{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T11:36:05Z","timestamp":1785411365592,"version":"3.56.0"},"reference-count":58,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T00:00:00Z","timestamp":1778544000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["R01AI127863"],"award-info":[{"award-number":["R01AI127863"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"award":["R01AI127863"],"award-info":[{"award-number":["R01AI127863"]}],"id":[{"id":"https:\/\/ror.org\/043z4tv69","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>Asymptomatic pharyngeal Neisseria meningitidis (Nm) carriage is seen in &gt;30% of sexually transmitted infection (STI) clinic attendees. With increasing reports of Nm urethritis and STI-related invasive disease outbreaks, longitudinal assessment and genomic characterization of Nm among patients at an urban STI clinic population in Columbus, Ohio, was undertaken. This study determined the genomic basis of oropharyngeal, urogenital and rectal Nm isolates carried by patients presenting for care. Cultures using media selective for Neisseria spp., Nm-specific PCR screening of colonies with oxidase-positive Gram-negative diplococci, PCR-based genogrouping and whole-genome sequencing of confirmed Nm were performed. Overall, genomic data of 453 oropharyngeal, 10 urethral, 5 rectal and 1 cervical Nm isolate were obtained between January 2018 and December 2019. Among oropharyngeal Nm isolates, genogrouping identified 37.7% as cnl (capsule null locus), 28% B, 13.5% E, 10.8% Z, 2.6% C and 2.6% Y. However, the cps locus was inactivated in \u226580% of isolates with specified genogroups. The major clonal complexes (ccs) were cc53, cc32, cc41\/44, cc1157, cc198 and cc4821. Two oropharyngeal, one rectal and three urethral isolates belonged to the ST-11 Nm urethritis clade (NmUC). Group Y ST-1466 Nm, recently linked to global urogenital and systemic infections, was also identified in the oropharynx.<\/jats:p>","DOI":"10.3390\/pathogens15050516","type":"journal-article","created":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T13:11:31Z","timestamp":1779196291000},"page":"516","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Genomic Typing of Meningococcal Carriage Isolates in an Urban Sexual Health Clinic"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7950-8197","authenticated-orcid":false,"given":"Yih-Ling","family":"Tzeng","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA 30322, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soma","family":"Sannigrahi","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA 30322, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abigail Norris","family":"Turner","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, OH 43210, USA"},{"name":"Sexual Health Clinic, Columbus Public Health, Columbus, OH 43215, USA"},{"name":"Division of Epidemiology, The Ohio State University College of Public Health, Columbus, OH 43210, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5024-1935","authenticated-orcid":false,"given":"Alexandria M.","family":"Carter","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, OH 43210, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brandon","family":"Snyder","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, OH 43210, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose A.","family":"Bazan","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, OH 43210, USA"},{"name":"Sexual Health Clinic, Columbus Public Health, Columbus, OH 43215, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David S.","family":"Stephens","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA 30322, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2196","DOI":"10.1016\/S0140-6736(07)61016-2","article-title":"Epidemic meningitis, meningococcaemia, and Neisseria meningitidis","volume":"369","author":"Stephens","year":"2007","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"821","DOI":"10.1099\/jmm.0.45529-0","article-title":"Neisseria meningitidis: An overview of the carriage state","volume":"53","author":"Yazdankhah","year":"2004","journal-title":"J. Med. Microbiol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1017\/S0950268800066449","article-title":"The Stonehouse survey: Nasopharyngeal carriage of meningococci and Neisseria lactamica","volume":"99","author":"Cartwright","year":"1987","journal-title":"Epidemiol. Infect."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"566","DOI":"10.3201\/eid1904.111799","article-title":"Description and nomenclature of Neisseria meningitidis capsule locus","volume":"19","author":"Harrison","year":"2013","journal-title":"Emerg. Infect. Dis."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"63","DOI":"10.3201\/eid1801.110901","article-title":"Invasive meningococcal capsular group Y disease, England and Wales, 2007\u20132009","volume":"18","author":"Ladhani","year":"2012","journal-title":"Emerg. Infect. Dis."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"973","DOI":"10.15585\/mmwr.mm7343a3","article-title":"Statewide Outbreak of Neisseria meningitidis Serogroup Y, Sequence Type 1466-Virginia, 2022\u20132024","volume":"73","author":"Robinson","year":"2024","journal-title":"MMWR Morb. Mortal. Wkly. Rep."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"B64","DOI":"10.1016\/j.vaccine.2009.04.061","article-title":"Meningococcal carriage and disease--population biology and evolution","volume":"27","author":"Caugant","year":"2009","journal-title":"Vaccine"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Watkins, E.R., and Maiden, M.C. (2012). Persistence of hyperinvasive meningococcal strain types during global spread as recorded in the PubMLST database. PLoS ONE, 7.","DOI":"10.1371\/journal.pone.0045349"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1136\/sextrans-2021-055173","article-title":"Molecular characterisation and antibiotic susceptibility of meningococcal isolates from healthy men who have sex with men","volume":"98","author":"Neri","year":"2022","journal-title":"Sex. Transm. Infect."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1097\/OLQ.0000000000001205","article-title":"Carriage of Neisseria meningitidis in Men Who Have Sex with Men Presenting to Public Sexual Health Clinics, New York City","volume":"47","author":"Ngai","year":"2020","journal-title":"Sex. Transm. Dis."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1007\/s10096-023-04550-8","article-title":"Meningococcal carriage in men who have sex with men presenting at a sexual health unit in Spain","volume":"42","author":"Carballo","year":"2023","journal-title":"Eur. J. Clin. Microbiol. Infect. Dis."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1016\/j.ijid.2021.02.062","article-title":"Oral and anal carriage of Neisseria meningitidis among sexually active HIV-infected men who have sex with men in Denmark 2014\u201315","volume":"105","author":"Tinggaard","year":"2021","journal-title":"Int. J. Infect. Dis."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1136\/sextrans-2016-052781","article-title":"Genomic analysis of urogenital and rectal Neisseria meningitidis isolates reveals encapsulated hyperinvasive meningococci and coincident multidrug-resistant gonococci","volume":"93","author":"Harrison","year":"2017","journal-title":"Sex. Transm. Infect."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1060","DOI":"10.15585\/mmwr.mm6738a4","article-title":"Meningococcal Disease Surveillance in Men Who Have Sex with Men-United States, 2015\u20132016","volume":"67","author":"Bozio","year":"2018","journal-title":"MMWR Morb. Mortal. Wkly. Rep."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1136\/sextrans-2024-056269","article-title":"Invasive Neisseria meningitidis subtype C in gay, bisexual and other men who have sex with men: A systematic review","volume":"101","author":"Rabuszko","year":"2025","journal-title":"Sex. Transm. Infect."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1093\/cid\/cix215","article-title":"Large Cluster of Neisseria meningitidis Urethritis in Columbus, Ohio, 2015","volume":"65","author":"Bazan","year":"2017","journal-title":"Clin. Infect. Dis."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Brooks, A., Lucidarme, J., Campbell, H., Campbell, L., Fifer, H., Gray, S., Hughes, G., Lekshmi, A., Schembri, G., and Rayment, M. (2020). Detection of the United States Neisseria meningitidis urethritis clade in the United Kingdom, August and December 2019-emergence of multiple antibiotic resistance calls for vigilance. Euro Surveill., 25.","DOI":"10.2807\/1560-7917.ES.2020.25.15.2000375"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"2130","DOI":"10.3201\/eid2910.221596","article-title":"Outbreak of Sexually Transmitted Nongroupable Neisseria meningitidis-Associated Urethritis, Vietnam","volume":"29","author":"Nguyen","year":"2023","journal-title":"Emerg. Infect. Dis."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Retchless, A.C., Kretz, C.B., Chang, H.Y., Bazan, J.A., Abrams, A.J., Norris Turner, A., Jenkins, L.T., Trees, D.L., Tzeng, Y.L., and Stephens, D.S. (2018). Expansion of a urethritis-associated Neisseria meningitidis clade in the United States with concurrent acquisition of N. gonorrhoeae alleles. BMC Genom., 19.","DOI":"10.1186\/s12864-018-4560-x"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"2210","DOI":"10.3201\/eid2911.231082","article-title":"Detection of Novel US Neisseria meningitidis Urethritis Clade Subtypes in Japan","volume":"29","author":"Takahashi","year":"2023","journal-title":"Emerg. Infect. Dis."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"e01699-20","DOI":"10.1128\/JCM.01699-20","article-title":"Genomic characterization of emerging bacterial uropathogen Neisseria meningitidis misidentified as Neisseria gonorrhoeae by nucleic acid amplification testing","volume":"59","author":"Sukhum","year":"2020","journal-title":"J. Clin. Microbiol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"e0057522","DOI":"10.1128\/jcm.00575-22","article-title":"Meningococcal Urethritis: Old and New","volume":"60","author":"Burns","year":"2022","journal-title":"J. Clin. Microbiol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"4237","DOI":"10.1073\/pnas.1620971114","article-title":"Emergence of a new Neisseria meningitidis clonal complex 11 lineage 11.2 clade as an effective urogenital pathogen","volume":"114","author":"Tzeng","year":"2017","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_24","unstructured":"Health Alert Network (2025, April 25). Increase in Invasive Serogroup Y Meningococcal Disease in the United States. Center for Preparedness and Response (CPR): The CDC Health Alert Network, Available online: https:\/\/www.cdc.gov\/han\/2024\/han00505.html."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Dolan Thomas, J., Hatcher, C.P., Satterfield, D.A., Theodore, M.J., Bach, M.C., Linscott, K.B., Zhao, X., Wang, X., Mair, R., and Schmink, S. (2011). sodC-based real-time PCR for detection of Neisseria meningitidis. PLoS ONE, 6.","DOI":"10.1371\/journal.pone.0019361"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1089\/cmb.2012.0021","article-title":"SPAdes: A new genome assembly algorithm and its applications to single-cell sequencing","volume":"19","author":"Bankevich","year":"2012","journal-title":"J. Comput. Biol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"e01609-18","DOI":"10.1128\/JCM.01609-18","article-title":"Whole-Genome Sequencing for Characterization of Capsule Locus and Prediction of Serogroup of Invasive Meningococcal Isolates","volume":"57","author":"Marjuki","year":"2019","journal-title":"J. Clin. Microbiol."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Buono, S.A., Kelly, R.J., Topaz, N., Retchless, A.C., Silva, H., Chen, A., Ramos, E., Doho, G., Khan, A.N., and Okomo-Adhiambo, M.A. (2020). Web-Based Genome Analysis of Bacterial Meningitis Pathogens for Public Health Applications Using the Bacterial Meningitis Genomic Analysis Platform (BMGAP). Front. Genet., 11.","DOI":"10.3389\/fgene.2020.601870"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"4690","DOI":"10.1016\/j.vaccine.2016.08.015","article-title":"Distribution of Bexsero(R) Antigen Sequence Types (BASTs) in invasive meningococcal disease isolates: Implications for immunisation","volume":"34","author":"Brehony","year":"2016","journal-title":"Vaccine"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"19490","DOI":"10.1073\/pnas.1013758107","article-title":"Qualitative and quantitative assessment of meningococcal antigens to evaluate the potential strain coverage of protein-based vaccines","volume":"107","author":"Donnelly","year":"2010","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"6086","DOI":"10.1016\/j.vaccine.2010.06.083","article-title":"Broad vaccine coverage predicted for a bivalent recombinant factor H binding protein based vaccine to prevent serogroup B meningococcal disease","volume":"28","author":"Jiang","year":"2010","journal-title":"Vaccine"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"e00036-18","DOI":"10.1128\/mBio.00036-18","article-title":"Predicting the Susceptibility of Meningococcal Serogroup B Isolates to Bactericidal Antibodies Elicited by Bivalent rLP2086, a Novel Prophylactic Vaccine","volume":"9","author":"McNeil","year":"2018","journal-title":"mBio"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"e02161-20","DOI":"10.1128\/JCM.02161-20","article-title":"Meningococcal Deduced Vaccine Antigen Reactivity (MenDeVAR) Index: A Rapid and Accessible Tool That Exploits Genomic Data in Public Health and Clinical Microbiology Applications","volume":"59","author":"Rodrigues","year":"2020","journal-title":"J. Clin. Microbiol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1395","DOI":"10.1101\/gr.232397.117","article-title":"GrapeTree: Visualization of core genomic relationships among 100,000 bacterial pathogens","volume":"28","author":"Zhou","year":"2018","journal-title":"Genome Res."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"647","DOI":"10.1046\/j.1365-2958.1998.01101.x","article-title":"A gonococcal porA pseudogene: Implications for understanding the evolution and pathogenicity of Neisseria gonorrhoeae","volume":"30","author":"Feavers","year":"1998","journal-title":"Mol. Microbiol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"S212","DOI":"10.1093\/ofid\/ofz360.493","article-title":"Prevalence of Oropharyngeal Meningococcal Carriage in an Urban STD Clinic","volume":"6","author":"Turner","year":"2019","journal-title":"Open Forum Infect. Dis."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Jolley, K.A., and Maiden, M.C. (2010). BIGSdb: Scalable analysis of bacterial genome variation at the population level. BMC Bioinform., 11.","DOI":"10.1186\/1471-2105-11-595"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"558","DOI":"10.1016\/j.meegid.2008.04.002","article-title":"Genetics and evolution of Neisseria meningitidis: Importance for the epidemiology of meningococcal disease","volume":"8","author":"Caugant","year":"2008","journal-title":"Infect. Genet. Evol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"ofac661","DOI":"10.1093\/ofid\/ofac661","article-title":"Antibiotic Susceptibility Profile for the US Neisseria meningitidis Urethritis Clade","volume":"10","author":"Bazan","year":"2023","journal-title":"Open Forum Infect. Dis."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1127","DOI":"10.1128\/JCM.44.3.1127-1131.2006","article-title":"Consecutive use of two multiplex PCR-based assays for simultaneous identification and determination of capsular status of nine common Neisseria meningitidis serogroups associated with invasive disease","volume":"44","author":"Bennett","year":"2006","journal-title":"J. Clin. Microbiol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1764","DOI":"10.1128\/JCM.42.4.1764-1765.2004","article-title":"PCR-based assay for detection of Neisseria meningitidis capsular serogroups 29E, X, and Z","volume":"42","author":"Bennett","year":"2004","journal-title":"J. Clin. Microbiol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1761","DOI":"10.1093\/cid\/ciz767","article-title":"Genomic Characterization of Recent and Historic Meningococcal Serogroup E Invasive Disease in Australia: A Case Series","volume":"70","author":"Thangarajah","year":"2020","journal-title":"Clin. Infect. Dis."},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Whaley, M.J., Vuong, J.T., Topaz, N., Chang, H.Y., Thomas, J.D., Jenkins, L.T., Hu, F., Schmink, S., Steward-Clark, E., and Mathis, M. (2022). Genomic Insights on Variation Underlying Capsule Expression in Meningococcal Carriage Isolates from University Students, United States, 2015\u20132016. Front. Microbiol., 13.","DOI":"10.3389\/fmicb.2022.815044"},{"key":"ref_44","unstructured":"CDC (2026, February 25). Meningococcal Disease Surveillance and Trends, Available online: https:\/\/www.cdc.gov\/meningococcal\/php\/surveillance\/index.html."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Sankaranarayanan, K., Peifer, A., Prussing, C., Owuor Bielli, E., Owens, E., Wahl, K., Kidney, A., Haas, W., Ojha, A., and Vaughn, C.B. (2025). Investigation of invasive Neisseria meningitidis serogroup Y ST1466 case increases in New York State. Front. Public Health, 13.","DOI":"10.3389\/fpubh.2025.1709761"},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Lahra, M.M., Latham, N.H., Templeton, D.J., Read, P., Carmody, C., Ryder, N., Ellis, S.E., Madden, E.F., Parasuraman, A., and Wells, J. (2024). Investigation and response to an outbreak of Neisseria meningitidis serogroup Y ST-1466 urogenital infections, Australia. Commun. Dis. Intell., 48.","DOI":"10.33321\/cdi.2024.48.20"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"591","DOI":"10.3109\/00365548.2015.1010228","article-title":"First case of Neisseria meningitidis capsule null locus infection in China","volume":"47","author":"Xu","year":"2015","journal-title":"Infect. Dis."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1110","DOI":"10.3201\/eid2704.203612","article-title":"Evolution of Sequence Type 4821 Clonal Complex Hyperinvasive and Quinolone-Resistant Meningococci","volume":"27","author":"Chen","year":"2021","journal-title":"Emerg. Infect. Dis."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"683","DOI":"10.3201\/eid2404.171744","article-title":"Evolution of Sequence Type 4821 Clonal Complex Meningococcal Strains in China from Prequinolone to Quinolone Era, 1972\u20132013","volume":"24","author":"Guo","year":"2018","journal-title":"Emerg. Infect. Dis."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1016\/j.ijid.2014.08.022","article-title":"CC4821 serogroup W meningococcal disease in China","volume":"29","author":"He","year":"2014","journal-title":"Int. J. Infect. Dis."},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Lucidarme, J., Zhu, B., Xu, L., Bai, X., Gao, Y., Gonzalez-Lopez, J.J., Mulhall, R., Scott, K.J., Smith, A., and Stefanelli, P. (2020). Genomic analysis of the meningococcal ST-4821 complex-Western clade, potential sexual transmission and predicted antibiotic susceptibility and vaccine coverage. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0243426"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"376","DOI":"10.1056\/NEJMe1916440","article-title":"Good News and Bad News-4CMenB Vaccine for Group B Neisseria meningitidis","volume":"382","author":"Harrison","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_53","first-page":"100966","article-title":"The genomic epidemiology of Neisseria meningitidis carriage from a randomised controlled trial of 4CMenB vaccination in an asymptomatic adolescent population","volume":"43","author":"Leong","year":"2024","journal-title":"Lancet Reg. Health West. Pac."},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"Morselli, S., Gaspari, V., Cantiani, A., Salvo, M., Foschi, C., Lazzarotto, T., and Marangoni, A. (2021). Meningococcal Carriage in \u2018Men Having Sex with Men\u2019 With Pharyngeal Gonorrhoea. Front. Cell. Infect. Microbiol., 11.","DOI":"10.3389\/fcimb.2021.798575"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1128\/mSphere.00197-20","article-title":"Insights on Population Structure and Within-Host Genetic Changes among Meningococcal Carriage Isolates from U.S. Universities","volume":"5","author":"Joseph","year":"2020","journal-title":"mSphere"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"e00855-21","DOI":"10.1128\/mBio.00855-21","article-title":"Genetic Diversity of Meningococcal Serogroup B Vaccine Antigens among Carriage Isolates Collected from Students at Three Universities in the United States, 2015\u20132016","volume":"12","author":"Marjuki","year":"2021","journal-title":"mBio"},{"key":"ref_57","first-page":"759","article-title":"Regulation of capsule in Neisseria meningitidis","volume":"42","author":"Tzeng","year":"2016","journal-title":"Crit. Rev. Microbiol."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"e03068-19","DOI":"10.1128\/mBio.03068-19","article-title":"Localized Hypermutation is the Major Driver of Meningococcal Genetic Variability during Persistent Asymptomatic Carriage","volume":"11","author":"Green","year":"2020","journal-title":"mBio"}],"container-title":["Pathogens"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-0817\/15\/5\/516\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T13:30:37Z","timestamp":1779197437000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-0817\/15\/5\/516"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,12]]},"references-count":58,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2026,5]]}},"alternative-id":["pathogens15050516"],"URL":"https:\/\/doi.org\/10.3390\/pathogens15050516","relation":{},"ISSN":["2076-0817"],"issn-type":[{"value":"2076-0817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,12]]}}}