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Genomic Typing of Meningococcal Carriage Isolates in an Urban Sexual Health Clinic

Yih-Ling Tzeng1, Soma Sannigrahi1, Abigail Norris Turner2,3,4

  • 1Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA 30322, USA.

Pathogens (Basel, Switzerland)
|May 27, 2026
PubMed

Insights

Neisseria meningitidis (Nm) carriage is common in STI clinics. This study characterized Nm genomes from patients, finding specific strains linked to urethritis and invasive disease, highlighting potential transmission routes.

Area of Science:

  • Microbiology
  • Genomics
  • Public Health

Background:

  • Asymptomatic pharyngeal Neisseria meningitidis (Nm) carriage affects over 30% of attendees at sexually transmitted infection (STI) clinics.
  • Increasing reports of Nm urethritis and STI-related invasive disease outbreaks necessitate further investigation into Nm epidemiology.
  • Understanding the genomic basis of Nm carriage in STI clinic populations is crucial for public health interventions.

Purpose of the Study:

  • To conduct a longitudinal assessment and genomic characterization of Nm isolates from patients at an urban STI clinic.
  • To determine the genomic basis of oropharyngeal, urogenital, and rectal Nm isolates carried by patients seeking care.
  • To identify specific Nm strains and clonal complexes associated with carriage and potential disease transmission.

Main Methods:

  • Collection and culturing of Neisseria spp. from oropharyngeal, urethral, rectal, and cervical samples.
  • Nm-specific PCR screening, oxidase testing, and genogrouping of isolates.
  • Whole-genome sequencing of confirmed Nm isolates to determine genomic characteristics and clonal complexes.

Main Results:

  • Genomic data from 453 oropharyngeal, 10 urethral, 5 rectal, and 1 cervical Nm isolate were obtained.
  • Oropharyngeal isolates included genogroups cnl, B, E, Z, C, and Y, with inactivated cps loci in most.
  • Key clonal complexes identified were cc53, cc32, cc41/44, cc1157, cc198, and cc4821; the Nm urethritis clade (NmUC) and Group Y ST-1466 Nm were also detected.

Conclusions:

  • Genomic characterization of Nm in an urban STI clinic population reveals diverse carriage and identifies strains linked to urethritis and systemic infections.
  • The presence of the Nm urethritis clade (NmUC) and Group Y ST-1466 Nm in oropharyngeal carriage highlights potential transmission pathways.
  • Further research is needed to understand the clinical implications and transmission dynamics of these Nm strains within STI clinic settings.
Keywords:
Neisseria meningitidisST-1466STI clinicscapsulecarriageclonal complex

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