Dataset Information

Changing carriage rate of Neisseria meningitidis among university students during the first week of term: cross sectional study.

ABSTRACT: OBJECTIVE:To determine the rates of, and risk factors for, meningococcal carriage and acquisition among university students. DESIGN:Repeated cross sectional study. PARTICIPANTS:2,507 students in their first year at university. MAIN OUTCOME MEASURES:Prevalence of carriage of meningococci and risk factors for carriage and acquisition of meningococci. RESULTS:Carriage rates for meningoccoci increased rapidly in the first week of term from 6.9% on day 1, to 11.2% on day 2, to 19.0% on day 3, and to 23.1% on day 4. The average carriage rate during the first week of term in October among students living in catered halls was 13.9%. By November this had risen to 31.0% and in December it had reached 34. 2%. Independent associations for acquisition of meningococci in the autumn term were frequency of visits to a hall bar (5-7 visits: odds ratio 2.7, 95% confidence interval 1.5 to 4.8), active smoking (1.6, 1.0 to 2.6), being male (1.6, 1.2 to 2.2), visits to night clubs (1. 3, 1.0 to 1.6), and intimate kissing (1.4, 1.0 to 1.8). Lower rates of acquisition were found in female only halls (0.5, 0.3 to 0.9). The most commonly acquired meningococcal strain was C2a P1.5 (P1.2), which has been implicated in clusters of invasive meningococcal disease at other UK universities. CONCLUSIONS:Carriage rates of meningococci among university students increase rapidly in the first week of term, with further increases during the term. The rapid rate of acquisition may explain the increased risk of invasive meningococcal disease and the timing of cases and outbreaks in university students.

SUBMITTER: Neal KR

PROVIDER: S-EPMC27326 | biostudies-literature | 2000 Mar

REPOSITORIES: biostudies-literature

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Changing carriage rate of Neisseria meningitidis among university students during the first week of term: cross sectional study.

Neal K R KR Nguyen-Van-Tam J S JS Jeffrey N N Slack R C RC Madeley R J RJ Ait-Tahar K K Job K K Wale M C MC Ala'Aldeen D A DA

BMJ (Clinical research ed.) 20000301 7238

<h4>Objective</h4>To determine the rates of, and risk factors for, meningococcal carriage and acquisition among university students.<h4>Design</h4>Repeated cross sectional study.<h4>Participants</h4>2,507 students in their first year at university.<h4>Main outcome measures</h4>Prevalence of carriage of meningococci and risk factors for carriage and acquisition of meningococci.<h4>Results</h4>Carriage rates for meningoccoci increased rapidly in the first week of term from 6.9% on day 1, to 11.2% ...[more]

PMID: 10731181

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Project description:UnlabelledNeisseria meningitidis colonizes the nasopharyngeal mucosa of healthy populations asymptomatically, although the bacterial surface is rich in motifs that activate the host innate immunity. What determines the tolerant host response to this bacterium in asymptomatic carriers is poorly understood. We demonstrated that the conserved meningococcal surface protein NhhA orchestrates monocyte (Mo) differentiation specifically into macrophage-like cells with a CD200R(hi) phenotype (NhhA-M?). In response to meningococcal stimulation, NhhA-M? failed to produce proinflammatory mediators. Instead, they upregulated interleukin-10 (IL-10) and Th2/regulatory T cell (Treg)-attracting chemokines, such as CCL17, CCL18, and CCL22. Moreover, NhhA-M? were highly efficient in eliminating bacteria. The in vivo validity of these findings was corroborated using a murine model challenged with N. meningitidis systematically or intranasally. The NhhA-modulated immune response protected mice from septic shock; Mo/M? depletion abolished this protective effect. Intranasal administration of NhhA induced an anti-inflammatory response, which was associated with N. meningitidis persistence at the nasopharynx. In vitro studies demonstrated that NhhA-triggered Mo differentiation occurred upon engaged Toll-like receptor 1 (TLR1)/TLR2 signaling and extracellular signal-regulated kinase (ERK) and Jun N-terminal protein kinase (JNK) activation and required endogenously produced IL-10 and tumor necrosis factor alpha (TNF-?). Our findings reveal a strategy that might be adopted by N. meningitidis to maintain asymptomatic nasopharyngeal colonization.ImportanceNeisseria meningitidis is an opportunistic human-specific pathogen that colonizes the nasopharyngeal mucosa asymptomatically in approximately 10% of individuals. Very little is known about how this bacterium evades immune activation during the carriage stage. Here, we observed that N. meningitidis, via the conserved surface protein NhhA, skewed monocyte differentiation into macrophages with a CD200R(hi) phenotype. Both in vivo and in vitro data demonstrated that these macrophages, upon meningococcal infection, played an important role in forming a homeostatic immune microenvironment through their capacity to eliminate invading bacteria and to generate anti-inflammatory mediators. This work provides novel insight into the mechanisms underlying the commensal persistence of N. meningitidis.

Dataset Information

Changing carriage rate of Neisseria meningitidis among university students during the first week of term: cross sectional study.

Publications

Changing carriage rate of Neisseria meningitidis among university students during the first week of term: cross sectional study.

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