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

Publisher: National Center for Infectious Diseases, Centers for Disease Control and Prevention (CDC) Country of Publication: United States NLM ID: 9508155 Publication Model: Print Cited Medium: Internet ISSN: 1080-6059 (Electronic) Linking ISSN: 10806040 NLM ISO Abbreviation: Emerg Infect Dis Subsets: MEDLINE

Original Publication: Atlanta, GA : National Center for Infectious Diseases, Centers for Disease Control and Prevention (CDC), [1995-

Neisseria meningitidis*/genetics ; Quinolones*/pharmacology; Penicillins ; Cefotaxime/pharmacology ; China/epidemiology ; Neisseria/genetics ; Microbial Sensitivity Tests ; Anti-Bacterial Agents/pharmacology ; Penicillin Resistance/genetics

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 (Pen ^NS ) meningococci, we analyzed 491 meningococci and 724 commensal Neisseria isolates in Shanghai, China, during 1965-2020. The Pen ^NS proportion increased from 0.3% in 1965-1985 to 7.0% in 2005-2014 and to 33.3% in 2015-2020. Of the 26 Pen ^NS 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 Pen ^NS meningococci were resistant to cefotaxime, 2 within the CC4821 cluster. With 96% of the Pen ^NS 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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United Kingdom WT_ Wellcome Trust

Keywords: CC4821; China; Neisseria meningitidis; Shanghai; antimicrobial resistance; bacteria; clonal complex 4821; horizontal gene transfer; multidrug resistance; penicillin; third-generation cephalosporins

0 (Penicillins)
0 (Quinolones)
N2GI8B1GK7 (Cefotaxime)
0 (Anti-Bacterial Agents)

Date Created: 20230124 Date Completed: 20230126 Latest Revision: 20240415

20240415

PMC9881793

10.3201/eid2902.221066

36692352