Meningococcal carriage in Dutch adolescents and young adults; a cross-sectional and longitudinal cohort study

M. B. van Ravenhorst; M. W. Bijlsma; M. A. van Houten; V. M. D. Struben; A. S. Anderson; J. Eiden; L. Hao; K. U. Jansen; H. Jones; N. Kitchin; L. Pedneault; E. A. M. Sanders; A. van der Ende

doi:https://doi.org/10.1016/j.cmi.2017.02.008

Meningococcal carriage in Dutch adolescents and young adults; a cross-sectional and longitudinal cohort study

M. B. van Ravenhorst, M. W. Bijlsma, M. A. van Houten, V. M. D. Struben, A. S. Anderson, J. Eiden, L. Hao, K. U. Jansen, H. Jones, N. Kitchin, L. Pedneault, E. A. M. Sanders, A. van der Ende

Research output: Contribution to journal › Article › Academic › peer-review

28 Citations (Scopus)

Abstract

Objectives: Current information on rates and dynamics of meningococcal carriage is essential for public health policy. This study aimed to determine meningococcal carriage prevalence, its risk factors and duration in the Netherlands, where meningococcal C vaccine coverage is >90%. Several methods to identify serogroups of meningococcal carriage isolates among adolescent and young adults were compared. Methods: Oropharyngeal swabs were collected from 1715 participants 13-23 years of age in 2013-2014; 300 were prospectively followed over 8 months. Cultured isolates were characterized by Ouchterlony, real-time (rt-) PCR or whole-genome sequencing (WGS). Direct swabs were assessed by rt-PCR. Questionnaires on environmental factors and behaviour were also obtained. Results: A meningococcal isolate was identified in 270/1715 (16%) participants by culture. Of MenB isolates identified by whole genome sequencing, 37/72 (51%) were correctly serogrouped by Ouchterlony, 46/51 (90%) by rt-PCR of cultured isolates, and 39/51 (76%) by rt-PCR directly on swabs. A sharp increase in carriage was observed before the age of 15 years. The age-related association disappeared after correction for smoking, level of education, frequent attendance to crowded social venues, kissing in the previous week and alcohol consumption. Three participants carried the same strain identified at three consecutive visits in an 8-month period. In these isolates, progressively acquired mutations were observed. Conclusions: Whole genome sequencing of culture isolates was the most sensitive method for serogroup identification. Based upon results of this study and risk of meningococcal disease, an adolescent meningococcal vaccination might include children before the age of 15 years to confer individual protection and potentially to establish herd protection. (C) 2017 The Authors. Published by Elsevier Ltd on behalf of European Society of Clinical Microbiology and Infectious Diseases

Original language	English
Pages (from-to)	573.e1-573.e7
Journal	Clinical Microbiology and Infection
Volume	23
Issue number	8
Early online date	2017
DOIs	https://doi.org/10.1016/j.cmi.2017.02.008
Publication status	Published - Aug 2017

Keywords

Adolescent
Carrier State/epidemiology
Cross-Sectional Studies
Female
Humans
Longitudinal Studies
Male
Meningococcal Infections/epidemiology
Neisseria meningitidis/classification
Netherlands/epidemiology
Oropharynx/microbiology
Prevalence
Prospective Studies
Real-Time Polymerase Chain Reaction
Risk Factors
Serogroup
Serotyping
Surveys and Questionnaires
Time Factors
Whole Genome Sequencing
Young Adult

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https://doi.org/10.1016/j.cmi.2017.02.008

Cite this

van Ravenhorst, M. B., Bijlsma, M. W., van Houten, M. A., Struben, V. M. D., Anderson, A. S., Eiden, J., Hao, L., Jansen, K. U., Jones, H., Kitchin, N., Pedneault, L., Sanders, E. A. M., & van der Ende, A. (2017). Meningococcal carriage in Dutch adolescents and young adults; a cross-sectional and longitudinal cohort study. Clinical Microbiology and Infection, 23(8), 573.e1-573.e7. https://doi.org/10.1016/j.cmi.2017.02.008

@article{038f97d08cd74f72b04313d07629f9e0,

title = "Meningococcal carriage in Dutch adolescents and young adults; a cross-sectional and longitudinal cohort study",

abstract = "Objectives: Current information on rates and dynamics of meningococcal carriage is essential for public health policy. This study aimed to determine meningococcal carriage prevalence, its risk factors and duration in the Netherlands, where meningococcal C vaccine coverage is >90%. Several methods to identify serogroups of meningococcal carriage isolates among adolescent and young adults were compared. Methods: Oropharyngeal swabs were collected from 1715 participants 13-23 years of age in 2013-2014; 300 were prospectively followed over 8 months. Cultured isolates were characterized by Ouchterlony, real-time (rt-) PCR or whole-genome sequencing (WGS). Direct swabs were assessed by rt-PCR. Questionnaires on environmental factors and behaviour were also obtained. Results: A meningococcal isolate was identified in 270/1715 (16%) participants by culture. Of MenB isolates identified by whole genome sequencing, 37/72 (51%) were correctly serogrouped by Ouchterlony, 46/51 (90%) by rt-PCR of cultured isolates, and 39/51 (76%) by rt-PCR directly on swabs. A sharp increase in carriage was observed before the age of 15 years. The age-related association disappeared after correction for smoking, level of education, frequent attendance to crowded social venues, kissing in the previous week and alcohol consumption. Three participants carried the same strain identified at three consecutive visits in an 8-month period. In these isolates, progressively acquired mutations were observed. Conclusions: Whole genome sequencing of culture isolates was the most sensitive method for serogroup identification. Based upon results of this study and risk of meningococcal disease, an adolescent meningococcal vaccination might include children before the age of 15 years to confer individual protection and potentially to establish herd protection. (C) 2017 The Authors. Published by Elsevier Ltd on behalf of European Society of Clinical Microbiology and Infectious Diseases",

keywords = "Adolescent, Carrier State/epidemiology, Cross-Sectional Studies, Female, Humans, Longitudinal Studies, Male, Meningococcal Infections/epidemiology, Neisseria meningitidis/classification, Netherlands/epidemiology, Oropharynx/microbiology, Prevalence, Prospective Studies, Real-Time Polymerase Chain Reaction, Risk Factors, Serogroup, Serotyping, Surveys and Questionnaires, Time Factors, Whole Genome Sequencing, Young Adult",

author = "{van Ravenhorst}, {M. B.} and Bijlsma, {M. W.} and {van Houten}, {M. A.} and Struben, {V. M. D.} and Anderson, {A. S.} and J. Eiden and L. Hao and Jansen, {K. U.} and H. Jones and N. Kitchin and L. Pedneault and Sanders, {E. A. M.} and {van der Ende}, A.",

year = "2017",

month = aug,

doi = "https://doi.org/10.1016/j.cmi.2017.02.008",

language = "English",

volume = "23",

pages = "573.e1--573.e7",

journal = "Clinical Microbiology and Infection",

issn = "1198-743X",

publisher = "Elsevier Limited",

number = "8",

}

van Ravenhorst, MB, Bijlsma, MW, van Houten, MA, Struben, VMD, Anderson, AS, Eiden, J, Hao, L, Jansen, KU, Jones, H, Kitchin, N, Pedneault, L, Sanders, EAM & van der Ende, A 2017, 'Meningococcal carriage in Dutch adolescents and young adults; a cross-sectional and longitudinal cohort study', Clinical Microbiology and Infection, vol. 23, no. 8, pp. 573.e1-573.e7. https://doi.org/10.1016/j.cmi.2017.02.008

TY - JOUR

T1 - Meningococcal carriage in Dutch adolescents and young adults; a cross-sectional and longitudinal cohort study

AU - van Ravenhorst, M. B.

AU - Bijlsma, M. W.

AU - van Houten, M. A.

AU - Struben, V. M. D.

AU - Anderson, A. S.

AU - Eiden, J.

AU - Hao, L.

AU - Jansen, K. U.

AU - Jones, H.

AU - Kitchin, N.

AU - Pedneault, L.

AU - Sanders, E. A. M.

AU - van der Ende, A.

PY - 2017/8

Y1 - 2017/8

N2 - Objectives: Current information on rates and dynamics of meningococcal carriage is essential for public health policy. This study aimed to determine meningococcal carriage prevalence, its risk factors and duration in the Netherlands, where meningococcal C vaccine coverage is >90%. Several methods to identify serogroups of meningococcal carriage isolates among adolescent and young adults were compared. Methods: Oropharyngeal swabs were collected from 1715 participants 13-23 years of age in 2013-2014; 300 were prospectively followed over 8 months. Cultured isolates were characterized by Ouchterlony, real-time (rt-) PCR or whole-genome sequencing (WGS). Direct swabs were assessed by rt-PCR. Questionnaires on environmental factors and behaviour were also obtained. Results: A meningococcal isolate was identified in 270/1715 (16%) participants by culture. Of MenB isolates identified by whole genome sequencing, 37/72 (51%) were correctly serogrouped by Ouchterlony, 46/51 (90%) by rt-PCR of cultured isolates, and 39/51 (76%) by rt-PCR directly on swabs. A sharp increase in carriage was observed before the age of 15 years. The age-related association disappeared after correction for smoking, level of education, frequent attendance to crowded social venues, kissing in the previous week and alcohol consumption. Three participants carried the same strain identified at three consecutive visits in an 8-month period. In these isolates, progressively acquired mutations were observed. Conclusions: Whole genome sequencing of culture isolates was the most sensitive method for serogroup identification. Based upon results of this study and risk of meningococcal disease, an adolescent meningococcal vaccination might include children before the age of 15 years to confer individual protection and potentially to establish herd protection. (C) 2017 The Authors. Published by Elsevier Ltd on behalf of European Society of Clinical Microbiology and Infectious Diseases

AB - Objectives: Current information on rates and dynamics of meningococcal carriage is essential for public health policy. This study aimed to determine meningococcal carriage prevalence, its risk factors and duration in the Netherlands, where meningococcal C vaccine coverage is >90%. Several methods to identify serogroups of meningococcal carriage isolates among adolescent and young adults were compared. Methods: Oropharyngeal swabs were collected from 1715 participants 13-23 years of age in 2013-2014; 300 were prospectively followed over 8 months. Cultured isolates were characterized by Ouchterlony, real-time (rt-) PCR or whole-genome sequencing (WGS). Direct swabs were assessed by rt-PCR. Questionnaires on environmental factors and behaviour were also obtained. Results: A meningococcal isolate was identified in 270/1715 (16%) participants by culture. Of MenB isolates identified by whole genome sequencing, 37/72 (51%) were correctly serogrouped by Ouchterlony, 46/51 (90%) by rt-PCR of cultured isolates, and 39/51 (76%) by rt-PCR directly on swabs. A sharp increase in carriage was observed before the age of 15 years. The age-related association disappeared after correction for smoking, level of education, frequent attendance to crowded social venues, kissing in the previous week and alcohol consumption. Three participants carried the same strain identified at three consecutive visits in an 8-month period. In these isolates, progressively acquired mutations were observed. Conclusions: Whole genome sequencing of culture isolates was the most sensitive method for serogroup identification. Based upon results of this study and risk of meningococcal disease, an adolescent meningococcal vaccination might include children before the age of 15 years to confer individual protection and potentially to establish herd protection. (C) 2017 The Authors. Published by Elsevier Ltd on behalf of European Society of Clinical Microbiology and Infectious Diseases

KW - Adolescent

KW - Carrier State/epidemiology

KW - Cross-Sectional Studies

KW - Female

KW - Humans

KW - Longitudinal Studies

KW - Male

KW - Meningococcal Infections/epidemiology

KW - Neisseria meningitidis/classification

KW - Netherlands/epidemiology

KW - Oropharynx/microbiology

KW - Prevalence

KW - Prospective Studies

KW - Real-Time Polymerase Chain Reaction

KW - Risk Factors

KW - Serogroup

KW - Serotyping

KW - Surveys and Questionnaires

KW - Time Factors

KW - Whole Genome Sequencing

KW - Young Adult

U2 - https://doi.org/10.1016/j.cmi.2017.02.008

DO - https://doi.org/10.1016/j.cmi.2017.02.008

M3 - Article

C2 - 28192234

SN - 1198-743X

VL - 23

SP - 573.e1-573.e7

JO - Clinical Microbiology and Infection

JF - Clinical Microbiology and Infection

IS - 8

ER -