背景:该分析调查了南澳大利亚州青少年4年以上脑膜炎球菌携带的纵向变化。
方法:来自“B部分”研究的数据,其中包括一项针对中学生的全州整群随机对照试验(2017年和2018年n=34,489)和针对17-25岁离校者的连续横断面研究(2019-2020年n=4,028).个人每年收集口咽拭子。这项研究包括两个独特的队列:(1)在2019年注册的个人,在2017年,2018年和2019年连续进行了三次年度拭子;(2)在2020年注册的个人,在2017年,2018年和2020年进行了拭子。使用PCR和全基因组测序鉴定疾病相关的脑膜炎奈瑟球菌基因组。单因素分析确定了反复携带(≥2)的危险因素。
结果:在离校生中,50(1.7%,总计n=2,980)在连续访问中检测到了运输。在连续访问中携带脑膜炎球菌的参与者中,38/50(76.0%)具有通过porAPCR检测到的相同基因组。其中,19具有相同的MLST类型,并且表现出最小的变化,表明他们最有可能持续携带相同的分离株(范围为226到490天,平均持续时间352[SD51]天)。在2019年的离校生队列中,6.7%的人在放学后的第一年获得了马车,而在最后一个学年则为3.3%。与单车检测相比,年龄较大的青少年可能更容易发生复发(16岁与≤15岁相比;OR=1.97(95CI1.0,3.86);p=0.048).
结论:虽然运输通常是短暂的,一些青少年/年轻人可能有持续性携带,很可能是脑膜炎球菌传播的一个重要群体.
BACKGROUND: This analysis investigated longitudinal changes in meningococcal carriage in adolescents in South Australia over 4 years.
METHODS: Data from the \"B Part of It\"
study, which included a state-wide cluster randomized controlled
trial in secondary-school students (n = 34,489 in 2017 and 2018) and serial cross-sectional studies in school leavers aged 17-25 years (n = 4028 in 2019-2020). Individuals had oropharyngeal swabs collected annually. This
study included two unique cohorts: (1) individuals enrolled in 2019, with three consecutive annual swabs taken in 2017, 2018 and 2019; and (2) individuals enrolled in 2020, with swabs taken in 2017, 2018, and 2020. Disease-associated N. meningitidis genogroups were identified using PCR and whole genome sequencing. Univariate analysis identified risk factors for recurrent carriage (≥2).
RESULTS: Among school leavers, 50 (1.7%, total n = 2980) had carriage detected at successive visits. In participants with meningococcal carriage at successive visits, 38/50 (76.0%) had the same genogroup detected by porA PCR. Of those, 19 had the same MLST type and demonstrated minimal variation, indicating they most likely had sustained carriage of the same isolate (range 226 to 490 days, mean duration 352 [SD 51] days). In the 2019 school leaver cohort, 6.7% acquired carriage in their first year out of school compared to 3.3% in their final school year. Compared to single carriage detection, recurrent carriage was potentially more likely in older adolescents (16 compared to ≤15 years; OR = 1.97 (95%CI 1.0, 3.86); p = 0.048).
CONCLUSIONS: Whilst carriage is typically transient, some adolescents/young adults may have persistent carriage and are likely to be an important group in the transmission of meningococci.