Evolution of Sequence Type 4821 Clonal Complex Hyperinvasive and Quinolone-Resistant Meningococci

Expansion of quinolone-resistant Neisseria meningitidis clone China from sequence type (ST) 4821 clonal complex (CC4821) caused a serogroup shift from serogroup A to serogroup C invasive meningococcal disease (IMD) in China. To determine the relationship among globally distributed CC4821 meningococc...

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Bibliographic Details
Published in:Emerging infectious diseases 2021-04, Vol.27 (4), p.1110-1122
Main Authors: Chen, Mingliang, Harrison, Odile B, Bratcher, Holly B, Bo, Zhiyan, Jolley, Keith A, Rodrigues, Charlene M C, Bray, James E, Guo, Qinglan, Zhang, Xi, Chen, Min, Maiden, Martin C J
Format: Article
Language:English
Subjects:
Analysis
Antigens
Antimicrobial agents
bacteria
Causes of
Cloning
Drug resistance
Evolution of Sequence Type 4821 Clonal Complex Hyperinvasive and Quinolone-Resistant Meningococci
Genes
Genetic aspects
genome
Genomes
Meningitis
meningitis/encephalitis
Mutation
Neisseria meningitidis
Original Research
Penicillin
phylogenetic analysis
ST4821 clonal complex
Vaccines
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Summary:Expansion of quinolone-resistant Neisseria meningitidis clone China from sequence type (ST) 4821 clonal complex (CC4821) caused a serogroup shift from serogroup A to serogroup C invasive meningococcal disease (IMD) in China. To determine the relationship among globally distributed CC4821 meningococci, we analyzed whole-genome sequence data from 173 CC4821 meningococci isolated from 4 continents during 1972-2019. These meningococci clustered into 4 sublineages (1-4); sublineage 1 primarily comprised of IMD isolates (41/50, 82%). Most isolates from outside China (40/49, 81.6%) formed a distinct sublineage, the Europe-USA cluster, with the typical strain designation B:P1.17-6,23:F3-36:ST-3200(CC4821), harboring mutations in penicillin-binding protein 2. These data show that the quinolone-resistant clone China has expanded to other countries. The increasing distribution worldwide of serogroup B CC4821 raises the concern that CC4821 has the potential to cause a pandemic that would be challenging to control, despite indirect evidence that the Trumenba vaccine might afford some protection.
ISSN:1080-6040
1080-6059
DOI:10.3201/eid2704.203612