Outbreak strain characterisation and pharyngeal carriage detection following a protracted group B meningococcal outbreak in adolescents in South-West England

Stephen Clark, Jay Lucidarme, Georgina Angel, Aiswarya Lekshmi, Begonia Morales-Aza, Laura Willerton, Helen Campbell, Steve J Gray, Shamez Ladhani, Mike Wade, Mary Elizabeth Ramsay, Julie Yates, Adam Finn, Ray Borrow

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Abstract

Between April 2016 and September 2017, four cases of group B meningococcal disease were reported among sixth-form college students in Bristol, UK. Culture and non-culture whole genome sequencing was utilised and demonstrated that the four genomes of the responsible ST-41 strains clustered closely on a sub-lineage of ST-41/44 clonal complex. The outbreak resulted in two fatalities. A distinct social group associated with one of the cases was selected for vaccination with 4CMenB and pharyngeal swabbing. In vitro culturing, multiple real-time PCR assays (sodC, ctrA and siaDB) and a PorA PCR-sequencing assay were used to detect meningococcal colonisation and a carriage rate of 32.6% was observed. Furthermore, a high proportion of the pharyngeal swabs (78.3%) yielded a Factor H-Binding Protein (fHbp) nucleotide allele suggesting that the antigenic gene is prevalent among non-meningococcal flora, most likely Neisseria commensals. This may have implications for fHbp as a vaccine antigen should it be shown to influence bacterial colonisation.
Original languageEnglish
Article number9990 (2019)
Number of pages8
JournalScientific Reports
Volume9
Issue number1
DOIs
Publication statusPublished - 10 Jul 2019

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Clark, S., Lucidarme, J., Angel, G., Lekshmi, A., Morales-Aza, B., Willerton, L., Campbell, H., Gray, S. J., Ladhani, S., Wade, M., Ramsay, M. E., Yates, J., Finn, A., & Borrow, R. (2019). Outbreak strain characterisation and pharyngeal carriage detection following a protracted group B meningococcal outbreak in adolescents in South-West England. Scientific Reports, 9(1), [9990 (2019)]. https://doi.org/10.1038/s41598-019-46483-3