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
Green Published, gold, Green Submitted
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