Genomic surveillance of Neisseria meningitidis serogroup B invasive strains: Diversity of vaccine antigen types, Brazil, 2016-2018

Abstract

Background Neisseria meningitidis serogroup B remains a prominent cause of invasive meningococcal disease (IMD) in Brazil. Because two novel protein-based vaccines against serogroup B are available, the main purpose of this study was to provide data on the diversity and distribution of meningococcal vaccine antigen types circulating in Brazil. Methodology Genetic lineages, vaccine antigen types, and allele types of antimicrobial-associated resistance genes based on whole-genome sequencing of a collection of 145 Neisseria meningitidis serogroup B invasive strains recovered in Brazil from 2016 to 2018 were collected. Results A total of 11 clonal complexes (ccs) were identified among the 145 isolates, four of which were predominant, namely, cc461, cc35, cc32, and cc213, accounting for 72.0% of isolates. The most prevalent fHbp peptides were 24 (subfamily A/variant 2), 47 (subfamily A/variant 3), 1 (subfamily B/variant 1) and 45 (subfamily A/variant 3), which were predominantly associated with cc35, cc461, cc32, and cc213, respectively. The NadA peptide was detected in only 26.2% of the isolates. The most frequent NadA peptide 1 was found almost exclusively in cc32. We found seven NHBA peptides that accounted for 74.5% of isolates, and the newly described peptide 1390 was the most prevalent peptide exclusively associated with cc461. Mutated penA alleles were detected in 56.5% of the isolates, whereas no rpoB and gyrA mutant alleles were found. Conclusion During the study period, changes in the clonal structure of circulating strains were observed, without a predominance of a single hyperinvasive lineage, indicating that an epidemiologic shift has occurred that led to a diversity of vaccine antigen types in recent years in Brazil.

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

“…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…”

“…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. The literature describes that these hypervirulent strains could be associated with a higher frequency of serious clinical manifestations such as meningococcemia and worse clinical outcome, with higher PICU admissions and a higher percentage of more atypical presentations, such as septic arthritis.…”