Genomic characterization of invasive Neisseria meningitidis in Spain (2011/12-2022/23): expansion of clonal complex 213 and the potential threat to 4CMenB vaccine strain coverage.
Por:
Roca-Grande J, Mir-Cros A, Munoz-Almagro C, Lung M, Bellés-Bellés A, Càmara J, Cercenado E, Galán-Ladero MÁ, Martín-Nalda A, Moreno-Mingorance A, Navarro de la Cruz D, Orellana MÁ, Palop B, Pérez-Argüello A, Puigsech-Boixeda G, Quesada MD, Rivera A, Rodriguez-Fernandez A, Ruiz de Gopegui E, Sarvisé C, Soler-García a, Viñado B, Larrosa N and González-López JJ
Publicada:
1 dic 2025
Ahead of Print:
27 mar 2025
Resumen:
Invasive meningococcal disease (IMD) is associated with significant global morbidity and mortality and is addressed by conjugated polysaccharide and subcapsular vaccines. In Spain, data on 4CMenB vaccine strain coverage and antimicrobial susceptibility are limited. This study aimed to describe the genomic epidemiology, predict 4CMenB vaccine strain coverage, and assess antimicrobial susceptibility of 323 Neisseria meningitidis isolates causing IMD, collected from 57 Clinical Microbiology Laboratories in Spain over 12 years (2011/12-2022/23). Whole genome sequencing was performed to identify serogroup, clonal complex (cc), and antimicrobial resistance determinants. Vaccine strain coverage for serogroup B (MenB) isolates was predicted using the genetic Meningococcal Antigen Typing System approach. The most prevalent serogroups were B (57.9%), W (21.4%), C (10.4%), and Y (8.4%). MenB predominated throughout most seasons, except during the 2019/20 season when serogroup W peaked. Post-COVID-19 pandemic, MenB remained the most frequent (70.2%). Thirteen cc were identified among MenB isolates, with cc213 being the most prevalent (40.1%). Only 28.9% of MenB isolates were predicted to be covered by 4CMenB, with cc213 showing an exceptionally low coverage rate (5.3%) due to antigenic variants poorly targeted by the vaccine. Notably, cc213 was responsible for twice the proportion of MenB cases in 4CMenB-vaccinated versus unvaccinated. All isolates were susceptible to third generation cephalosporins, and 13.5% showed penicillin resistance. This study highlights the alarming prevalence of cc213 among MenB IMD cases in Spain and the limited 4CMenB coverage against this cc. The disproportionate representation of cc213 in vaccinated individuals underscores its potential to compromise vaccine effectiveness.
Filiaciones:
Roca-Grande J:
Microbiology Research Group, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
Department of Genetics and Microbiology, Universitat Autònoma de Barcelona, Bellaterra, Spain
CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
Mir-Cros A:
Microbiology Research Group, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
Munoz-Almagro C:
Infectious Diseases and Microbiome Research Group, Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, Esplugues, Spain
CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
School of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain
Lung M:
Department of Clinical Microbiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain
Bellés-Bellés A:
Department of Clinical Microbiology, Hospital Universitari Arnau de Vilanova, Institut de Recerca Biomèdica de Lleida (IRB-Lleida), Lleida, Spain
Càmara J:
Department of Clinical Microbiology, Hospital Universitari de Bellvitge, IDIBELL-UB, L'Hospitalet de Llobregat, Spain
CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
Cercenado E:
CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
Department of Clinical Microbiology and Infectious Disease, Hospital General Universitario Gregorio Marañón, Madrid, Spain
Galán-Ladero MÁ:
Department of Clinical Microbiology, Hospital Universitario Reina Sofía, Córdoba, Spain
Martín-Nalda A:
Pediatric Infectious Diseases and Immunodeficiencies Unit, Children's Hospital, Hospital Universitari Vall d'Hebron Campus, Barcelona, Spain
Moreno-Mingorance A:
Microbiology Research Group, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
Navarro de la Cruz D:
Department of Clinical Microbiology, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain
Orellana MÁ:
Department of Clinical Microbiology, Hospital Universitario 12 de Octubre, Madrid, Spain
Palop B:
Department of Clinical Microbiology, Hospital Regional Universitario de Málaga, Málaga, Spain
Pérez-Argüello A:
Infectious Diseases and Microbiome Research Group, Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, Esplugues, Spain
Puigsech-Boixeda G:
Microbiology Research Group, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
Department of Genetics and Microbiology, Universitat Autònoma de Barcelona, Bellaterra, Spain
CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
Quesada MD:
Department of Clinical Microbiology, Hospital Universitari Germans Trias i Pujol, UAB, Badalona, Spain
Rivera A:
Department of Genetics and Microbiology, Universitat Autònoma de Barcelona, Bellaterra, Spain
Department of Clinical Microbiology, Hospital de la Santa Creu i Sant Pau, Sant Pau Biomedical Research Institute (IIB Sant Pau), Barcelona, Spain
Rodriguez-Fernandez A:
Department of Clinical Microbiology, Hospital Universitario Marqués de Valdecilla-IDIVAL, Santander, Spain
Ruiz de Gopegui E:
Department of Clinical Microbiology, Hospital Universitario Son Espases, Instituto de Investigación Sanitaria Illes Balears (IdISBa), Palma de Mallorca, Spain
Sarvisé C:
Department of Clinical Microbiology, Hospital Universitari de Tarragona Joan XXIII, Pere Virgili Health Research Institute (IISPV), Tarragona, Spain
Soler-García a:
Infectious Diseases and Microbiome Research Group, Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, Esplugues, Spain
Department of Pediatrics, Hospital Sant Joan de Deu, Esplugues, Spain
Viñado B:
Department of Clinical Microbiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain
Larrosa N:
Microbiology Research Group, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
Department of Genetics and Microbiology, Universitat Autònoma de Barcelona, Bellaterra, Spain
CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
Department of Clinical Microbiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain
González-López JJ:
Microbiology Research Group, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
Department of Genetics and Microbiology, Universitat Autònoma de Barcelona, Bellaterra, Spain
CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
Department of Clinical Microbiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain
Green Submitted, Green Accepted, gold
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