{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T03:38:57Z","timestamp":1785901137545,"version":"3.56.0"},"reference-count":23,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2024,11,4]],"date-time":"2024-11-04T00:00:00Z","timestamp":1730678400000},"content-version":"vor","delay-in-days":5,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,10,30]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>4CMenB appears to be effective in reducing Neisseria gonorrhoeae (Ng) infections. Aims are to assess factors associated with breakthrough rectal Ng after 4CMenB and evaluate clinical and microbiological characteristics of breakthrough infections compared with before vaccination.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This was a retrospective study of gay, bisexual, and other men who have sex with men (GBMSM) vaccinated with 4CMenB (2 doses) between 2017 and 2023 at the San Raffaele Scientific Institute for Research, Hospitalization and Healthcare (IRCCS San Raffaele Scientific Institute), Milan, Italy, and tested for rectal Ng. Rectal Ng infection is considered breakthrough if it occurs &amp;gt;1 month after the second 4CMenB dose and with positive nucleic acid amplification test (NAAT) result. Follow-up was from July 2017 (first 4CMenB vaccination) to November 2023 (data freeze). Rectal Ng was screened with both NAAT and gonococcal-specific cultures. Characteristics of individuals with or without breakthrough Ng and of Ng infections before or after 4CMenB were compared using Mann-Whitney and \u03c72\/Fisher tests.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Overall, 473 GBMSM vaccinated with 4CMenB were included, with a median age (interquartile range) of 43 (37\u201351) years; 451 of 473 were living with human immunodeficiency virus. The percentage of NAAT-positive rectal Ng swab samples was 76 of 957 (7.7%) after 4CMenB and 51 of 456 (11.1%) before. Breakthrough rectal Ng after baseline were 76 in 57 of 473 people. People with rectal Ng after 4CMenB were younger, more likely to have a previous sexually transmitted infection, and had more sexual partners than those without (all P &amp;lt; .001). Breakthrough rectal Ng infections were less frequently symptomatic (34.2% vs 66.7%; P = .001) and more likely with negative gonococcal-specific culture (55.3% vs 19.6%; P &amp;lt; .001) compared with before vaccination.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Breakthrough rectal Ng infections after 4CMenB were 76 in 57\/473 people, preferentially identified in GBMSM with higher-risk sexual behaviors, were less often symptomatic, and more often with negative gonococcal-specific cultures, suggesting lower infection virulence.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ofid\/ofae562","type":"journal-article","created":{"date-parts":[[2024,11,4]],"date-time":"2024-11-04T09:23:48Z","timestamp":1730712228000},"source":"Crossref","is-referenced-by-count":6,"title":["Breakthrough Rectal <i>Neisseria gonorrhoeae<\/i> Infections After Meningococcal B Vaccination: Microbiological and Clinical Features"],"prefix":"10.1093","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7811-6255","authenticated-orcid":false,"given":"Angelo Roberto","family":"Raccagni","sequence":"first","affiliation":[{"name":"Infectious Diseases Unit, Vita-Salute San Raffaele University , Milan ,","place":["Italy"]},{"name":"Infectious Diseases Unit, IRCCS San Raffaele Scientific Institute , Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Diotallevi","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, IRCCS San Raffaele Scientific Institute , Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riccardo","family":"Lolatto","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, IRCCS San Raffaele Scientific Institute , Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Bruzzesi","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, Vita-Salute San Raffaele University , Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria del Carmen","family":"Garcia Martearena","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, Vita-Salute San Raffaele University , Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilaria","family":"Mainardi","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, Vita-Salute San Raffaele University , Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caterina","family":"Candela","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, Vita-Salute San Raffaele University , Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana","family":"Canetti","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, IRCCS San Raffaele Scientific Institute , Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Girolamo","family":"Piromalli","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, IRCCS San Raffaele Scientific Institute , Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"Clementi","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, Vita-Salute San Raffaele University , Milan ,","place":["Italy"]},{"name":"Laboratory of Microbiology and Virology, IRCCS San Raffaele Scientific Institute , Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Burioni","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, Vita-Salute San Raffaele University , Milan ,","place":["Italy"]},{"name":"Laboratory of Microbiology and Virology, IRCCS San Raffaele Scientific Institute , Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonella","family":"Castagna","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, Vita-Salute San Raffaele University , Milan ,","place":["Italy"]},{"name":"Infectious Diseases Unit, IRCCS San Raffaele Scientific Institute , Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2673-2731","authenticated-orcid":false,"given":"Silvia","family":"Nozza","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, Vita-Salute San Raffaele University , Milan ,","place":["Italy"]},{"name":"Infectious Diseases Unit, IRCCS San Raffaele Scientific Institute , Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,11,4]]},"reference":[{"key":"2025062420030559700_ofae562-B1","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1038\/s41572-019-0128-6","article-title":"Gonorrhoea","volume":"5","author":"Unemo","year":"2019","journal-title":"Nat Rev Dis Primers"},{"key":"2025062420030559700_ofae562-B2"},{"key":"2025062420030559700_ofae562-B3","doi-asserted-by":"crossref","first-page":"e576","DOI":"10.1016\/S1473-3099(24)00031-8","article-title":"Use of a meningococcal group B vaccine (4CMenB) in populations at high risk of gonorrhoea in the UK","volume":"24","author":"Ladhani","year":"2024","journal-title":"Lancet Infect Dis"},{"key":"2025062420030559700_ofae562-B4","doi-asserted-by":"crossref","first-page":"100738","DOI":"10.1016\/j.lanepe.2023.100738","article-title":"Prevention strategies for sexually transmitted infections, HIV, and viral hepatitis in Europe","volume":"34","author":"G\u00f6kengin","year":"2023","journal-title":"Lancet Reg Health Eur"},{"key":"2025062420030559700_ofae562-B5","doi-asserted-by":"crossref","first-page":"1021","DOI":"10.1016\/S1473-3099(21)00812-4","article-title":"Effectiveness of a serogroup B outer membrane vesicle meningococcal vaccine against gonorrhoea: a retrospective observational study","volume":"22","author":"Abara","year":"2022","journal-title":"Lancet Infect Dis"},{"key":"2025062420030559700_ofae562-B6","doi-asserted-by":"crossref","first-page":"e1341","DOI":"10.1093\/cid\/ciac436","article-title":"Prevention of Neisseria gonorrhoeae with meningococcal B vaccine: a matched cohort study in Southern California","volume":"76","author":"Bruxvoort","year":"2023","journal-title":"Clin Infect Dis"},{"key":"2025062420030559700_ofae562-B7","doi-asserted-by":"crossref","first-page":"1011","DOI":"10.1016\/S1473-3099(21)00754-4","article-title":"Effectiveness and impact of the 4CMenB vaccine against invasive serogroup B meningococcal disease and gonorrhoea in an infant, child, and adolescent programme: an observational cohort and case-control study","volume":"22","author":"Wang","year":"2022","journal-title":"Lancet Infect Dis"},{"key":"2025062420030559700_ofae562-B8","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1016\/j.jinf.2023.05.021","article-title":"4CMenB sustained vaccine effectiveness against invasive meningococcal B disease and gonorrhoea at three years post programme implementation","volume":"87","author":"Wang","year":"2023","journal-title":"J Infect"},{"key":"2025062420030559700_ofae562-B9","first-page":"247","article-title":"Meningococcus B vaccination effectiveness against Neisseria gonorrhoeae infection in people living with HIV: a case-control study","volume":"50","author":"Raccagni","year":"2023","journal-title":"Sex Transm Dis"},{"key":"2025062420030559700_ofae562-B10","doi-asserted-by":"crossref","first-page":"1603","DOI":"10.1016\/S0140-6736(17)31449-6","article-title":"Effectiveness of a group B outer membrane vesicle meningococcal vaccine against gonorrhoea in New Zealand: a retrospective case-control study","volume":"390","author":"Petousis-Harris","year":"2017","journal-title":"Lancet"},{"key":"2025062420030559700_ofae562-B11","doi-asserted-by":"crossref","first-page":"5","DOI":"10.3390\/vaccines7010005","article-title":"Effectiveness of a group B outer membrane vesicle meningococcal vaccine in preventing hospitalization from gonorrhea in New Zealand: a retrospective cohort study","volume":"7","author":"Paynter","year":"2019","journal-title":"Vaccines (Basel)"},{"key":"2025062420030559700_ofae562-B12","doi-asserted-by":"crossref","first-page":"1030","DOI":"10.1016\/S1473-3099(21)00744-1","article-title":"Public health impact and cost-effectiveness of gonorrhoea vaccination: an integrated transmission-dynamic health-economic modelling analysis","volume":"22","author":"Whittles","year":"2022","journal-title":"Lancet Infect Dis"},{"key":"2025062420030559700_ofae562-B13","doi-asserted-by":"crossref","first-page":"e1008602","DOI":"10.1371\/journal.ppat.1008602","article-title":"The serogroup B meningococcal outer membrane vesicle-based vaccine 4CMenB induces cross-species protection against Neisseria gonorrhoeae","volume":"16","author":"Leduc","year":"2020","journal-title":"PLoS Pathog"},{"key":"2025062420030559700_ofae562-B14","doi-asserted-by":"crossref","first-page":"1101","DOI":"10.1093\/cid\/ciy1061","article-title":"The serogroup B meningococcal vaccine Bexsero elicits antibodies to Neisseria gonorrhoeae","volume":"69","author":"Semchenko","year":"2019","journal-title":"Clin Infect Dis"},{"key":"2025062420030559700_ofae562-B15","doi-asserted-by":"crossref","first-page":"2696","DOI":"10.1136\/bmj.p2696","article-title":"Routinely offer MenB jabs to prevent gonorrhoea, UK vaccine committee recommends","volume":"383","author":"Mahase","year":"2023","journal-title":"BMJ"},{"key":"2025062420030559700_ofae562-B16","doi-asserted-by":"crossref","first-page":"937","DOI":"10.1016\/S1473-3099(22)00343-7","article-title":"We need estimates of gonorrhoea vaccine protection and symptomaticity by sex and anatomical site","volume":"22","author":"White","year":"2022","journal-title":"Lancet Infect Dis"},{"key":"2025062420030559700_ofae562-B17","doi-asserted-by":"crossref","first-page":"633","DOI":"10.3201\/eid3004.231392","article-title":"Concurrent outbreaks of hepatitis A, invasive meningococcal disease, and mpox, Florida, USA, 2021-2022","volume":"30","author":"Doyle","year":"2024","journal-title":"Emerg Infect Dis"},{"key":"2025062420030559700_ofae562-B18","doi-asserted-by":"crossref","first-page":"1296","DOI":"10.1056\/NEJMoa2211934","article-title":"Postexposure doxycycline to prevent bacterial sexually transmitted infections","volume":"388","author":"Luetkemeyer","year":"2023","journal-title":"N Engl J Med"},{"key":"2025062420030559700_ofae562-B19","doi-asserted-by":"crossref","first-page":"370","DOI":"10.1111\/hiv.13586","article-title":"Propositive follow-up: long-term immune responses to the 4CMenB and MenACWY vaccines in people living with HIV","volume":"25","author":"San Francisco Ramos","year":"2024","journal-title":"HIV Med"},{"key":"2025062420030559700_ofae562-B20","doi-asserted-by":"crossref","first-page":"1093","DOI":"10.1016\/S1473-3099(24)00236-6","article-title":"Doxycycline prophylaxis and meningococcal group B vaccine to prevent bacterial sexually transmitted infections in France (ANRS 174 DOXYVAC): a multicentre, open-label, randomised trial with a 2\u2008\u00d7\u20082 factorial design","volume":"24","author":"Molina","year":"2024","journal-title":"Lancet Infect Dis"},{"key":"2025062420030559700_ofae562-B21","first-page":"e8","article-title":"Healthy vaccinee bias and MenB-FHbp vaccine effectiveness against gonorrhea","volume":"50","author":"Abara","year":"2023","journal-title":"Sex Transm Dis"},{"key":"2025062420030559700_ofae562-B22","doi-asserted-by":"crossref","first-page":"e543","DOI":"10.1016\/S1473-3099(24)00452-3","article-title":"The potential role of the 4CMenB vaccine in combating gonorrhoea: the need for nuance in interpreting the DOXYVAC trial","volume":"24","author":"White","year":"2024","journal-title":"Lancet Infect Dis"},{"key":"2025062420030559700_ofae562-B23","doi-asserted-by":"crossref","first-page":"540","DOI":"10.1097\/OLQ.0000000000001981","article-title":"Trends of antimicrobial susceptibility of Neisseria gonorrhoeae isolates between 2012 and 2023: results from an open Italian cohort","volume":"51","author":"Lucente","year":"2024","journal-title":"Sex Transm Dis"}],"container-title":["Open Forum Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ofid\/article-pdf\/11\/11\/ofae562\/60793673\/ofae562.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ofid\/article-pdf\/11\/11\/ofae562\/60793673\/ofae562.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,25]],"date-time":"2025-06-25T00:03:17Z","timestamp":1750809797000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ofid\/article\/doi\/10.1093\/ofid\/ofae562\/7863731"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10,30]]},"references-count":23,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2024,10,30]]}},"URL":"https:\/\/doi.org\/10.1093\/ofid\/ofae562","relation":{},"ISSN":["2328-8957"],"issn-type":[{"value":"2328-8957","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2024,11]]},"published":{"date-parts":[[2024,10,30]]},"article-number":"ofae562"}}