Evolution of Sequence Type 4821 Clonal Complex Hyperinvasive and Quinolone-Resistant Meningococci
Mingliang Chen, Odile B. Harrison, Holly B. Bratcher, Zhiyan Bo, Keith A. Jolley, Charlene M.C. Rodrigues, James E. Bray, Qinglan Guo, Xi Zhang, Min Chen, Martin Maiden
Abstract
N eisseria meningitidis, a leading cause of bacterial meningitis and septicemia globally, causes 1.2 million invasive meningococcal disease (IMD) cases annually and a case-fatality rate of 11% (1). Meningococci are classifi ed into 12 serogroups based on capsular polysaccharides (1); genetic relationships among isolates are defi ned by clonal complexes (CCs) identifi ed by multilocus sequence typing (MLST), which are surrogates for lineages (2). The relationship among serogroups, CCs (lineages), and IMD fl uctuates over time and by location, but IMD isolates are dominated by CCs known as hyperinvasive lineages, usually associated with one of the 6 disease-causing serogroups (MenA, MenB, MenC, MenW, MenX, and MenY).