INTRODUCTIONThe aim of this case series is to describe the clinical course of 2 patients with Neisseria meningitidis corneal ulcers.

CLINICAL PICTUREA 49-year-old man (Patient 1) and a 22- year-old man (Patient 2) both experienced eye pain and were found to have corneal ulcers with surrounding infiltrate and ground-glass appearance. Gram-negative diplococci were seen in the first case. N. meningitidis was isolated in culture of corneal scrapings from both patients.

TREATMENTPatient 1 was treated with levofloxacin (0.5%) and cefazolin (50 mg/mL) eye drops hourly and intravenous ceftriaxone and oral rifampicin. Patient 2 was treated with cefazolin (50 mg/mL) and gentamicin (14 mg/mL) eye drops hourly, as well as intravenous ceftriaxone.

OUTCOMEThe corneal ulcers resolved with anterior stromal scarring and no impairment of vision.

CONCLUSIONSCorneal ulcers caused by N. meningitidis may respond well to treatment without permanent visual sequelae. However, in view of the potential ocular and systemic complications, it is important to investigate and treat patients with N. meningitidis infection aggressively.

Adult ; Cornea ; microbiology ; pathology ; Diagnosis, Differential ; Eye Infections, Bacterial ; microbiology ; pathology ; Humans ; Keratitis ; microbiology ; pathology ; Male ; Meningococcal Infections ; microbiology ; pathology ; Middle Aged ; Neisseria meningitidis ; isolation & purification

OBJECTIVETo study the molecular subtypes and microflora structure of Neisseria meningitidis (Nm) strains isolated in Jiangxi province.

METHODSA total of 123 Nm strains separately isolated from patients, close contacts and health people in 1976-1987 and 2005-2008 were investigated by multilocus sequence typing (MLST) and PorA subtyping, to test the characteristics of gene Nm and sequence porA. Minimum spanning tree was constructed by using BioNumerics software based on data of MLST; and the microflora structure was then analyzed.

RESULTSThe serogroups of 67 Nm strains isolated in 1976-1987 included group A (43 strains), group B (18 strains), group C (1 strains) and group W135 (5 strains); while the serogroups of 56 Nm strains isolated in 2005-2008 included group A (3 strains), group B (7 strains), group C (45 strains) and 1 ungrouped strain. The total 123 Nm strains could be divided into 40 MLST types; while the 46 strains in group A could be divided into 14 MLST types, 29 out of which belonged to ST-3 type, accounting for 63.0% (29/46) as the dominant type. All of the 29 strains were isolated between 1976 and 1987, while 14 strains were isolated from patients, 9 were from close contacts and 6 were from health people. The 46 strains in group C could be divided into 5 MLST types, 41 out of which belonged to ST-4821 type, accounting for 89.1% (41/46). All of the strains were isolated between 2005 and 2008, 6 strains were isolated from patients, 6 were from close contacts and 29 were from health people. The porA gene of the total 123 Nm strains were classified to 32 different types, including 24 different VR1 types and 22 different VR2 types. The dominant PorA type of the prevalent strain (ST-3 type, group A) between 1976 and 1987 was P1.7-1, 10, accounting for 39.1% (18/46) of the strains in group A; while the 18 strains were isolated from 11 patients, 4 close contacts and 3 health people. The dominant PorA type of the prevalent strain (ST-4821 type, group C) between 2005 and 2008 was P1.20, 9, accounting for 46.3% (19/41) of the ST-4821 strains in group C; while the 19 strains were isolated from 1 close contacts and 18 health people. P1.7-2, 14 dominated since 2006, including 22 strains, accounting for 53.7% (22/41) of the ST-4821 strains in group C, isolated from 6 patients, 5 close contacts and 11 health people. There were no dominant PorA type found in group B and all the 5 strains in group W135 belonged to ST-174 and the PorA type was P1.21, 16, isolating from 3 close contacts and 2 health people between 1979 and 1980.

CONCLUSIONNm isolated in Jiangxi province showed significant gene polymorphism, as well as predominant lineages existing. In different periods, the prevalent lineages varied a lot, as translating from serogroup A: ST-3:P1.7-1, 10 to serogroup C: ST-4821:P1.7-2, 14 nowadays.

Bacterial Typing Techniques ; China ; epidemiology ; Genotype ; Humans ; Meningococcal Infections ; epidemiology ; microbiology ; Neisseria meningitidis ; classification ; genetics ; isolation & purification ; Serotyping

In order to investigate carriage status and serum groups distribution of Neisseria meningitidis(Nm) among healthy population in Jiangsu Province, four counties were selected as monitoring sites by random sampling method for cross-sectional study. Throat swab specimens were collected from four monitoring sites in October to November 2019 and November to December 2020 for bacterial culture and Real-time PCR detection. Chi-square test was used to compare the positive rate of Neisseria meningitidis, and multiple logistic regression model was used to analyze the influencing factors of Neisseria meningitidis carrier rate. The results showed that among 1 512 samples, 57 strains of Nm were isolated, and the carrier rate was 3.77%. Serogroup B was the dominant group (36.84%), followed by un-known serogroups (33.33%), serogroup C was the third (17.54%), serogroup W135 and serogroup A were 7.02% and 5.26%, respectively. The carriage rate (8.60%) of 15-20 years old was significantly higher than others (1.77%-3.74%)(Pearson χ²=18.211, P<0.05). Region, age and immunization history were risk factors for Neisseria meningitidis carrier rate. In summary, the Nm carrier rate of healthy population in Jiangsu Province is relatively low, which indicates that the epidemic cases will continue to be sporadic in the future. However, the prevention and control of meningococcal epidemics on campus should be strengthened, and the monitoring of neisseria meningitidis group B should be maintained as it has become the dominant epidemic strain.
Humans ; Adolescent ; Young Adult ; Adult ; Neisseria meningitidis ; Meningococcal Infections/prevention & control* ; Prevalence ; Cross-Sectional Studies ; Carrier State/microbiology*

PURPOSE: Neisseria meningitidis is a leading cause of bacterial meningitis in young adults. University students, especially those living in dormitories, have been known to be at increased risk of meningococcal disease. We performed a longitudinal study to determine the carriage rates of N. meningitidis and the changes thereof. MATERIALS AND METHODS: We recruited Inha University freshmen who were, at that time, admitted to a student dormitory. A pharyngeal swab was taken from all participant who were also asked to complete a questionnaire. This was repeated four weeks later. RESULTS: A total of 136 students were enrolled at the first culture. After four weeks, 128 students were enrolled, including 106 re-participants. The overall carriage rates changed from 11.8% to 14.1%. In analysis of the 106 re-participants, "visiting to pubs" was associated with carriage of N. meningitis for both the first (p=0.047) and second cultures (p=0.026). Serogroup C was found to be the most frequent serogroup (5 isolates), while 3 isolates were found from serogroup B. The most prevalent PorA types were P1.22,14-6 (4 isolates) and P1.19,15 (3 isolates). The DNA sequences of PorA VR2 were changed in 2 students during prolonged carriage. CONCLUSION: The meningococcal carriage rate among first year university students who resided in a dormitory did not significantly increase over 4-week interval between cultures, which is markedly different from those reported in Western studies. Close social contact appeared to be related with carriage. Our data also revealed diversity in PorA types, suggesting the possibility of rapid mutation of the PorA gene during the 4-week interval.
Female ; Genotype ; Humans ; Korea ; Male ; Meningococcal Infections/microbiology ; Neisseria meningitidis/classification/*genetics/pathogenicity ; Serotyping ; Students/statistics & numerical data ; Universities/statistics & numerical data ; Young Adult

Acute Disease ; Aged ; Anti-Bacterial Agents/therapeutic use* ; Bacteremia/microbiology* ; Female ; Hepatitis B, Chronic/complications* ; Hepatitis C, Chronic/complications* ; Humans ; Hypersplenism/complications* ; Liver Cirrhosis/complications* ; Meningococcal Infections/microbiology* ; Neisseria meningitidis/isolation & purification* ; Peritonitis/microbiology*