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Genomic characterization of invasive meningococcal X isolates from Brazil, 1992-2022
Ana Paula Cassiolato1, Carlos Henrique Camargo1, Maria Cristina Piccoli Cecconi2
1Center of Bacteriology, Instituto Adolfo Lutz (IAL), São Paulo, State of São Paulo, Brazil.
Introduction:
Invasive meningococcal disease (IMD) is a major health problem. Given the post-COVID-19 pandemic scenario with the loosening of the non-pharmacological measures to control the virus transmission and considering the observed global reduction of meningococcal vaccination coverage, an increase in IMD cases can be expected.
Methodology:
Using whole-genome sequencing, we characterized six Neisseria meningitidis serogroup X (MenX) isolates recovered from IMD cases in Brazil in the last 30 years.
Results:
The predominance (66.6%, 4/6) of ST2888 presenting fHbp 160, NHBA 129, NadA 21, and PorA 19,15 was found on isolates. Two novel STs, 15458 and 15477, were described.
Conclusion:
This study describes the circulation of MenX lineage ST2888 in Brazil, previously reported only in Europe. Continuous universal surveillance is crucial to implement prompt public health measures aiming to prevent and control non-vaccine preventable serogroup X IMD cases.
Insights
Invasive meningococcal disease (IMD) caused by serogroup X (MenX) is a concern. This study identified the MenX ST2888 lineage in Brazil, previously only seen in Europe, highlighting the need for ongoing surveillance.
Area of Science:
- Microbiology
- Genomics
- Epidemiology
Background:
- Invasive meningococcal disease (IMD) remains a significant public health challenge globally.
- The post-COVID-19 pandemic era, marked by relaxed non-pharmaceutical interventions and decreased vaccination rates, poses a heightened risk for increased IMD incidence.
- Serogroup X (MenX) is a notable cause of IMD, particularly in regions with limited vaccine availability.
Purpose of the Study:
- To characterize Neisseria meningitidis serogroup X (MenX) isolates from invasive disease cases in Brazil.
- To investigate the genetic makeup and phylogenetic relationships of MenX strains circulating in Brazil over the past three decades.
- To assess the potential emergence and spread of specific MenX lineages within the Brazilian population.
Main Methods:
- Whole-genome sequencing (WGS) was employed to analyze six MenX isolates from Brazilian IMD cases spanning 30 years.
- Genomic data were used to determine sequence types (STs) and identify specific virulence-associated genes, including fHbp, NHBA, NadA, and PorA.
- Phylogenetic analysis was conducted to understand the evolutionary history and geographic origins of the studied MenX isolates.
Main Results:
- The ST2888 lineage, previously documented primarily in Europe, was predominant (66.6%, 4/6) among the Brazilian MenX isolates.
- These ST2888 isolates shared specific genetic profiles, including fHbp allele 160, NHBA allele 129, NadA allele 21, and PorA alleles 19,15.
- Two novel STs, ST-15458 and ST-15477, were identified, expanding the known genetic diversity of MenX in Brazil.
Conclusions:
- The study confirms the circulation of the MenX ST2888 lineage in Brazil, indicating potential international transmission or independent emergence.
- The findings underscore the importance of continuous genomic surveillance for non-vaccine-preventable serogroups like MenX.
- Proactive public health strategies are essential to monitor and control the spread of MenX IMD, especially in light of evolving epidemiological landscapes.
