Related Experiment Video
Updated: Nov 9, 2025
Inducing Meningococcal Meningitis Serogroup C in Mice via Intracisternal Delivery
Published on: November 5, 2019
Increase in penicillin-resistant invasive meningococcal serogroup W ST-11 complex isolates in England
Laura Willerton1, Jay Lucidarme1, Andrew Walker1
1Meningococcal Reference Unit, Public Health England, Manchester Royal Infirmary, Manchester, United Kingdom.
Introduction:
Invasive meningococcal disease (IMD) caused by serogroup W meningococci belonging to the ST-11 complex (MenW:cc11) has been increasing globally since the early 2000s. Penicillin resistance among meningococci due to the production of beta-lactamase remains relatively rare. Isolates displaying resistance and reduced susceptibility to penicillin due to alterations in the penA gene (encoding Penicillin Binding Protein 2) are increasingly reported. In 2016, a penicillin-resistant clade of MenW:cc11 isolates with altered penA genes was identified in Australia. More recently, an increase in penicillin-resistant invasive MenW:cc11 isolates was observed in England. Here, we investigate the distribution of penicillin resistance among English invasive MenW:cc11 isolates.
Methods:
Isolates from IMD cases in England from July 2010 to August 2019 underwent whole genome sequencing and antibiotic susceptibility testing as part of routine surveillance. The PubMLST Neisseria database was used to determine the distribution of penicillin resistance among English MenW:cc11 isolates and to identify other closely related isolates.
Results:
Twenty-five out of 897 English invasive MenW:cc11 isolates were resistant to penicillin; identified among six distinct sublineages and a singleton. Expansion of the Australian penicillin-resistant clade included isolates from several new countries as well as 20 English isolates. A newly identified penicillin resistance-associated lineage was also identified among several countries.
Conclusion:
Penicillin resistance among diverse MenW:cc11 isolates is increasing. Surveillance of antibiotic resistance among meningococci is essential to ensure continued effective use.
Insights
Penicillin resistance in invasive meningococcal disease (IMD) serogroup W, ST-11 complex (MenW:cc11) is rising globally. This study found increasing penicillin resistance in English MenW:cc11 isolates, highlighting the need for ongoing surveillance.
Area of Science:
- Microbiology
- Infectious Diseases
- Genomics
Background:
- Invasive meningococcal disease (IMD) caused by serogroup W meningococci (MenW:cc11) has shown a global increase since the early 2000s.
- While beta-lactamase-mediated penicillin resistance is rare, resistance due to penA gene alterations is increasingly reported.
- A penicillin-resistant MenW:cc11 clade emerged in Australia in 2016, with recent increases observed in England.
Purpose of the Study:
- To investigate the distribution and emergence of penicillin resistance within invasive MenW:cc11 isolates in England.
- To track the spread of known penicillin-resistant clades and identify new resistance-associated lineages.
Main Methods:
- Whole genome sequencing and antibiotic susceptibility testing of 897 English invasive MenW:cc11 isolates from July 2010 to August 2019.
- Utilized the PubMLST Neisseria database for lineage determination and identification of related isolates.
Main Results:
- Twenty-five (2.8%) of 897 isolates exhibited penicillin resistance, distributed across six sublineages and a singleton.
- The Australian penicillin-resistant clade was detected in England, alongside isolates from other countries.
- A novel penicillin resistance-associated lineage was identified in multiple countries, including England.
Conclusions:
- Penicillin resistance is an emerging threat among diverse MenW:cc11 isolates.
- Continuous surveillance of antibiotic resistance in meningococci is crucial for maintaining effective treatment strategies.
