Evolution of sequence type 4821 clonal complex hyperinvasive and quinolone-resistant meningococci

Journal article

Expansion of quinolone-resistant Neisseria meningitidis clone China^{CC4821-R1-C/B} 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^{CC4821-R1-C/B} 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.

Authors: Chen, M; Harrison, OB; Bratcher, HB; Bo, Z; Jolley, KA

• Publication status: Published
• Peer review status: Peer reviewed
• Publisher: Centers for Disease Control and Prevention
• Journal: Emerging Infectious Diseases
• Volume: 27
• Issue: 4
• Pages: 1110-1122
• Publication date: 2021-03-04
• DOI: 10.3201/eid2704.203612
• EISSN: 1080-6059
• ISSN: 1080-6040
• Pmid: 33754991
• Language: English
• Keywords: quinolones; neisseria meningitidis; serogroup; meningococcal infections; meningococcal vaccines; Europe; China