Genome analysis of a MDR Streptococcus pneumoniae 23F serotype causing meningoencephalitis in a 10-months refugee

Tamara Salloum1, Elie Tannous2, Samar Merheb-Ghoussoub3

  • 1Lebanese American University, Byblos, Lebanon. tamara.salloum@lau.edu.

Abstract

Insights

Genomic analysis revealed a multidrug-resistant Streptococcus pneumoniae strain, ST-277, linked to infant meningoencephalitis. High genome diversity may explain its invasiveness, highlighting the need for whole-genome sequencing in disease surveillance.

Area of Science:

  • Microbiology
  • Genomics
  • Infectious Diseases

Background:

  • Streptococcus pneumoniae is a significant cause of invasive pneumococcal diseases (IPD).
  • The resurgence of S. pneumoniae-associated meningoencephalitis in Lebanon is a growing public health concern.
  • Multidrug resistance in S. pneumoniae complicates treatment and increases disease severity.

Purpose of the Study:

  • To perform a comparative genome analysis of a multidrug-resistant S. pneumoniae isolate (LAU-23F) responsible for meningoencephalitis and fatality in an infant.
  • To investigate the genetic basis of the isolate's resistance and invasiveness by comparing it with 24 related public genome sequences.
  • To identify specific genetic features contributing to the virulence and resistance profile of the S. pneumoniae strain.

Main Methods:

  • Comparative whole-genome sequencing (WGS) of the S. pneumoniae LAU-23F isolate.
  • Analysis of serotype, capsular genes, multilocus sequence typing (MLST), and single nucleotide polymorphisms (SNPs).
  • Investigation of penicillin-binding protein (PBP) gene mosaicity and screening for virulence factors and resistance genes.

Main Results:

  • The isolate was identified as ST-277, serotype 23F, exhibiting intermediate resistance to ciprofloxacin, cefuroxime, and penicillin.
  • Gene mosaicity was observed in pbp2x, with pbp1a and pbp2b conserved compared to a reference strain.
  • High genomic heterogeneity was noted, particularly in phage-encoded regions, and a diverse array of virulence factors was detected.

Conclusions:

  • The extensive genomic diversity of the S. pneumoniae LAU-23F isolate likely contributes to its significant invasiveness.
  • Genomic approaches, including WGS, are crucial for effective clinical diagnostics and surveillance of streptococcal infections.
  • This study underscores the importance of continuous genomic monitoring to understand and combat emerging infectious threats.

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