Experimental nasopharyngeal colonization by Neisseria meningitidis using explant organ culture

This chapter will describe the use of organ cultures of human nasopharyngeal mucosa to study the interaction of Neisseria meningitidis with this complex tissue. Colonization of nasopharyngeal mucosa is the first step in the pathogenesis of meningococcal disease. Supporting evidence for this is the correlation between the prevalence of community carriage and the occurrence of meningococcal disease (1). During nonepidemic periods, the baseline prevalence of nasopharyngeal carriage of meningococci is 5-10% but is considerably higher in certain populations such as military personnel (2), and in households of cases (3). There are a number of influences on the acquisition of meningococcal carriage; these include smoking (4) but not season (5). It is possible that coincident viral infections may affect acquisition of meningococ cal carriage (6,7). There is good evidence that genetic factors are involved, as some individuals appear resistant to acquisition of carriage, while others chronically or intermittently carry N. meningitidis (8). Carriage of the organism also appears to be associated with secretor status (9). The precise site within the nasopharynx that Neisseria meningitidis colonizes and invades is not known. However, during natural carriage, the organism can be isolated both from the rhinopharynx and from the throat (10).