Two multi-fragment recombination events resulted in the beta-lactam-resistant serotype 11A-ST6521 related to Spain9V-ST156 pneumococcal clone spreading in south-western Europe, 2008 to 2016


Por: Gonzalez-Diaz, A, Machado, MP, Camara, J, Yuste, J, Varon, E, Domenech, M, Del Grosso, M, Marimon, JM, Cercenado, E, Larrosa, N, Quesada, MD, Fontanals, D, El-Mniai, A, Cubero, M, Carrico, JA, Marti, S, Ramirez, M and Ardanuy, C

Publicada: 23 abr 2020
Resumen:
Background: The successful pneumococcal clone Spain(9V)-ST156 (PMEN3) is usually associated with vaccine serotypes 9V and 14. Aim: Our objective was to analyse the increase of a serotype 11A variant of PMEN3 as cause of invasive pneumococcal disease (IPD) in Spain and its spread in south-western Europe. Methods: We conducted a prospective multicentre study of adult IPD in Spain (2008-16). Furthermore, a subset of 61 penicillin-resistant serotype 11A isolates from France, Italy, Portugal and Spain were subjected to whole genome sequencing (WGS) and compared with 238 genomes from the European Nucleotide Archive (ENA). Results: Although the incidence of serotype 11A in IPD was stable, a clonal shift was detected from CC62 (penicillin-susceptible) to CC156 (penicillin-resistant). By WGS, three major 11A-CC156 lineages were identified, linked to ST156 (n=5 isolates; France, Italy and Portugal), ST166 (n=4 isolates; France and Portugal) and ST838/6521 (n=52 isolates; France, Portugal and Spain). Acquisition of the capsule allowed to escape vaccine effect. AP200 (11A-ST62) was the donor for ST156 and ST838/6521 but not for ST166. In-depth analysis of ST838/6521 lineage showed two multi-fragment recombination events including four and seven fragments from an 11A-ST62 and an NT-ST344 representative, respectively. Conclusion: The increase in penicillin-resistant serotype 11A IPD in Spain was linked to the spread of a vaccine escape PMEN3 recombinant clone. Several recombination events were observed in PMEN3 acquiring an 11A capsule. The most successful 11A-PMEN3 lineage spreading in south-western Europe appeared after two multi-fragment recombination events with representatives of two major pneumococcal clones (11A-ST62 and NT-ST344).

Filiaciones:
Gonzalez-Diaz, A:
 IDIBELL UB, Microbiol Dept, Hosp Univ Bellvitge, Lhospitalet De Llobregat, Spain

 ISCIII, Res Network Resp Dis CIBERES, Madrid, Spain

Machado, MP:
 Univ Lisbon, Fac Med, Inst Microbiol, Inst Mol Med, Lisbon, Portugal

Camara, J:
 IDIBELL UB, Microbiol Dept, Hosp Univ Bellvitge, Lhospitalet De Llobregat, Spain

 ISCIII, Res Network Resp Dis CIBERES, Madrid, Spain

Yuste, J:
 ISCIII, Res Network Resp Dis CIBERES, Madrid, Spain

 ISCIII, Pneumococcal Reference Lab, Ctr Nacl Referencia, Madrid, Spain

Varon, E:
 Ctr Hosp Intercommunal Creteil, Natl Reference Ctr Pneumococci, Creteil, France

Domenech, M:
 ISCIII, Pneumococcal Reference Lab, Ctr Nacl Referencia, Madrid, Spain

Del Grosso, M:
 Ist Super Sanita, Infect Dis Dept, Rome, Italy

Marimon, JM:
 ISCIII, Res Network Resp Dis CIBERES, Madrid, Spain

 Donostialdea Integrated Hlth Org, Biodonostia, Infect Dis Area,Microbiol Dept, Resp Infect & Antimicrobial Resistance Grp,Osakid, San Sebastian, Spain

Cercenado, E:
 ISCIII, Res Network Resp Dis CIBERES, Madrid, Spain

 Hosp Gen Univ Gregorio Maranon, Clin Microbiol & Infect Dis Dept, Madrid, Spain

Larrosa, N:
 UAB, Microbiol Dept, Hosp Univ Vall dHebron, Barcelona, Spain

:
 UAB, Microbiol Dept, Clin Lab North Metropolitan Area, Hosp Univ Germans Trias & Pujol, Badalona, Spain

Fontanals, D:
 Hosp Univ Parc Tauli, Microbiol Dept, Sabadell, Spain

El-Mniai, A:
 Ctr Hosp Intercommunal Creteil, Natl Reference Ctr Pneumococci, Creteil, France

Cubero, M:
 IDIBELL UB, Microbiol Dept, Hosp Univ Bellvitge, Lhospitalet De Llobregat, Spain

 ISCIII, Res Network Resp Dis CIBERES, Madrid, Spain

Carrico, JA:
 Univ Lisbon, Fac Med, Inst Microbiol, Inst Mol Med, Lisbon, Portugal

Marti, S:
 IDIBELL UB, Microbiol Dept, Hosp Univ Bellvitge, Lhospitalet De Llobregat, Spain

 ISCIII, Res Network Resp Dis CIBERES, Madrid, Spain

Ramirez, M:
 Univ Lisbon, Fac Med, Inst Microbiol, Inst Mol Med, Lisbon, Portugal

Ardanuy, C:
 IDIBELL UB, Microbiol Dept, Hosp Univ Bellvitge, Lhospitalet De Llobregat, Spain

 ISCIII, Res Network Resp Dis CIBERES, Madrid, Spain

 Univ Barcelona, Sch Med, Dept Pathol & Expt Therapeut, Barcelona, Spain
ISSN: 15607917





EUROSURVEILLANCE
Editorial
European Centre for Disease Prevention and Control (ECDC), TOMTEBODAVAGEN 11A, STOCKHOLM, 171 83, SWEDEN, Francia
Tipo de documento: Article
Volumen: 25 Número: 16
Páginas: 42-51
WOS Id: 000528319500006
ID de PubMed: 32347199
imagen Green Published, gold, Green Submitted

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