Genomic and evolutionary insights into a novel Neisseria meningitidis genogroup W clonal complex 11 variant with dual resistance to penicillin and azithromycin in Spain

clonal complex 11 (cc11) is a hyperinvasive lineage associated with global dissemination and outbreaks, including the 'South American/UK' sublineage. In Spain, cc11 serogroup W cases have increased in recent years; however, the evolutionary dynamics of circulating variants remain insufficiently characterized. This study aimed to assess the clonal diversity, temporal evolution and antimicrobial resistance profiles of cc11 isolates recovered in Spain between 2011 and 2025. A total of 1,226 isolates (406 invasive and 820 non-invasive) were collected across 8 Spanish regions, from which cc11 isolates were selected for analysis. Whole-genome sequencing (WGS) was used to perform core-genome multilocus sequence typing and SNP-based Bayesian phylogenetics to characterize population structure. Antimicrobial susceptibility was assessed using gradient diffusion, and genetic determinants of resistance were identified by WGS. We identified 179 cc11 isolates, mostly belonging to genogroup W (73.7%) and lineage 11.1 (85.5%). The 'South American/UK' sublineage was the main sublineage and displayed extensive diversification. A previously undescribed variant, designated the '2020 strain', emerged with an estimated most recent common ancestor in 2017 and accounted for 77.2% of 'South American/UK' sublineage isolates recovered between 2023 and 2025. This variant was mainly identified in respiratory samples from men who have sex with men but was also associated with invasive meningococcal disease in other population groups. The '2020 strain' exhibited resistance to penicillin and azithromycin, likely driven by penicillin-binding protein 2 and MtrCDE alterations. The emergence of this antimicrobial-resistant variant highlights the adaptive capacity of cc11 and the importance of genomic surveillance to monitor its evolution and public health relevance.

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Publication Details

Journal
Microbial Genomics
Published
2026-05-12
DOI
https://doi.org/10.1099/mgen.0.001703
Primary Topic
Bacterial Infections and Vaccines
Type
article
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article

Genomic and evolutionary insights into a novel Neisseria meningitidis genogroup W clonal complex 11 variant with dual resistance to penicillin and azithromycin in Spain

Núria Serre‐Delcor, M. Ángeles Orellana, Alba Bellés Bellés, Belén Viñado et al.
Microbial Genomics
Bacterial Infections and Vaccines
article

Genomic and evolutionary insights into a novel Neisseria meningitidis genogroup W clonal complex 11 variant with dual resistance to penicillin and azithromycin in Spain

Núria Serre‐Delcor, M. Ángeles Orellana, Alba Bellés Bellés, Belén Viñado, Carlos Rodrigo, Begoña Palop, Maider Arando, Mercedes Galan-Ladero, Alba Mir-Cros, Josep Roca-Grande, Carolina Sarvisé, Jesús Trejo-Zahínos, Patricia Álvarez‐López, Emilia Cercenado, Amaresh Pérez-Argüello, Mar Olga Pérez-Moreno, Daniel Navarro De la Cruz, Jorge Calvo, Enrique Ruíz de Gopegui, Frederic Gómez, Guillem Puigsech-Boixeda, Ana Rodríguez‐Fernández, M Dolores Quesada, M Nieves Larrosa, Joan López-Madueño, Albert Moreno-Mingorance, Jordi Càmara, Yannick Hoyos-mallecot, Pere Soler-palacín, Alba Rivera, Jorge Néstor García-Pérez, Inés Oliveira-Souto, Andrea Martín-Nalda, Vicente Descalzo, Juan José González-López, Mayli Lung, Carmen Muñoz-Almagro, Aleix Soler-Garcia
article en

Abstract

clonal complex 11 (cc11) is a hyperinvasive lineage associated with global dissemination and outbreaks, including the 'South American/UK' sublineage. In Spain, cc11 serogroup W cases have increased in recent years; however, the evolutionary dynamics of circulating variants remain insufficiently characterized. This study aimed to assess the clonal diversity, temporal evolution and antimicrobial resistance profiles of cc11 isolates recovered in Spain between 2011 and 2025. A total of 1,226 isolates (406 invasive and 820 non-invasive) were collected across 8 Spanish regions, from which cc11 isolates were selected for analysis. Whole-genome sequencing (WGS) was used to perform core-genome multilocus sequence typing and SNP-based Bayesian phylogenetics to characterize population structure. Antimicrobial susceptibility was assessed using gradient diffusion, and genetic determinants of resistance were identified by WGS. We identified 179 cc11 isolates, mostly belonging to genogroup W (73.7%) and lineage 11.1 (85.5%). The 'South American/UK' sublineage was the main sublineage and displayed extensive diversification. A previously undescribed variant, designated the '2020 strain', emerged with an estimated most recent common ancestor in 2017 and accounted for 77.2% of 'South American/UK' sublineage isolates recovered between 2023 and 2025. This variant was mainly identified in respiratory samples from men who have sex with men but was also associated with invasive meningococcal disease in other population groups. The '2020 strain' exhibited resistance to penicillin and azithromycin, likely driven by penicillin-binding protein 2 and MtrCDE alterations. The emergence of this antimicrobial-resistant variant highlights the adaptive capacity of cc11 and the importance of genomic surveillance to monitor its evolution and public health relevance.

Microbial GenomicsVol. 12(5)
Universitat Autònoma de Barcelona (ES), Hospital Sant Joan de Déu Barcelona (ES), Instituto de Salud Carlos III (ES), Hospital de Sant Pau (ES), Bellvitge University Hospital (ES), Hospital Universitari Arnau de Vilanova (ES), Hospital General Universitario Gregorio Marañón (ES), Universitat Internacional de Catalunya (ES), Althaia (ES), Complejo Hospitalario Universitario de Santiago (ES), Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (ES), Hospital Universitario 12 De Octubre (ES), Institut de Recerca Biomèdica Catalunya Sud (ES), Vall d'Hebron Institut de Recerca (ES), Hospital Regional Universitario de Málaga (ES), Instituto de Investigación Marqués de Valdecilla (ES), Centro de Investigación Biomédica en Red (ES), Hospital Universitario Reina Sofía (ES), Health Research Institute of the Balearic Islands (ES), Vall d'Hebron Hospital Universitari (ES), Instituto de Investigación Biomédica de Lleida (ES), Hospital Universitari de Tortosa Verge de la Cinta (ES), Hospital Universitario Son Espases (ES), Hospital Universitari Germans Trias i Pujol (ES), Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (ES)
Centro de Investigación Biotecnológica en Red de Enfermedades Infecciosas, Instituto de Salud Carlos III
Good health and well-being
Openalex Percentile: Top 7%
Bacterial Infections and Vaccines
DOIOpen Access PDFOpenAlex
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