Genomic Characterization of Urethritis-Associated Neisseria meningitidis Shows that a Wide Range of N. meningitidis Strains Can Cause Urethritis

摘要

The genus Neisseria comprises many commensal organisms as well as two primarily pathogenic species. Pathogenic Neisseria species include Neisseria gonorrhoeae (also known as the gonococcus), the etiologic agent of gonorrhea, and N. meningitidis (also known as the meningococcus), the etiologic agent of meningococcal meningitis and meningococcemia. However, the distinction between commensal and pathogen is imprecise: Neisseria strains classically defined as commensals can cause disease, and N. meningitidis strains defined as pathogenic routinely persist asymptomatically in carriers (1). Accordingly, the meningococcus inhabits the nasopharynx commensally in about 10% of the population; this carriage state is likely the source for symptomatic cases of meningococcal disease (1). Furthermore, although N. meningitidis and N. gonorrhoeae were conventionally thought to occupy distinct human ecological niches, case reports in the literature across several decades have indicated that N. meningitidis is capable of invading and colonizing the urethra and in doing so results in urethritis akin to that caused by gonococcal infection (2–4). Oral sex has been strongly associated with many such cases, suggesting that pathogenesis depends on orogenital contact (2, 5, 6).