Infection With the US Neisseria meningitidis Urethritis Clade Does Not Lower Future Risk of Urethral Gonorrhea.
Infection With the US Neisseria meningitidis Urethritis Clade Does Not Lower Future Risk of Urethral Gonorrhea.
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感染美国脑膜炎奈瑟菌尿道炎分支不会降低未来尿道淋病的风险。
DOI：
10.1093/cid/ciab824
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发表时间：
2022
期刊：
影响因子：
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通讯作者：
Bazan,JoseA
中科院分区：
文献类型：
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作者：
Turner,AbigailNorris;Carter,AlexandriaM;Tzeng,Yih-Ling;Stephens,DavidS;Brown,MorganA;Snyder,BrandonM;Retchless,AdamC;Wang,Xin;Bazan,JoseA
背景脑膜炎奈瑟菌（Nm）和淋病奈瑟菌（Ng）之间的交叉保护性免疫可能有助于淋球菌疫苗的开发。 B 群脑膜炎球菌 (MenB) 外膜囊泡 (OMV) 疫苗可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。我们检查了美国 Nm 尿道炎分支 (US_NmUC) 感染男性的淋病风险。方法我们在 2015 年 1 月至 2018 年 4 月期间对患有尿道 US_NmUC 的男性 (n = 128) 进行了一项回顾性队列研究。以诊断日期作为基线访视，我们在回访时检查了 Ng 状态，以计算尿道 Ng 风险。我们将这些数据与 3 个参考人群进行了比较：患有尿道 Ng 的男性 (n = 253)、尿道衣原体 (Ct) (n = 251) 和无尿道 Ng 或 Ct 的男性 (n = 255)。我们进行了敏感性分析，以评估各种审查方法、缺失数据和感染的解剖部位。我们还比较了基于 OMV 的 MenB-4C 疫苗、US_NmUC 和 Ng 中的蛋白质抗原序列。结果参与者主要是黑人 (65%) 和异性恋 (82%)。经过随访，91 名男性患上了尿道 Ng。患有尿道 US_NmUC 的男性与既往患有尿道 Ng 的男性具有相似的 Ng 风险（调整后的风险比 [aHR]：1.27；95% CI：0.65–2.48）。与有尿道 Ct 的男性相比，有尿道 US_NmUC 的男性 Ng 风险无显着增加（aHR：1.51；95% CI：0.79–2.88），与没有尿道 Ng 或 Ct 的男性相比，Ng 风险显着增加（aHR：3.55；95% CI：1.27–9.91）。大多数分析的蛋白质抗原具有高度的序列相似性。结论尽管共享蛋白质抗原具有显着的序列相似性，但尿道US_NmUC感染并不能预防淋病。
BackgroundCross-protective immunity betweenNeisseria meningitidis(Nm) andNeisseria 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.MethodsWe 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.ResultsParticipants 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.ConclusionsUrethral US_NmUC infection did not protect against gonorrhea despite substantial sequence similarities in shared protein antigens.