Abstract
BACKGROUND: Neisseria meningitidis, known primarily for causing severe sepsis and meningitis, has also been identified as a cause of urethritis. However, reports of such cases in China are scarce. We present two cases of N. meningitidis strains isolated from the urogenital tract in China in 2024. METHODS: Two N. meningitidis isolates were recovered from the urogenital tract. Whole genome sequencing (WGS) was performed to identify genogroup and sequence type (ST), factor H binding protein (fHbp), capsule polysaccharide synthesis (cps) and nitrite reductase (aniA) gene. Phylogenetic analysis was also performed. RESULTS: The first case was an infertile female with significant symptoms of urethritis. The strain isolated from her cervical secretion (FE-07) was identified as genogroup Y, ST-1466, clone complex (cc)-174, fHbp variants 2.21, harboring intact cps locus, and frameshift-mutated aniA gene. The second case was an infertile male presenting with mild pruritus of the glans. The strain recovered from his semen (FE-08) was classified as nongroupable, ST-11026, cc-32, fHbp variants 1.1, harboring incomplete cps locus, and frameshift-mutated aniA gene. Both STs of N. meningitidis have not been reported in China previously and are phylogenetically distinct from strains with the same STs in the NCBI GenBank database. CONCLUSIONS: Our study highlights the emergence of N. meningitidis as a urogenital pathogen in China and underscores the need for vigilance against potential outbreaks of meningococcal urethritis.