Orogenital transmission of Neisseria meningitidis serogroup C confirmed by genotyping techniques

Abstract

Urethritis caused by Neisseria meningitidis in heterosexual patients is presumed to occur via orogenital contact, but confirmation has not been possible in most cases. Presented here is a case of urethritis caused by N. meningitidis, serogroup C, and the isolation of the same microorganism from the nasopharynx and endocervix of the patient's sexual partner. The similarity of the urethral and nasopharyngeal isolates' electrophoretic patterns, obtained using pulsed-field gel electrophoresis, proves the infection was transmitted via orogenital contact.

Nongonococcal urethritis: New views through the prism of modern molecular microbiology

“…Oral-genital sex is the presumed mode of transmission. This hypothesis was strengthened recently by the isolation of a N. meningitidis strain from from the pharynx of a woman, which matched the strain isolated from the urethra of her symptomatic male partner by pulsed field gel electrophoresis analysis [26].…”

Is Neisseria meningitidis a New Cause of Sexually Transmitted Disease?

“…meningitidis has been isolated previously from anogenital sites and has been documented as a cause of anogenital infection in many publications (3)(4)(5)(6)(7)(8)(9)(10). The first report of genital meningococcal infection was published in 1942, when Carpenter and Charles (3) described the recovery of 7 isolates of N. meningitidis among 103 urogenital isolates of Neisseria species from patients with clinical symptoms of gonococcal infection.…”

“…McKenna et al (7) reported that N. meningitidis was isolated from 79 (0.14%) of 57,170 men who presented with urethritis caused by gram-negative diplococci. In heterosexual individuals, such as our second patient, most cases of genital infection occur via orogenital transmission, with the nasopharynx as the major reservoir in healthy carriers (8). Clinicians should be aware of the possibility of isolating meningococci from anogenital sites, particularly in the homosexual population and when a history of orogenital contact is provided or suspected.…”

“…As sexual habits change, the anatomic niches for the two species and the infections they cause may occasionally overlap (2)(3)(4)(5)(6)(7)(8)(9)(10). N. meningitidis can colonize the anogenital tract in men and women, causing urethritis, proctitis, and cervicitis (3)(4)(5)(6)(7)(8)(9)(10), whereas N. gonorrhoeae has been reported to cause meningitis and pharyngitis (2). We report two cases of anogenital infection caused by N. meningitidis: one case involves a homosexual male with proctitis, and the second case involves a patient with urethritis.…”

Description of an Unusual Neisseria meningitidis Isolate Containing and Expressing Neisseria gonorrhoeae-Specific 16S rRNA Gene Sequences

“…Those two species historically were thought to be isolated populations (18). However, N. meningitidis is quite frequently described as the causative agent of urogenital infections (19)(20)(21)(22)(23)(24), and there are numerous examples of N. meningitidis and Neisseria gonorrhoeae being coisolated either from the pharynx (25)(26)(27) or from urogenital sites (28)(29)(30)(31). Consequently, Hodge et al discovered a Neisseria strain that phenotypically resembles N. meningitidis but reacts with serological tests intended for gonococcal confirmation (32).…”