TY - JOUR AU - Chen, Mingliang AU - Harrison, Odile AU - Bratcher, Holly AU - Bo, Zhiyan AU - Jolley, Keith AU - Rodrigues, Charlene M.C. AU - Bray, James AU - Guo, Qinglan AU - Zhang, Xi AU - Chen, Min AU - Maiden, Martin C.J. T1 - Evolution of Sequence Type 4821 Clonal Complex Hyperinvasive and Quinolone-Resistant Meningococci T2 - Emerging Infectious Disease journal PY - 2021 VL - 27 IS - 4 SP - 1110 SN - 1080-6059 AB - Expansion of quinolone-resistant Neisseria meningitidis clone ChinaCC4821-R1-C/B from sequence type (ST) 4821 clonal complex (CC4821) caused a serogroup shift from serogroup A to serogroup C invasive meningococcal disease (IMD) in China. To determine the relationship among globally distributed CC4821 meningococci, we analyzed whole-genome sequence data from 173 CC4821 meningococci isolated from 4 continents during 1972–2019. These meningococci clustered into 4 sublineages (1–4); sublineage 1 primarily comprised of IMD isolates (41/50, 82%). Most isolates from outside China (40/49, 81.6%) formed a distinct sublineage, the Europe–USA cluster, with the typical strain designation B:P1.17-6,23:F3-36:ST-3200(CC4821), harboring mutations in penicillin-binding protein 2. These data show that the quinolone-resistant clone ChinaCC4821-R1-C/B has expanded to other countries. The increasing distribution worldwide of serogroup B CC4821 raises the concern that CC4821 has the potential to cause a pandemic that would be challenging to control, despite indirect evidence that the Trumenba vaccine might afford some protection. KW - Neisseria meningitidis KW - meningitis/encephalitis KW - ST4821 clonal complex KW - bacteria KW - genome KW - phylogenetic analysis KW - recombination KW - quinolone resistance KW - antimicrobial resistance KW - China DO - 10.3201/eid2704.203612 UR - https://wwwnc.cdc.gov/eid/article/27/4/20-3612_article ER - End of Reference