Increase in penicillin-resistant invasive meningococcal serogroup W ST-11 complex isolates in England

Willerton, Laura; Lucidarme, Jay; Walker, A. Earl; Lekshmi, Aiswarya; Clark, S. A.; Gray, Steve; Borrow, Raymond

doi:10.1016/j.vaccine.2021.03.002

Cited by 8 publications

(11 citation statements)

References 36 publications

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“…The increase in PenR serogroup W isolates over the last four years ( S1 Fig ) was due to a rise in the number of serogroup W ST-11 CC isolates harbouring penA9 , as reported previously [ 22 ]. The decrease of serogroup B PenS isolates overtime ( S1 Fig ) was largely due to a decrease in serogroup B PenS ST-41/44 CC isolates with penA1 and ST-269 CC isolates with penA3 and penA27 ( Fig 3 ).…”

Section: Resultssupporting

confidence: 78%

“…The recent increase was largely due to PenR serogroup W ST-11 CC isolates that have emerged in a lineage that originated in South America in the early 2000s, and that has since spread to Europe, Australasia and North America [ 35 – 37 ]. Since 2016, Australia and the UK have both observed an increase in PenR isolates within the so-called original UK W:cc11 strain or the South American strain sublineage [ 22 , 23 ]. Reports of penicillin-resistant meningococcal strains causing IMD in complement deficient individuals receiving chemoprophylaxis [ 38 , 39 ] make this strain particular cause for concern.…”

Section: Discussionmentioning

confidence: 99%

“…Penicillin resistance among meningococci due to the production of beta lactamase is rare, however, has recently been identified among ST-23 CC isolates in the USA [ 12 ]. Penicillin resistance and reduced susceptibility due to amino acid substitutions (AASs) (F504L, A510V, I515V, H541N, and I566V) in penA , encoding penicillin binding protein 2 (PBP2), are more frequently observed worldwide [ 18 – 21 ], and several countries have recently reported an increase in penicillin resistant invasive serogroup W ST-11 CC isolates [ 22 , 23 ].…”

Section: Introductionmentioning

confidence: 99%

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Antibiotic resistance among invasive Neisseria meningitidis isolates in England, Wales and Northern Ireland (2010/11 to 2018/19)

et al. 2021

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Invasive meningococcal disease (IMD), caused by Neisseria meningitidis, can have a fatality rate as high as 10%, even with appropriate treatment. In the UK, penicillin is administered to patients in primary care whilst third generation cephalosporins, cefotaxime and ceftriaxone, are administered in secondary care. The first-choice antibiotic for chemoprophylaxis of close contacts is ciprofloxacin, followed by rifampicin. Immunocompromised individuals are often recommended antibiotic chemoprophylaxis and vaccination due to a greater risk of IMD. Resistance to antibiotics among meningococci is relatively rare, however reduced susceptibility and resistance to penicillin are increasing globally. Resistance to third generation cephalosporins is seldom reported, however reduced susceptibility to both cefotaxime and ceftriaxone has been observed. Rifampicin resistance has been reported among meningococci, mainly following prophylaxis, and ciprofloxacin resistance, whilst uncommon, has also been reported across the globe. The Public Health England Meningococcal Reference Unit receives and characterises the majority of isolates from IMD cases in England, Wales and Northern Ireland. This study assessed the distribution of antibiotic resistance to penicillin, rifampicin, ciprofloxacin and cefotaxime among IMD isolates received at the MRU from 2010/11 to 2018/19 (n = 4,122). Out of the 4,122 IMD isolates, 113 were penicillin-resistant, five were ciprofloxacin-resistant, two were rifampicin-resistant, and one was cefotaxime-resistant. Penicillin resistance was due to altered penA alleles whilst rifampicin and ciprofloxacin resistance was due to altered rpoB and gyrA alleles, respectively. Cefotaxime resistance was observed in one isolate which had an altered penA allele containing additional mutations to those harboured by the penicillin-resistant isolates. This study identified several isolates with resistance to antibiotics used for current treatment and prophylaxis of IMD and highlights the need for continued surveillance of resistance among meningococci to ensure continued effective use.

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Section: Resultssupporting

confidence: 78%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Antibiotic resistance among invasive Neisseria meningitidis isolates in England, Wales and Northern Ireland (2010/11 to 2018/19)

et al. 2021

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“…1 ). This indicates, for the first time, that the penicillin-resistant invasive serogroup W, ST-11 CC lineage circulating in several countries ( 5 , 6 ) has already emerged in Japan. Three penicillin and ciprofloxacin-resistant isolates, NIID576, NIID614, and NIID620, recovered from individuals in different prefectures, were classified as the same nontypeable serogroup ST-32 CC strains harboring both penA33 (identified previously in penicillin-nonsusceptible strains) ( 14 ) and gyrA376 with a T91I substitution responsible for ciprofloxacin resistance ( Fig.…”

Section: Observationmentioning

confidence: 84%

“…A penicillin-resistant isolate NIID669 was classified into serogroup W, ST-11 clonal complex (CC) harboring penA9 , a mosaic penA allele that has been reported in strains with reduced penicillin susceptibility ( 6 , 9 , 14 ), which clustered to a clade of the same serogroup and CC containing penicillin-resistant strains from New Zealand ( penA9 ) ( Fig. 1 ).…”

Section: Observationmentioning

confidence: 99%

Penicillin- and Ciprofloxacin-Resistant Invasive Neisseria meningitidis Isolates from Japan

et al. 2022

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Although antibiotics such as penicillin and ceftriaxone can treat invasive meningococcal disease (IMD), the emergence and spread of antibiotic-resistant Neisseria meningitidis have become a global concern. To provide effective treatment, including chemoprophylaxis to IMD patients and their close contacts, we highlighted the importance of recognizing the antibiotic resistance and genetic features of N. meningitidis isolates.

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An analysis of Neisseria meningitidis strains causing meningococcal septic arthritis in England and Wales: 2010–2020

Gyamfi-Brobbey

Clark

Campbell³

et al. 2022

Journal of Infection

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Increase in penicillin-resistant invasive meningococcal serogroup W ST-11 complex isolates in England

Cited by 8 publications

References 36 publications

Antibiotic resistance among invasive Neisseria meningitidis isolates in England, Wales and Northern Ireland (2010/11 to 2018/19)

Antibiotic resistance among invasive Neisseria meningitidis isolates in England, Wales and Northern Ireland (2010/11 to 2018/19)

Penicillin- and Ciprofloxacin-Resistant Invasive Neisseria meningitidis Isolates from Japan

An analysis of Neisseria meningitidis strains causing meningococcal septic arthritis in England and Wales: 2010–2020

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