Longitudinal study of meningococcal carriage rates in university entrants living in a dormitory in South Korea

Abstract

University students, especially those living in dormitories, are known to have a high risk of invasive meningococcal disease. We performed a longitudinal study to investigate the change in Neisseria meningitidis carriage rates and identify the risk factors for carriage acquisition in university students in South Korea. We recruited university entrants who were admitted to a student dormitory. Pharyngeal swabs were taken from participants at baseline, 1 month, and 3 months, and the subjects completed a questionnaire. Culture and real-time polymerase chain reaction (PCR) for species-specific ctrA and sodC genes were performed. The cultured isolates or PCR-positive samples were further evaluated for epidemiologic characterization using serogrouping, PorA typing, FetA typing, and multilocus sequence typing (MLST). At the first visit, we enrolled 332 participants who were predominantly male (64.2%) with a median age of 19 years. Meningococcal carriage rates increased from 2.7% (95% confidence interval [CI] 0.9–4.4%) at baseline to 6.3% (95% CI 3.4–9.0%) at 1 month and 11.8% (95% CI 7.8–15.6%) at 3 months. Nongroupable isolates accounted for 50.0% of all isolates, with serogroup B being the next most prevalent (24.1%). In the study population, male sex (OR 2.613, 95% CI 1.145–5.961, p = 0.022) and frequent pub or club visits (OR 3.701, 95% CI 1.536–8.919, p = 0.004) were significantly associated with meningococcal carriage. Based on serotype and MLST analyses, six carriers transmitted meningococci to other study participants. N. meningitidis carriage rates among new university entrants who lived in a dormitory significantly increased within the first 3 months of dormitory stay, probably owing to the transmission of identical genotype among students. Based on the risk of meningococcal disease, meningococcal vaccination should be considered for students before dormitory admission.

Meningococcal Disease in the Post–COVID-19 Era: A Time to Prepare

“…A study of British university students found that meningococcal carriage increased from 6.9% on the first day of classes to 23.1% three days later, with average carriage rates among students living in catered halls increasing from 13.9% in October to 34.2% in December [ 35 ]. A more recent study of students newly admitted to a university dormitory in South Korea also reported an increase in meningococcal carriage rates over time, from 2.7% at baseline to 6.3% at 1 month and to 11.8% at 3 months [ 36 ]. Furthermore, studies have established that visits to bars or other crowded venues and kissing are significant risk factors for meningococcal acquisition [ 35 , 37 , 38 ].…”