Meningococcal disease - Bristol

Creation of sample collection from "Be on the TEAM" study throat swabs for molecular (PCR) analysis of meningococcal carriage and carriage density

Meningitis Now University of Bristol research - meningococcal disease

Background

Meningococcal group B bacteria (MenB) are a common cause of meningitis and sepsis in the UK. Bexsero and Trumenba are two new vaccines designed to protect against MenB infection. 

Bexsero has been offered to all babies in the UK since 2015 and is reducing the numbers of cases of meningitis and sepsis in young children. Although there is strong public support for offering MenB vaccine to older children, it is harder to justify the cost as there are fewer cases in this age group. 

However, teenagers carry high numbers of bacteria in the back of their throats, so if MenB vaccines also reduce the chance of those teenagers carrying MenB bacteria, the cost of giving them the vaccine would be worthwhile as this could reduce cases of MenB infection in all age groups. This is called ‘herd immunity’. The government is funding a large study, called “Be on the TEAM” (teenagers against meningitis) in an attempt to find out whether this happens.

What the research team will do

This project will bring together all the swabs collected in the Be on the TEAM study and the bacterial growth from the first analysis – which detects carriers using culture alone – into a single collection. Subject to future funding, these samples can then be investigated further by molecular analysis. 

Over the last 5 years, researchers in Bristol have been developing new techniques for studying throat carriage of meningitis-causing bacteria. This has improved ways to take and store throat swabs.  

By combining a technique that detects bacterial DNA called polymerase chain reaction (PCR) with conventional methods of growing the bacteria it is possible to detect twice as many carriers. The PCR method alone can also accurately and inexpensively measure the number of bacteria in a swab sample.

How this research will help fight meningitis

Molecular analysis (PCR) of this large collection of samples will provide vital information about the impact of MenB vaccination on bacterial carriage in teenagers, and potentially produce evidence to influence immunisation policy.

By assembling and preserving all these samples into a single collection, the researchers are also creating a resource for future investigation into other aspects of upper respiratory tract microbiology in teenagers.

Progress so far - June 2021

The aim of this project is to collect and preserve the throat swabs and bacterial cultures from participants in the Be on the TEAM study into a single collection. This will provide a resource for future molecular analysis of meningococcal carriage rates and densities.

By March 2020, more than 21,000 samples had been transferred from study sites around the UK for storage in Bristol.

The arrival of the Covid-19 pandemic in the UK, together with the subsequent first UK lockdown and resulting school closures meant that study vaccination and sampling clinics had to close in March 2020. It was hoped that the collection of the outstanding samples would just be delayed, but unfortunately the study was terminated early, with no further sample collection possible. At this point, roughly half of participants enrolled had completed their study participation.

About 1,000 samples were collected from young people during February and March 2020, during the early phase of the Covid-19 pandemic in the UK. Additional funding from Oxford BRC and the Rockinghorse charity in Brighton enabled these samples to be analysed for the presence of SARS-CoV-2 (the virus causing the pandemic). The results of this analysis are currently being prepared for publication.

There are still samples at various study sites around the UK and these will hopefully be transferred to Bristol over the next few months.

Help support this research

This research has been made possible thanks to the generous support of The Starfish Trust and A Life for A Cure. Help us continue by donating, or raising funds for our work. On behalf of everyone who will benefit, now and in the future, thank you.

Researchers

Professor Adam Finn, Dr Matthew Snape, Dr Caroline Trotter and Professor Martin Maiden.

Institution

University of Bristol.

More information 

If you would like more information about this project, or our research in general, please contact research@meningitisnow.org.