Prevalence and Characteristics of Carriage of Neisseria meningitidis Among Young Israeli Adults

Noa Sofer-Sali; Diana Roif-Kaminsky; Yair Motro; Boris Khalfin; Eva Avramovich; Inbal Galor; Amir Shlaifer; Adir Sommer; Ran Rutenberg; Yacov Sachter; Avraham Yitzhak; Daniel Grupel; Jacob Moran-Gilad

doi:10.1093/ofid/ofac482

Prevalence and Characteristics of Carriage of Neisseria meningitidis Among Young Israeli Adults

Open Forum Infect Dis. 2022 Sep 19;9(10):ofac482. doi: 10.1093/ofid/ofac482. eCollection 2022 Oct.

Authors

Affiliations

¹ Braun School of Public Health and Community Medicine, The Hebrew University of Jerusalem-Hadassah Medical Organization, Jerusalem, Israel.
² Department of Health Policy and Management, School of Public Health, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel.
³ Israel Defense Forces Medical Corps, Tel Hashomer, Ramat Gan, Israel.
⁴ Department of Ophthalmology, Rambam Health Care Campus, Haifa, Israel.
⁵ Emergency Department, Beilinson Hospital, Rabin Medical Center, Petah Tikva, Israel.
⁶ Surgery Division, Soroka University Medical Center, Beer Sheva, Israel.
⁷ Department of Internal Medicine B, Soroka University Medical Center, Beer Sheva, Israel.

Abstract

Background: No updated data currently exist regarding Neisseria meningitidis carriage and genomic epidemiology among young Israeli adults.

Methods: Oropharyngeal swabs were collected from 1801 military recruits on the day of recruitment during 2019. Neisseria meningitidis was detected and identified by culture and quantitative polymerase chain reaction (qPCR). Confirmed isolates were serotyped by qPCR, and encapsulated strains underwent whole-genome sequencing. Risk factors for carriage were determined by analyzing focused questionnaires using uni- and multivariate models. Genomic typing was performed by means of core genome multilocus sequence typing.

Results: Carriage rates overall and of encapsulated strains were 20.1% and 6.7%, respectively. Genogroups B (49.2%) and Y (26.7%) were the most commonly encapsulated strains. Genogroups C, W, and X were scarce, and genogroup A was absent. The most notable clonal complexes (CCs) were CC23 (n = 30), CC32 (n = 16), and CC44/41 (n = 9). Carriage was significantly associated with smoking (odds ratio [OR], 1.82; 95% CI, 1.43-2.33) and boarding school attendance before recruitment (OR, 1.49; 95% CI, 1.14-1.96).

Conclusions: The prevalence of meningococcal carriage among young Israeli adults is high, compared with similar studies in other developed countries. This might be due to sociocultural characteristics including smoking and boarding school attendance during and after high school. The dominant genogroups and CCs found were compatible with those implicated in invasive disease in Israel.

Keywords: Neisseria meningitidis; carriage; epidemiology; genomics; risk factors.