# Clinical and molecular epidemiology of the sexual transmission of Neisseria meningitidis

> **NIH NIH R01** · OHIO STATE UNIVERSITY · 2020 · $603,170

## Abstract

PROJECT SUMMARY/ABSTRACT:
Rapid control of emerging and re-emerging pathogens is essential to reduce transmission, morbidity and cost.
Sexually transmitted diseases (STDs) – which disproportionately affect low-income individuals, racial and
ethnic minority groups, and women – place a tremendous burden on the health of the public, as these
infections are associated with increased risks of cancer, infertility and HIV. The ongoing, high level of STD
transmission suggests that if a novel STD pathogen emerged, it could spread efficiently through established
sexual networks. Among male STD patients in Columbus Ohio, we have identified an ongoing outbreak of
urethritis caused by a distinct, novel clade of non-groupable Neisseria meningitidis (Nm) belonging to the
pathogenic sequence type (ST)-11 clonal complex. Since January 2015, 20% of infections initially thought to
be caused by the endemic STD pathogen Neisseria gonorrhoeae (Ng, the cause of gonorrhea) were ultimately
determined to be caused by Nm. Nm is a Gram-negative diplococcus that normally colonizes the oropharynx
(OP). Whereas Nm has been reported as an occasional urogenital pathogen for decades, the incidence of Nm
urogenital disease is very low and suggests that sexual transmission of this pathogen is typically inefficient.
However, preliminary analyses of urethral isolates from the Columbus outbreak reveal important
genotypic and phenotypic changes in this Nm clade that may contribute to enhanced survival in the
urogenital tract and sexual transmission. The proposed project has two aims. Aim 1 will define the clinical
epidemiology of this distinct, novel Nm clade among STD clinic patients. At the same clinic where the outbreak
was detected, we will screen all adult patients for urogenital Nm infection over a two-year period. Those
reporting recent receptive anal or oral sex will also be screened for rectal and OP Nm infection, respectively.
Patients infected with the outbreak Nm clade (index cases) and their Nm-infected and Nm-uninfected sex
partners will be followed monthly for six months. All participants will provide detailed sexual behavior data and
undergo monthly Nm screening at multiple anatomical sites. We will elucidate who is infected, how and where
they are infected, and the spectrum of symptoms they experience. We will also determine response to
treatment, assess self-clearance in the absence of treatment, characterize the sexual network, and estimate
both the risk of Nm acquisition by sex partners and the risk of reinfection of index cases. Aim 2 will define the
molecular epidemiology and genetic characteristics of the Nm clade that is causing the Columbus outbreak.
Using whole genome sequencing, we will continue to define the genomic profile of the outbreak clade, link
isolates’ genetic characteristics to clinical outcomes and other factors, and determine how the genotypic
features of this clade have evolved over the course of the outbreak. Through innovative characterization...

## Key facts

- **NIH application ID:** 9965724
- **Project number:** 5R01AI127863-04
- **Recipient organization:** OHIO STATE UNIVERSITY
- **Principal Investigator:** Jose A. Bazan
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $603,170
- **Award type:** 5
- **Project period:** 2017-08-09 → 2023-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9965724

## Citation

> US National Institutes of Health, RePORTER application 9965724, Clinical and molecular epidemiology of the sexual transmission of Neisseria meningitidis (5R01AI127863-04). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/9965724. Licensed CC0.

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