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Genomic surveillance of invasive Neisseria meningitidis isolates circulating in Paraguay, 2009-2021
María Eugenia León1, Anibal Yasunari Kawabata2, Cristina Minako Nagai1
1Department of Bacteriology and Mycology, Central Public Health Laboratory (LCSP), Asunción, Paraguay.
Introduction:
Invasive meningococcal disease (IMD) remains a significant public health concern and one of the leading causes of morbidity and mortality worldwide. In Paraguay, IMD continues to pose a serious health challenge.
Methodology:
A retrospective, descriptive, cross-sectional observational study was conducted. Whole-genome sequencing was employed to perform multilocus sequence sequence typing (MLST), vaccine antigens characterization, and antimicrobial resistance gene profiling of Neisseria meningitidis isolates obtained from children and adults with IMD, as part of the Bacterial Meningitis Surveillance Program in Paraguay during 2009-2021.
Results:
Eight clonal complexes were identified, with cc103 being the most frequent, followed by cc11, cc35, cc167, cc41/44, cc865, cc32, and cc60. Regarding vaccine antigens, the fHbp variant A05 peptide targeted by MenB-FHbp was absent, whereas the B01 variant was detected in 3 out of 70 isolates (4.3%). For the 4CMenB vaccine components, peptide 1 of fHbp (subfamily B/variant 1), NHBA peptide 2, and NadA peptide 8 were absent, while PorA P1.7-2,4 was found in one isolate (1.4%). Mutated penA alleles were present in 73.7% of the isolates. Major peptides (PorA, PorB, FetA, NHBA, fHbp) were correlated with clonal complexes and serogroups.
Conclusion:
This is the first genomic study of Neisseria meningitidis conducted in Paraguay, enabling a novel understanding of the genetic characteristics of invasive isolates. The generation of genomic data is essential for monitoring the spread of circulating lineages or clones that may alter their antigenic profiles to evade host immune responses.
Insights
This study analyzed invasive meningococcal disease (IMD) isolates in Paraguay using whole-genome sequencing. Most isolates belonged to clonal complex 103, with variations in vaccine antigens and high rates of antimicrobial resistance genes.
Area of Science:
- Genomics
- Microbiology
- Public Health
Background:
- Invasive meningococcal disease (IMD) is a significant global health threat.
- IMD poses a continuous challenge in Paraguay, necessitating detailed epidemiological surveillance.
- Understanding the genetic makeup of Neisseria meningitidis is crucial for disease control.
Purpose of the Study:
- To conduct the first genomic analysis of Neisseria meningitidis isolates in Paraguay.
- To characterize the genetic diversity, vaccine antigen profiles, and antimicrobial resistance of IMD-causing strains.
- To inform public health strategies for IMD prevention and control in the region.
Main Methods:
- Retrospective, descriptive, cross-sectional observational study design.
- Whole-genome sequencing of Neisseria meningitidis isolates from IMD cases (2009-2021).
- Multilocus sequence typing (MLST), vaccine antigen characterization, and antimicrobial resistance profiling.
Main Results:
- Eight clonal complexes (CCs) identified, with CC103 being the most prevalent.
- Variations in vaccine antigen coverage were observed, with some key peptides absent or present at low frequencies.
- High prevalence (73.7%) of mutated penA alleles, indicating potential antimicrobial resistance.
Conclusions:
- This genomic study provides novel insights into the genetic landscape of invasive meningococcal isolates in Paraguay.
- Genomic data are vital for tracking circulating strains and potential immune evasion mechanisms.
- Findings highlight the need for ongoing genomic surveillance to adapt vaccination and treatment strategies.
