Genomic characterization of invasive Neisseria meningitidis in Spain (2011/12-2022/23): expansion of clonal complex 213 and the potential threat to 4CMenB vaccine strain coverage
Por:
Roca-Grande, J, Mir-Cros, A, Muñoz-Almagro, C, Lung, MY, Bellés-Bellés, A, Càmara, J, Cercenado, E, Galán-Ladero, MA, Martín-Nalda, A, Moreno-Mingorance, A, de la Cruz, DN, Orellana, MA, Palop, B, Pérez-Argüello, A, Puigsech-Boixeda, G, Quesada, MD, Rivera, A, Rodriguez-Fernandez, A, de Gopegui, ER, Sarvisé, C, Soler-Garcia, A, Viñado, B, Larrosa, N, González-López, JJ
Publicada:
31 dic 2025
Resumen:
Invasive meningococcal disease (IMD) is associated with significant global morbidity and mortality and is addressed by conjugated polysaccharide and subcapsular vaccines. In Spain, data on 4CMenB vaccine strain coverage and antimicrobial susceptibility are limited. This study aimed to describe the genomic epidemiology, predict 4CMenB vaccine strain coverage, and assess antimicrobial susceptibility of 323 Neisseria meningitidis isolates causing IMD, collected from 57 Clinical Microbiology Laboratories in Spain over 12 years (2011/12-2022/23). Whole genome sequencing was performed to identify serogroup, clonal complex (cc), and antimicrobial resistance determinants. Vaccine strain coverage for serogroup B (MenB) isolates was predicted using the genetic Meningococcal Antigen Typing System approach. The most prevalent serogroups were B (57.9%), W (21.4%), C (10.4%), and Y (8.4%). MenB predominated throughout most seasons, except during the 2019/20 season when serogroup W peaked. Post-COVID-19 pandemic, MenB remained the most frequent (70.2%). Thirteen cc were identified among MenB isolates, with cc213 being the most prevalent (40.1%). Only 28.9% of MenB isolates were predicted to be covered by 4CMenB, with cc213 showing an exceptionally low coverage rate (5.3%) due to antigenic variants poorly targeted by the vaccine. Notably, cc213 was responsible for twice the proportion of MenB cases in 4CMenB-vaccinated versus unvaccinated. All isolates were susceptible to third generation cephalosporins, and 13.5% showed penicillin resistance. This study highlights the alarming prevalence of cc213 among MenB IMD cases in Spain and the limited 4CMenB coverage against this cc. The disproportionate representation of cc213 in vaccinated individuals underscores its potential to compromise vaccine effectiveness.
Filiaciones:
Roca-Grande, J:
Vall dHebron Barcelona Hosp Campus, Vall dHebron Inst Recerca VHIR, Microbiol Res Grp, Barcelona, Spain
Univ Autonoma Barcelona, Dept Genet & Microbiol, Bellaterra, Spain
Inst Salud Carlos III, CIBER Enfermedades Infecciosas CIBERINFEC, Madrid, Spain
Mir-Cros, A:
Vall dHebron Barcelona Hosp Campus, Vall dHebron Inst Recerca VHIR, Microbiol Res Grp, Barcelona, Spain
Inst Salud Carlos III, CIBER Enfermedades Infecciosas CIBERINFEC, Madrid, Spain
Muñoz-Almagro, C:
Hosp St Joan de Deu, Inst Recerca St Joan de Deu, Paediat Infect Dis Res Grp, Esplugues, Spain
Inst Salud Carlos III, CIBER Epidemiol & Salud Publ CIBERESP, Madrid, Spain
Univ Int Catalunya, Sch Med & Hlth Sci, Barcelona, Spain
Lung, MY:
Hosp Univ Vall dHebron, Dept Clin Microbiol, Barcelona, Spain
Bellés-Bellés, A:
Hosp Arnau Vilanova, Lleida, Spain
Càmara, J:
Hosp Univ Bellvitge, Lhospitalet De Llobregat, Spain
Inst Salud Carlos III, CIBER Enfermedades Resp CIBERES, Majadahonda, Spain
Cercenado, E:
Inst Salud Carlos III, CIBER Enfermedades Resp CIBERES, Majadahonda, Spain
Hosp Gen Univ Gregorio Maranon, Dept Clin Microbiol & Infect Dis, Madrid, Spain
Galán-Ladero, MA:
Hosp Univ Reina Sofia, Dept Clin Microbiol, Cordoba, Spain
Martín-Nalda, A:
Univ Autonoma Barcelona UAB, Hosp Univ Vall dHebron Campus, Bellaterra, Spain
Moreno-Mingorance, A:
Vall dHebron Barcelona Hosp Campus, Vall dHebron Inst Recerca VHIR, Microbiol Res Grp, Barcelona, Spain
Inst Salud Carlos III, CIBER Enfermedades Infecciosas CIBERINFEC, Madrid, Spain
de la Cruz, DN:
Complejo Hosp Univ Santiago, Santiago De Compostela, Spain
Orellana, MA:
Hosp Univ 12 Octubre, Dept Clin Microbiol, Madrid, Spain
Palop, B:
Hosp Reg Univ Malaga, Dept Clin Microbiol, Malaga, Spain
Pérez-Argüello, A:
Hosp St Joan de Deu, Inst Recerca St Joan de Deu, Paediat Infect Dis Res Grp, Esplugues, Spain
Puigsech-Boixeda, G:
Vall dHebron Barcelona Hosp Campus, Vall dHebron Inst Recerca VHIR, Microbiol Res Grp, Barcelona, Spain
Univ Autonoma Barcelona, Dept Genet & Microbiol, Bellaterra, Spain
Inst Salud Carlos III, CIBER Enfermedades Infecciosas CIBERINFEC, Madrid, Spain
Quesada, MD:
UAB, Hosp Univ Germans Trias I Pujol, Dept Clin Microbiol, Badalona, Spain
Rivera, A:
Univ Autonoma Barcelona, Dept Genet & Microbiol, Bellaterra, Spain
Hosp Santa Creu & Sant Pau, St Pau Biomed Res Inst IIB St Pau, Dept Genet, Barcelona, Spain
Rodriguez-Fernandez, A:
Hosp Univ Marques Valdecilla IDIVAL, IDIVAL, La Cavada, Spain
de Gopegui, ER:
Hosp Univ Son Espases, Dept Clin Microbiol, Inst Invest Sanitaria Illes Balears IdISBa, Palma de Mallorca, Spain
Sarvisé, C:
Hosp Univ Tarragona Joan XXIII, Pere Virgili Hlth Res Inst IISPV, Cardiol Div, Tarragona, Spain
Soler-Garcia, A:
Hosp St Joan de Deu, Inst Recerca St Joan de Deu, Paediat Infect Dis Res Grp, Esplugues, Spain
Hosp St Joan de Deu, Neurol, Esplugues, Spain
Viñado, B:
Hosp Univ Vall dHebron, Dept Clin Microbiol, Barcelona, Spain
Larrosa, N:
Vall dHebron Barcelona Hosp Campus, Vall dHebron Inst Recerca VHIR, Microbiol Res Grp, Barcelona, Spain
Univ Autonoma Barcelona, Dept Genet & Microbiol, Bellaterra, Spain
Inst Salud Carlos III, CIBER Enfermedades Infecciosas CIBERINFEC, Madrid, Spain
Hosp Univ Vall dHebron, Dept Clin Microbiol, Barcelona, Spain
González-López, JJ:
Vall dHebron Barcelona Hosp Campus, Vall dHebron Inst Recerca VHIR, Microbiol Res Grp, Barcelona, Spain
Univ Autonoma Barcelona, Dept Genet & Microbiol, Bellaterra, Spain
Inst Salud Carlos III, CIBER Enfermedades Infecciosas CIBERINFEC, Madrid, Spain
Hosp Univ Vall dHebron, Dept Clin Microbiol, Barcelona, Spain
Green Accepted, gold
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