Emergence of Neisseria meningitidis W South American sublineage strain variant in Brazil: disease and carriage

Abstract

Introduction. Invasive meningococcal disease is a major health problem, impacting morbidity and mortality worldwide. Exploratory genomics has revealed insights into adaptation, transmissibility and virulence to elucidate endemic, outbreaks or epidemics caused by Neisseria meningitidis serogroup W (MenW) strains. Gap Statement. Limited information on the genomics of Neisseria meningitis serogroup W ST11/cc11 is available from emerging countries, especially in contemporary isolates. Aim. To (i) describe the antigenic diversity and distribution of genetic lineages of N. meningitidis serogroup W circulating in Brazil; (ii) study the carriage prevalence of hypervirulent clones in adolescents students and (iii) analyse the potential risk factors for meningococcal carriage. Methodology. Using whole-genome sequencing, we analysed the genomic diversity of 92 invasive N. meningitidis serogroup W isolates circulating in Brazil from 2016 to 2019. A cross-sectional survey of meningococcal carriage was conducted in 2019, in the city of Florianópolis, Brazil, among a representative sample of 538 students. Results. A predominance (58.5 %, 41/82) of ST11/cc11 presenting PorB2-144, PorA VR1–5, VR2-2, FetA 1–1, and a novel fHbp peptide 1241 was found on invasive N. meningitidis W isolates, on the other hand, a high diversity of clonal complexes was found among carriage isolates. The overall carriage rate was 7.5 % (40/538). A total of 28 of 538 swab samples collected were culture positive for N. meningitidis , including four serogroup/genogroup B isolates (14.8 %;4/27), 1 serogroup/genogroup Y isolate (3.7 %;1/27), 22 (81.5 %; 22/27) non-groupable isolates. No MenW isolate was identified among carriages isolates. Conclusion. This report describes the emergence of the new MenW ST11/cc11 South America sublineage variant, named here, 2016 strain, carrying a novel fHbp peptide 1241, but its emergence, was not associated with an increased MenW carriage prevalence. Continuous surveillance is necessary to ascertain the role of this sublineage diversification and how its emergence can impact transmission.

Hypervirulent Strains of Neisseria meningitidis and Clinical Manifestations in Children With Invasive Meningococcal Disease

“…31 In the last decades, publications on molecular information in Latin America have increased, evidencing that in Colombia, cc ST-9493 was observed in MenB between 2013 and 2016 32 and in Chile, since 2011, there was an increase in cases of IMD due to cc ST11, with predominance over the other cc during 2012 and 2013. 17,33,34 Most MenW cc ST-11 strains in this study had an antigen profile: W:P1.5,2:ST-11 (cc11) and fHbp allele 22, which differs from MenW strains identified in Brazilian in recent years (W:P1.5,2:ST-11) with a novel fHbp peptide 1241, 35 or fHbp peptide 24 in MenB. 36 Our study shows a correlation between the clinical manifestations, outcome, and genotypic characterization of N. meningitidis, accounting for the 3 main circulating cc in our country during the 2010-2018 period, with a predominance of the cc ST11.…”

Molecular Сharacterization of <i>Neisseria meningitidis</i> Serogroup W in St. Petersburg

“…Начиная с 2000 г. эти менингококки несут ответственность за крупные эпидемии менингококковой инфекции в «менингитном поясе» в Африке [11], а также эндемические заболевания в Южной Америке, Европе, Соединенном Королевстве и Китае [12][13][14]. Вместе с тем, результаты исследований методом полногеномного секвенирования показали, что N.meningitidis серогруппы W ST11 характеризуются значительной генетической гетерогенностью [15].…”