Penicillin and Cefotaxime Resistance of Quinolone-Resistant Neisseria meningitidis Clonal Complex 4821, Shanghai, China, 1965–2020

Autor: Mingliang Chen, Youxing Shao, Jiayuan Luo, Lingyue Yuan, Minggui Wang, Min Chen, Qinglan Guo
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: Emerging Infectious Diseases, Vol 29, Iss 2, Pp 341-350 (2023)
Druh dokumentu: article
ISSN: 1080-6040
1080-6059
DOI: 10.3201/eid2902.221066
Popis: Clonal complex 4821 (CC4821) Neisseria meningitidis, usually resistant to quinolones but susceptible to penicillin and third-generation cephalosporins, is increasing worldwide. To characterize the penicillin-nonsusceptible (PenNS) meningococci, we analyzed 491 meningococci and 724 commensal Neisseria isolates in Shanghai, China, during 1965–2020. The PenNS proportion increased from 0.3% in 1965–1985 to 7.0% in 2005–2014 and to 33.3% in 2015–2020. Of the 26 PenNS meningococci, 11 (42.3%) belonged to the CC4821 cluster; all possessed mutations in penicillin-binding protein 2, mostly from commensal Neisseria. Genetic analyses and transformation identified potential donors of 6 penA alleles. Three PenNS meningococci were resistant to cefotaxime, 2 within the CC4821 cluster. With 96% of the PenNS meningococci beyond the coverage of scheduled vaccination and the cefotaxime-resistant isolates all from toddlers, quinolone-resistant CC4821 has acquired penicillin and cefotaxime resistance closely related to the internationally disseminated ceftriaxone-resistant gonococcal FC428 clone, posing a greater threat especially to young children.
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