title: Meningococcal Carriage in Military Recruits and University Students during the Pre MenB Vaccination Era in Greece (2014-2015).
abstract: OBJECTIVE
  The aim of the study was to estimate the meningococcal carriage rate and to identify the genotypic characteristics of the strains isolated from healthy military recruits and university students in order to provide data that might increase our understanding on the epidemiology of meningococcus and obtain information which helps to evaluate the potential effects on control programs such as vaccination.
  
  
  METHODS
  A total of 1420 oropharyngeal single swab samples were collected from military recruits and university students on voluntary basis, aged 18-26 years. New York City Medium was used for culture and the suspected N. meningitidis colonies were identified by Gram stain, oxidase and rapid carbohydrate utilization tests. Further characterisation was carried out by molecular methods (multiplex PCR, MLST, WGS).
  
  
  RESULTS
  The overall carriage rate was of 12.7%; 15% and 10.4% for recruits and university students respectively. MenB (39.4%) was the most prevalent followed by MenY (12.8%) and MenW (4.4%). Among the initial 76 Non Groupable (NG) isolates, Whole Genome Sequence Analysis (WGS) revealed that 8.3% belonged to MenE, 3.3% to MenX and 1.1% to MenZ, while, 53 strains (29.4%) were finally identified as capsule null. Genetic diversity was found among the MenB isolates, with 41/44 cc and 35 cc predominating.
  
  
  CONCLUSIONS
  Meningococcal carriage rate in both groups was lower compared to our previous studies (25% and 18% respectively) with predominance of MenB isolates. These findings, help to further our understanding on the epidemiology of meningococcal disease in Greece. Although the prevalence of carriage seems to have declined compared to our earlier studies, the predominant MenB clonal complexes (including 41/44cc and 35cc) are associated with invasive meningococcal disease.
authors.affiliation: National Meningitis Reference Laboratory (NMRL), Dept of Public Health, National School of Public Health, Athens, Greece.|European Public Health Microbiology Training Programme (EUPHEM), European Centre For Disease Prevention and Control, Stockholm, Sweden.
authors.forename: Kyriaki
authors.initials: K
authors.lastname: Tryfinopoulou
authors.affiliation: National Meningitis Reference Laboratory (NMRL), Dept of Public Health, National School of Public Health, Athens, Greece.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Kesanopoulos
authors.affiliation: National Meningitis Reference Laboratory (NMRL), Dept of Public Health, National School of Public Health, Athens, Greece.
authors.forename: Athanasia
authors.initials: A
authors.lastname: Xirogianni
authors.affiliation: National Meningitis Reference Laboratory (NMRL), Dept of Public Health, National School of Public Health, Athens, Greece.
authors.forename: Nektarios
authors.initials: N
authors.lastname: Marmaras
authors.affiliation: National Meningitis Reference Laboratory (NMRL), Dept of Public Health, National School of Public Health, Athens, Greece.
authors.forename: Anastasia
authors.initials: A
authors.lastname: Papandreou
authors.affiliation: Third Department of Paediatrics University General Hospital ATTIKON National Kapodistrian University of Athens, Athens, Greece.
authors.forename: Vassiliki
authors.initials: V
authors.lastname: Papaevangelou
authors.affiliation: Second Dept of Paediatrics "Aglaia Kyriakou" Children's Hospital, School of Medicine, National Kapodistrian University of Athens, Athens, Greece.
authors.forename: Maria
authors.initials: M
authors.lastname: Tsolia
authors.affiliation: European Public Health Microbiology Training Programme (EUPHEM), European Centre For Disease Prevention and Control, Stockholm, Sweden.
authors.forename: Aftab
authors.initials: A
authors.lastname: Jasir
authors.affiliation: National Meningitis Reference Laboratory (NMRL), Dept of Public Health, National School of Public Health, Athens, Greece.
authors.forename: Georgina
authors.initials: G
authors.lastname: Tzanakaki
mesh_terms: D000328:Adult; D000942:Antigens, Bacterial / Q000302:isolation & purification*; D002353:Carrier State; D005260:Female; D006115:Greece; D006801:Humans; D008297:Male; D008589:Meningococcal Infections / Q000453:epidemiology* / Q000235:genetics / Q000382:microbiology / Q000635:transmission; D022401:Meningococcal Vaccines / Q000235:genetics / Q000276:immunology; D008889:Military Personnel; D009345:Neisseria meningitidis / Q000235:genetics / Q000302:isolation & purification* / Q000472:pathogenicity; D009960:Oropharynx / Q000382:microbiology; D012703:Serotyping; D013334:Students; D014495:Universities
chemical_list: D000942:Antigens, Bacterial; D022401:Meningococcal Vaccines