TY  - JOUR
A1  - Taha, Muhamed-Kheir
A1  - Claus, Heike
A1  - Lappann, Martin
A1  - Veyrier, Frédéric J.
A1  - Otto, Andreas
A1  - Becher, Dörte
A1  - Deghmane, Ala-Eddine
A1  - Frosch, Matthias
A1  - Hellenbrand, Wiebke
A1  - Hong, Eva
A1  - du Châtelet, Isabelle Parent
A1  - Prior, Karola
A1  - Harmsen, Dag
A1  - Vogel, Ulrich
T1  - Evolutionary Events Associated with an Outbreak of Meningococcal Disease in Men Who Have Sex with Men
JF  - PLoS ONE
N2  - Meningococci spread via respiratory droplets, whereas the closely related gonococci are transmitted sexually. Several outbreaks of invasive meningococcal disease have been reported in Europe and the United States among men who have sex with men (MSM). We recently identified an outbreak of serogroup C meningococcal disease among MSM in Germany and France. In this study, genomic and proteomic techniques were used to analyze the outbreak isolates. In addition, genetically identical urethritis isolates were recovered from France and Germany and included in the analysis. Genome sequencing revealed that the isolates from the outbreak among MSM and from urethritis cases belonged to a clade within clonal complex 11. Proteome analysis showed they expressed nitrite reductase, enabling anaerobic growth as previously described for gonococci. Invasive isolates from MSM, but not urethritis isolates, further expressed functional human factor H binding protein associated with enhanced survival in a newly developed transgenic mouse model expressing human factor H, a complement regulatory protein. In conclusion, our data suggest that urethritis and outbreak isolates followed a joint adaptation route including adaption to the urogenital tract.
KW  - nitrites
KW  - genome sequencing
KW  - men who have sex with men
KW  - meningococcal disease
KW  - Neisseria meningitidis
KW  - Neisseria gonorrhoeae
KW  - mammalian genomics
KW  - mouse models
Y1  - 2016
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-179870
VL  - 11
IS  - 5
ER  - 
TY  - JOUR
A1  - Hellenbrand, Wiebke
A1  - Claus, Heike
A1  - Schink, Susanne
A1  - Marcus, Ulrich
A1  - Wichmann, Ole
A1  - Vogel, Ulrich
T1  - Risk of Invasive Meningococcal Disease in Men Who Have Sex with Men: Lessons Learned from an Outbreak in Germany, 2012-2013
JF  - PLoS ONE
N2  - Background
We undertook investigations in response to an invasive meningococcal disease (IMD) outbreak in men who have sex with men (MSM) in Berlin 2012–2013 to better understand meningococcal transmission and IMD risk in MSM.

Methods
We retrospectively searched for further IMD cases in MSM in Germany through local health departments and undertook exploratory interviews. We performed antigen sequence typing, characterized fHbp and aniA genes of strains with the outbreak finetype and reviewed epidemiologically or spatiotemporally linked cases from 2002–2014.

Results
Among the 148 IMD-cases notified from 01.01.2012–30.09.2013 in 18–59 year-old men we identified 13 MSM in 6 federal states: 11 serogroup C (MenC, all finetype C:P1.5–1,10–8:F3-6), 2 MenB. Interviews with 7 MSM revealed frequent meeting of multiple partners online or via mobile apps and illicit drug use as potential risk factors. MenC incidence was 13-fold higher in MSM than non-MSM. MenC isolates from 9/11 MSM had a novel fHbp allele 766. All C:P1.5–1,10–8:F3-6 strains from MSM versus 16/23 from non-MSM had intact aniA genes (p = 0.04). Although definitive evidence for transmission among MSM in epidemiological or spatiotemporal clusters in 2002–2014 was lacking, clusters were more frequent in men aged 20–49 years. Molecular analysis of C:P1.5–1,10–8:F3-6 strains revealed cases with intact aniA since 2007, mainly associated with fHbp361, fHbp766 and fHbp813, all involving one or more MSM.

Conclusions
MenC incidence was elevated in MSM during the study period. Multiple casual sexual contacts and illicit drug use were common in affected MSM. In all strains from MSM we detected an intact aniA gene coding for a nitrite reductase, which permits survival in microanaerobic environments and could play a role in meningococcal transmission in MSM through urogenital colonization. Furthermore, meningococcal transmission among MSM may be sustained over large areas and thus require modified spatiotemporal scanning algorithms for timely detection and control.
KW  - invasive meningococcal disease
KW  - men who have sex with men
KW  - Germany
Y1  - 2016
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-166842
VL  - 11
IS  - 8
ER  -