Detection of Neisseria meningitidis in Saliva and Oropharyngeal Samples from College Students

Abstract

Objectives Since conjugated polysaccharide vaccines reduce carriage of vaccine-type Neisseria meningitidis strains, meningococcal carriage is an accepted endpoint in monitoring vaccine effects. We have assessed vaccine-type genogroup carriage prevalence in students at the time of MenACWY vaccine introduction in The Netherlands. In addition, we evaluated the feasibility of saliva sampling and qPCR-based detection method for the surveillance of meningococcal carriage. Methods Paired saliva and oropharyngeal samples, collected from 299 students, were cultured for meningococcus. The DNA extracted from all bacterial growth was subjected to qPCRs quantifying meningococcal presence and genogroup-specific genes. Samples negative by culture yet positive for qPCR were cultured again for meningococcus. Results for saliva were compared with oropharyngeal samples. Results Altogether 74 (25% of 299) students were identified as meningococcal carrier by any method used. Sixty-one students (20%) were identified as carriers with qPCR. The difference between number of qPCR-positive oropharyngeal (n=59) and saliva (n=52) samples was not significant (McNemar’s test, p=0.07). Meningococci were cultured from 72 students (24%), with a significantly higher (p<0.001) number of oropharyngeal (n=70) compared with saliva (n=54) samples. The prevalence of genogroups A, B, C, W, and Y was none, 9%, 1% and 6%, respectively, and 8% of students carried MenACWY vaccine-type genogroup meningococci. Conclusions We show that the detected prevalence of meningococcal carriage between oropharyngeal and saliva samples was nondifferent with qPCR and moreover, detection with both samples was highly concordant. Saliva is easy to collect and when combined with qPCR detection can be considered for meningococcal carriage studies.