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Molecular characterization of Neisseria meningitidis strains causing non-invasive disease in Portugal from 2012-2024
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Introduction: Non-invasive meningococcal disease (NIMD) is not notifiable, and the prevalence of serogroups and antimicrobial resistance (AMR) are unknown. This study aims to investigate the genetic diversity of non-invasive isolates identified in Portugal (2012-2024), assess their genomic relationships with Portuguese invasive isolates and identify AMR profiles.
Material and Methods: All non-invasive N. meningitidis isolates were characterized by whole genome sequencing and the sequences submitted to the PubMLST/Neisseria.database. For antimicrobial susceptibility testing, antibiotic gradient strip diffusion (Etest) was used.
Results: A total of 141 non-invasive isolates were characterized by WGS with 88% identified from respiratory secretions. Serogroup B was the most prevalent (40.4%), followed by serogroups Y (10.6%), C and E (3.5% each), W, X and Z (1.4% each). Capsule null (cnl) isolates accounted 33.3%. In silico analysis revealed the main clonal complexes (cc): B-cc41/44 (21%) and cc162 (14%), Y-cc23 and cc103 (33.3% each) and cnl-cc53 (38.3%). Isolates belonging to cc11 were predominantly serogroup C (40%) and only 1 isolate was identified as serogroup W. All isolates were sensitive to ceftriaxone and 67.9% of the isolates were penicillin-nonsusceptible, while 2.9% and 3.9% were resistant to ciprofloxacin and rifampicin, respectively.
Conclusions: In this study, we identified non-invasive populations with similar genetic diversity when compared to invasive populations in previous studies[1]. In contrast, NIM isolates showed increased levels of resistance to penicillin and several isolates showed resistance to antibiotics used in IMD prophylaxis. These results emphasise the need for more studies on AMR among meningococci in order to ensure the effective use of antibiotics in the treatment of meningococcal disease.
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Neisseria meningitidis Non-Invasive Meningococcal disease 2012-2024 Infecções Sistémicas e Zoonoses Portugal