{Reference Type}: Journal Article
{Title}: Genomic diversity and antimicrobial susceptibility of invasive Neisseria meningitidis in South Africa, 2016-2021.
{Author}: Mikhari RL;Meiring S;de Gouveia L;Chan WY;Jolley KA;Van Tyne D;Harrison LH;Marjuki H;Ismail A;Quan V;Cohen C;Walaza S;von Gottberg A;du Plessis M;
{Journal}: J Infect Dis
{Volume}: 0
{Issue}: 0
{Year}: 2024 Apr 30
{Factor}: 7.759
{DOI}: 10.1093/infdis/jiae225
{Abstract}: <B>BACKGROUND: </B>Invasive meningococcal isolates in South Africa have in previous years (<2008) been characterized by serogroup B, C, W and Y lineages over time, with penicillin intermediate resistance (peni) at 6%. We describe the population structure and genomic markers of peni among invasive meningococcal isolates in South Africa, 2016-2021.<BR><B>METHODS: </B>Meningococcal isolates were collected through national, laboratory-based invasive meningococcal disease (IMD) surveillance. Phenotypic antimicrobial susceptibility testing and whole-genome sequencing were performed, and the mechanism of reduced penicillin susceptibility was assessed in silico.<BR><B>RESULTS: </B>Of 585 IMD cases reported during the study period, culture and PCR-based capsular group was determined for 477/585 (82%); and 241/477 (51%) were sequenced. Predominant serogroups included NmB (210/477; 44%), NmW (116/477; 24%), NmY (96/477; 20%) and NmC (48/477; 10%). Predominant clonal complexes (CC) were CC41/44 in NmB (27/113; 24%), CC11 in NmW (46/56; 82%), CC167 in NmY (23/44; 53%), and CC865 in NmC (9/24; 38%). Peni was detected in 16% (42/262) of isolates, and was due to the presence of a penA mosaic, with the majority harboring penA7, penA9 or penA14.<BR><B>CONCLUSIONS: </B>IMD lineages circulating in South Africa were consistent with those circulating prior to 2008, however peni was higher than previously reported, and occurred in a variety of lineages.