Meningococcal carriage in adolescents in the United Kingdom to inform timing of an adolescent vaccination strategy
Meningococcal carriage in adolescents in the United Kingdom to inform timing of an adolescent vaccination strategy
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DOI：
10.1016/j.jinf.2015.02.006
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发表时间：
2015-07-01
影响因子：
28.2
通讯作者：
Pollard, Andrew J.
中科院分区：
文献类型：
--
作者：
Jeppesen, Catherine A.;Snape, Matthew D.;Pollard, Andrew J.
目的：B群脑膜炎双球菌(MenB)疫苗的最新发展突出了咽部携带数据的重要性，特别是在青少年和年轻人中，以指导实施策略。我们描述了目前英国携带者在这一高危人群中的流行情况，并比较了携带者检测方法。方法：在这项多点研究中，从10-25岁的1040名中小学生和大学生中收集了3-4次咽拭子。脑膜炎双球菌携带者的检测采用标准培养结合血清凝集试验或培养分离株的聚合酶链式反应，或直接从拭子中进行。结果：脑膜炎球菌B群和Y群最为常见，带菌率分别高达6.5%和5.5%，且在整个青春期呈上升趋势。用血清凝集法进行鉴定往往不可靠，与培养结合聚合酶链式反应相比，直接聚合酶链式反应检测的敏感性为66%。在MenB分离株中，89.1%有fHBP亚家族变异。每1000人月的MenB携带率估计为2.8。结论：如果疫苗接种先于青少年的MenB携带率上升，则应在青春期早期进行。评估疫苗影响的研究应该使用分子方法来检测携带者。(C)2015年提交人。由爱思唯尔有限公司代表英国感染协会出版。
Objectives: Recent development of serogroup B meningococcal (MenB) vaccines highlights the importance of pharyngeal carriage data, particularly in adolescents and young adults, to inform implementation strategies. We describe current UK carriage prevalence in this high risk population and compare methods of carriage detection.Methods: In this multisite study, pharyngeal swabs were collected on 3-4 occasions over 6-12 months, from 1040 school and university students, aged 10-25 years. Meningococcal carriage was detected by standard culture combined with seroagglutination or PCR of cultured isolates, or by direct PCR from swab. The factor H binding protein (fHBP) variants present in meningococcal isolates were determined.Results: Meningococcal serogroups B and Y were most common, with carriage up to 6.5% and 5.5% respectively, increasing throughout adolescence. Identification by seroagglutination was often unreliable, and the sensitivity of direct PCR detection was 66% compared to culture combined with PCR. Of MenB isolates, 89.1% had subfamily A variants of fHBP. The acquisition rate of MenB carriage was estimated at 2.8 per 1000 person-months.Conclusions: If vaccination is to precede the adolescent rise in MenB carriage, these data suggest it should take place in early adolescence. Studies assessing vaccine impact should use molecular methods to detect carriage. (C) 2015 The Authors. Published by Elsevier Ltd on behalf of the The British Infection Association.