adolescents [14][15][16][17][18]. Nm can also colonize the rectum [14,19].…”