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Meningococcal carriage in men who have sex with men presenting at a sexual health unit in Spain

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Abstract

Neisseria meningitidis (Nm) is asymptomatically carried in the nasopharynx of 5–10% adults, although certain populations, such as men who have sex with men (MSM), exhibit a higher colonisation rate. Interest in Nm carriage has been renewed, owed to meningitis outbreaks within populations of MSM. The aim of this study was to characterise Nm isolates and risk factors for its carriage among MSM attending a sexual health unit. A retrospective cross-sectional study was undertaken between June 2018 and December 2021. We took anal, oropharyngeal, urethral, and blood samples as part of the sexually transmitted infection screening procedures routinely implemented. Nm isolates were subjected to antimicrobial susceptibility testing; the serogroup and genogroup were determined by multi-locus sequence typing. A total of 399 subjects were recruited, and the Nm oropharyngeal carriage rate was 29%, similar among both people living with HIV (PLWH) and uninfected individuals. Nm carriage was less common in vaccinated individuals, especially those who had received the tetravalent vaccine (2.6% vs. 10.6%, p = 0.008). The most frequent serogroups were B (40%) and non-groupable (45%). Most of the isolates were susceptible to ciprofloxacin (96%) and ceftriaxone (100%). However, we identified 21 strains (20%) belonging to hyperinvasive lineages (CC11, CC4821, CC32, CC41/44, CC213, and CC269), most of which belonged to serogroup B. Given that vaccination with MenACWY was associated with a low Nm carriage, we encourage routine vaccination of all MSM. Moreover, the administration of the meningitis B vaccine should also be assessed considering that several invasive lines included in serogroup B are circulating among MSM.

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Data availability

The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

The authors would like to thank all the patients, clinicians, and nurses at the Álvaro Cunqueiro Infectious Disease Unit without whom this work would not have been possible.

Funding

This research did not receive any specific funding grants from any agencies in the public, commercial, or not-for-profit sectors. Alexandre Pérez is employed on a Rio Hortega contract, financed by the Instituto de Salud Carlos III, file number CM20/00243.

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Authors and Affiliations

  1. Virology and Pathogenesis Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, Vigo, Spain

    Alexandre Pérez-González, Alejandro Araújo-Ameijeiras & Eva Poveda

  2. Infectious Diseases Unit, Department of Internal Medicine, Xerencia de Xestión Integrada de Vigo, Vigo, Spain

    Alexandre Pérez-González & Antonio Ocampo

  3. Microbiology and Infectiology Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, Vigo, Spain

    Raquel Carballo & Carmen Potel

  4. Microbiology Laboratory, Xerencia de Xestión Integrada de Vigo, Vigo, Spain

    Raquel Carballo

  5. Reference and Research Laboratory for Vaccines Preventable Bacterial Diseases, National Centre for Microbiology, Instituto de Salud Carlos III, 28220, Madrid, Spain

    Raquel Abad & Carmen Navarro

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  1. Alexandre Pérez-González
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Contributions

APG and CP conceptualised the study, APG planned the statistical analysis with input from CP and RC. APG, AAA, and AO designed the database and performed the data curation. RA and CN performed the Nm identification and molecular characterisation. CP and RC performed the cultures and antimicrobial susceptibility tests of Nm isolates. APG wrote the original manuscript draft, and EP and RA revised it for important intellectual content. All the authors have approved the final version of this article.

Corresponding author

Correspondence to Alexandre Pérez-González.

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Ethics approval

All the procedures performed in studies involving human participants were conducted in accordance with the ethical standards of the institutional research committee at Galicia and complied with the 1964 declaration of Helsinki and its later amendments or comparable ethical standards. This work was approved by the Ethics Committee of Pontevedra-Vigo-Ourense with reference number 2021/311.

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Informed consent was waived because of the retrospective design of this study.

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The authors declare no competing interests.

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Pérez-González, A., Carballo, R., Araújo-Ameijeiras, A. et al. Meningococcal carriage in men who have sex with men presenting at a sexual health unit in Spain. Eur J Clin Microbiol Infect Dis 42, 287–296 (2023). https://doi.org/10.1007/s10096-023-04550-8

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