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Meningococcal carriage during a clonal meningococcal B outbreak in France

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Abstract

The aim of this study performed in Normandy, France, was to analyze the pharyngeal meningococcal carriage at the peak of a clonal meningococcal B outbreak, which was subsequently controlled using an outer membrane vesicle vaccination. This cross-sectional study included randomly selected subjects aged 1–25 years. Carriers and non carriers were compared using unconditional logistic regression. Among the 3,522 volunteers, there were 196 (standardized rate: 6.46 %) Neisseria meningitidis carriers, of which there were only five with the outbreak strain (B:14:P1.7,16/ST-32; standardized rate: 0.18 %). From the multivariate analysis, older age, smoking, higher degree of socialization, and social deprivation appear to favor the carriage of all the strains included. Prior antibiotic treatment up to 12 months before swabbing, even with β-lactam, was protective against carriage. Our data indicate a low overall meningococcal carriage rate with a surprising protective effect of prior antibiotic exposure. The observed low carriage rate of the epidemic strain (B:14:P1.7,16/ST-32) contrasts with the high incidence of invasive meningococcal diseases (IMD) due to this strain. Hence, our data underline the high virulence of the strain and suggest a low level of natural immunity of the population against this strain. Although highly resource-consuming, carriage studies are helpful in guiding the implementation of control measures of IMD, such as mass vaccination or chemoprophylaxis.

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Acknowledgments

We are indebted to the volunteers and their families. We thank all the collaborators and people who help with the study. We are grateful to Jean-Luc Brière, Claire Sesbouë, and Corinne Leroy (Agence Régionale de Santé de Haute-Normandie), Yves Bloch, Jocelyne Chartier, Emilie Flévin, and Sylvie Zahaf (Centre Hospitalier Général de Dieppe), Jean-François Lemeland and Jean-Louis Pons (CHU de Rouen).

Additional members of the B14 STOP study group

Steering committee: Jean-Michel Alonso (Institut Pasteur), Isabelle Parent du Châtelet (Institut de Veille Sanitaire), Martin Révillion (Cellule Interrégionale d’Epidémiologie de Haute-Normandie), Jean-Philippe Leroy (Centre Hospitalier Universitaire de Rouen), Jean-Philippe Rigaud (Centre Hospitalier Général de Dieppe).

Coordination of the investigation center: Vincent Ferranti, Marion Duval-Affagard, and Michel Décreau (Centre Hospitalier Universitaire de Rouen).

Microbiological analysis: Nathalie Gence, Christine Godey, and Danièle Verson (Centre Hospitalier Universitaire de Rouen), Ala-Eddine Deghmane, Eva Hong, and Corinne Ruckly (Institut Pasteur).

Antibiotic consumption data collection: Marie-Noëlle Damon (Direction Régionale du Service Médical de Normandie).

Statistical analysis: Estelle Houivet and Vanessa Grassi (Centre Hospitalier Universitaire de Rouen).

Contributions

Valérie Delbos assisted François Caron in the supervision of the study. Valérie Delbos and François Caron wrote the report and had the final responsibility for the decision to submit for publication. Ludovic Lemée supervised the detection and identification of isolates, and their characterization by genogrouping, and wrote the corresponding report. Jacques Bénichou assessed the methodological quality of the paper and revised the report. Gilles Berthelot supervised the culture of swabs at the investigation center. Muhamed-Kheir Taha supervised the full characterization of isolates and revised the report. All authors contributed to the content of the report, and have seen and approved the final report.

Conflict of interest

All authors: no conflict.

Funding

The study was funded by the French Ministry of Health (“Programme Hospitalier de Recherche Clinique”).

Author information

Authors and Affiliations

  1. Centre Hospitalier Universitaire, Rouen, France

    V. Delbos, L. Lemée, J. Bénichou & F. Caron

  2. Université de Rouen, Rouen, France

    V. Delbos, L. Lemée, J. Bénichou & F. Caron

  3. Institut National de la Santé et de la Recherche Médicale (INSERM), Paris, France

    J. Bénichou

  4. Centre Hospitalier Général, Dieppe, France

    G. Berthelot

  5. Institut Pasteur, Paris, France

    M.-K. Taha

  6. Service des Maladies Infectieuses et Tropicales, Hôpital Charles Nicolle, 1 rue de Germont, 76031, Rouen, France

    V. Delbos

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  1. V. Delbos
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  2. L. Lemée
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  3. J. Bénichou
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  4. G. Berthelot
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  5. M.-K. Taha
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  6. F. Caron
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on behalf of the B14 STOP study group

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Correspondence to V. Delbos.

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Additional members of the B14 STOP study group are listed at the end of this article.

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Delbos, V., Lemée, L., Bénichou, J. et al. Meningococcal carriage during a clonal meningococcal B outbreak in France. Eur J Clin Microbiol Infect Dis 32, 1451–1459 (2013). https://doi.org/10.1007/s10096-013-1897-6

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  • DOI: https://doi.org/10.1007/s10096-013-1897-6

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