Abstract
BackgroundNeisseria meningitidis serogroup B remains a prominent cause of invasive meningococcal disease (IMD) in Brazil. Because two novel protein-based vaccines against serogroup B are available, the main purpose of this study was to provide data on the diversity and distribution of meningococcal vaccine antigen types circulating in Brazil.MethodologyGenetic lineages, vaccine antigen types, and allele types of antimicrobial-associated resistance genes based on whole-genome sequencing of a collection of 145 Neisseria meningitidis serogroup B invasive strains recovered in Brazil from 2016 to 2018 were collected.ResultsA total of 11 clonal complexes (ccs) were identified among the 145 isolates, four of which were predominant, namely, cc461, cc35, cc32, and cc213, accounting for 72.0% of isolates. The most prevalent fHbp peptides were 24 (subfamily A/variant 2), 47 (subfamily A/variant 3), 1 (subfamily B/variant 1) and 45 (subfamily A/variant 3), which were predominantly associated with cc35, cc461, cc32, and cc213, respectively. The NadA peptide was detected in only 26.2% of the isolates. The most frequent NadA peptide 1 was found almost exclusively in cc32. We found seven NHBA peptides that accounted for 74.5% of isolates, and the newly described peptide 1390 was the most prevalent peptide exclusively associated with cc461. Mutated penA alleles were detected in 56.5% of the isolates, whereas no rpoB and gyrA mutant alleles were found.ConclusionDuring the study period, changes in the clonal structure of circulating strains were observed, without a predominance of a single hyperinvasive lineage, indicating that an epidemiologic shift has occurred that led to a diversity of vaccine antigen types in recent years in Brazil.
Highlights
Invasive meningococcal disease (IMD) remains a major health problem and is a major cause of morbidity and mortality worldwide
Vaccine antigen types, and allele types of antimicrobial-associated resistance genes based on whole-genome sequencing of a collection of 145 Neisseria meningitidis serogroup B invasive strains recovered in Brazil from 2016 to 2018 were collected
The most prevalent factor Hbinding proteins (fHbp) peptides were 24, 47, 1 and 45, which were predominantly associated with cc35, cc461, cc32, and cc213, respectively
Summary
Invasive meningococcal disease (IMD) remains a major health problem and is a major cause of morbidity and mortality worldwide. During the 2000s, the proportion of IMD cases caused by serogroup B meningococcal strains declined from 74.5% in 2000 to 25.7% in 2008, corresponding to a decline from 0.54 to 0.14 per 100,000 inhabitants in the average annual incidence of disease due to this serogroup (S1 Fig). We observed a downward trend of IMD following the introduction of the MCC vaccine, from 1.54 per 100,000 in 2010 to 0.54 per 100,000 habitants in 2018, and observed a significant declining trend in incidence rates of serogroup B IMD cases [4] (S1 Fig), meningococcal serogroup B (MenB) remains the prominent cause of IMD in Brazil, in infants, with 1.5 cases per 100,000 habitants in 2018 (S2 Fig). Because two novel protein-based vaccines against serogroup B are available, the main purpose of this study was to provide data on the diversity and distribution of meningococcal vaccine antigen types circulating in Brazil
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