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

• Main Authors: Mingliang Chen, Odile B. Harrison, Holly B. Bratcher, Zhiyan Bo, Keith A. Jolley, Charlene M.C. Rodrigues, James E. Bray, Qinglan Guo, Xi Zhang, Min Chen, Martin C.J. Maiden
• Format: Article
• Language: English
• Published: Centers for Disease Control and Prevention 2021-04-01
• Series: Emerging Infectious Diseases
• Subjects: Neisseria meningitidis; meningitis/encephalitis; ST4821 clonal complex; bacteria; genome; phylogenetic analysis
• Online Access: https://wwwnc.cdc.gov/eid/article/27/4/20-3612_article

Expansion of quinolone-resistant Neisseria meningitidis clone ChinaCC4821-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 ChinaCC4821-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.