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cc by (c) González Díaz et al., 2020
Si us plau utilitzeu sempre aquest identificador per citar o enllaçar aquest document: https://hdl.handle.net/2445/173093

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

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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).

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GONZÁLEZ DÍAZ, Aida, MACHADO, Miguel p, CÁMARA, Jordi, YUSTE, José enrique, VARON, Emmanuelle, DOMENECH, Miriam, GROSSO, María del, MARIMÓN, José maría, CERCENADO, Emilia, LARROSA, Nieves, QUESADA, María dolores, FONTANALS, Dionísia, EL-MNIAI, Assiya, CUBERO, Meritxell, CARRICO, João a., MARTÍ MARTÍ, Sara, RAMIREZ, Mario, ARDANUY TISAIRE, María carmen. 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. _Eurosurveillance_. 2020. Vol. 25, núm. 16, pàgs. 42-51. [consulta: 23 de gener de 2026]. [Disponible a: https://hdl.handle.net/2445/173093]

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