Abstract
Introduction: Invasive meningococcal disease (IMD) caused by serogroup W meningococci belonging to the ST-11 complex (MenW:cc11) has been increasing globally since the early 2000s. Penicillin resistance among meningococci due to the production of beta-lactamase remains relatively rare. Isolates displaying resistance and reduced susceptibility to penicillin due to alterations in the penA gene (encoding Penicillin Binding Protein 2) are increasingly reported. In 2016, a penicillin-resistant clade of MenW:cc11 isolates with altered penA genes was identified in Australia. More recently, an increase in penicillin-resistant invasive MenW:cc11 isolates was observed in England. Here, we investigate the distribution of penicillin resistance among English invasive MenW:cc11 isolates.
Methods: Isolates from IMD cases in England from July 2010 to August 2019 underwent whole genome sequencing and antibiotic susceptibility testing as part of routine surveillance. The PubMLST Neisseria database was used to determine the distribution of penicillin resistance among English MenW:cc11 isolates and to identify other closely related isolates.
Results: Twenty-five out of 897 English invasive MenW:cc11 isolates were resistant to penicillin; identified among six distinct sublineages and a singleton. Expansion of the Australian penicillin-resistant clade included isolates from several new countries as well as 20 English isolates. A newly identified penicillin resistance-associated lineage was also identified among several countries.
Conclusion: Penicillin resistance among diverse MenW:cc11 isolates is increasing. Surveillance of antibiotic resistance among meningococci is essential to ensure continued effective use. Crown Copyright (c) 2021 Published by Elsevier Ltd.
| Original language | English |
|---|---|
| Pages (from-to) | 2719-2729 |
| Number of pages | 11 |
| Journal | Vaccine |
| Volume | 39 |
| Issue number | 19 |
| Early online date | 13 Apr 2021 |
| DOIs | |
| Publication status | Published - 6 May 2021 |
Bibliographical note
Funding Information: This publication made use of the Neisseria Multi Locus Sequence Typing website (https://pubmlst.org/ neisseria/) sited at the University of Oxford (Jolley et al. Wellcome Open Res 2018, 3:124). The development of this site has been funded by the Wellcome Trust and European Union. This publication also made use of the Meningitis Research Foundation Meningococcus Genome Library (http://www.meningitis.org/research/genome) developed by Public Health England, the Wellcome Trust Sanger Institute and the University of Oxford as a collaboration. The project is part funded by Meningitis Research Foundation. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.Open Access: This is an open access article under the CC BY license
(http://creativecommons.org/licenses/by/4.0/).
Publisher Copyright: Crown Copyright © 2021 Published by Elsevier Ltd.
Citation: Laura Willerton, Jay Lucidarme, Andrew Walker, Aiswarya Lekshmi, Stephen A. Clark, Steve J. Gray, Ray Borrow, Increase in penicillin-resistant invasive meningococcal serogroup W ST-11 complex isolates in England, Vaccine, Volume 39, Issue 19, 2021, Pages 2719-2729, ISSN 0264-410X.
DOI: https://doi.org/10.1016/j.vaccine.2021.03.002.
Keywords
- Antibiotic resistance
- Meningococcal
- Penicillin resistance
- ST-11 complex
- Serogroup W
- AUSTRALIA
- W135
- NEISSERIA-MENINGITIDIS
- DISEASE
- SUSCEPTIBILITY
- GLOBAL EPIDEMIOLOGY
- NETHERLANDS
