A mosaic tetracycline resistance gene tet(S/M) detected in an MDR pneumococcal CC230 lineage that underwent capsular switching in South Africa

• Autores: Lo, Stephanie W.; Gladstone, Rebecca A.; van Tonder, Andries; du Plessis, Mignon; Cornick, Jennifer; Hawkins, Paulina A.; Madhi, Shabir A.; Nzenze, Susan A.; Kandasamy, Rama; Ravikumar, K.L.; Elmdaghri, Naima; Kwambana Adams, Brenda; Grassi Almeida, Samanta Cristine; Skoczynska, Anna; Egorova, Ekaterina; Titov, Leonid; Saha, Samir K.; Paragi, Metka; Everett, Dean B; Antonio, Martin; Klugman, Keith P.; Li, Yuan; Metcalf, Benjamin J; Beall, Bernard; McGee, Lesley; Breiman, Robert F.; Bentley, Stephen D; von Gottberg, Anne; Brooks, Abdullah W.; Corso, Alejandra; Faccone, Diego Francisco
• Año de publicación: 2020
• Idioma: inglés
• Tipo de recurso: artículo
• Materia: PNEUMOCOCCAL; CC230; TETRACYCLINE
• Institución: Consejo Nacional de Investigaciones Científicas y Técnicas

Objectives: We reported tet(S/M) in Streptococcus pneumoniae and investigated its temporal spread in relation to nationwide clinical interventions. Methods: We whole-genome sequenced 12 254 pneumococcal isolates from 29 countries on an Illumina HiSeq sequencer. Serotype, multilocus ST and antibiotic resistance were inferred from genomes. An SNP tree was built using Gubbins. Temporal spread was reconstructed using a birth-death model. Results: We identified tet(S/M) in 131 pneumococcal isolates and none carried other known tet genes. Tetracycline susceptibility testing results were available for 121 tet(S/M)-positive isolates and all were resistant. A majority (74%) of tet(S/M)-positive isolates were from South Africa and caused invasive diseases among young children (59% HIV positive, where HIV status was available). All but two tet(S/M)-positive isolates belonged to clonal complex (CC) 230. A global phylogeny of CC230 (n=389) revealed that tet(S/M)-positive isolates formed a sublineage predicted to exhibit resistance to penicillin, co-trimoxazole, erythromycin and tetracycline. The birth-death model detected an unrecognized outbreak of this sublineage in South Africa between 2000 and 2004 with expected secondary infections (effective reproductive number, R) of ∼2.5. R declined to ∼1.0 in 2005 and <1.0 in 2012. The declining epidemic could be related to improved access to ART in 2004 and introduction of pneumococcal conjugate vaccine (PCV) in 2009. Capsular switching from vaccine serotype 14 to non-vaccine serotype 23A was observed within the sublineage. Conclusions: The prevalence of tet(S/M) in pneumococci was low and its dissemination was due to an unrecognized outbreak of CC230 in South Africa. Capsular switching in this MDR sublineage highlighted its potential to continue to cause disease in the post-PCV13 era.
Fil: Lo, Stephanie W.. Wellcome Sanger Institute; Reino Unido
Fil: Gladstone, Rebecca A.. Wellcome Sanger Institute; Reino Unido
Fil: van Tonder, Andries. Wellcome Sanger Institute; Reino Unido
Fil: du Plessis, Mignon. National Institute for Communicable Diseases; Sudáfrica. University of the Witwatersrand; Sudáfrica
Fil: Cornick, Jennifer. University of Liverpool; Reino Unido
Fil: Hawkins, Paulina A.. University Of Emory. Rollins School Of Public Health; Estados Unidos
Fil: Madhi, Shabir A.. University of the Witwatersrand; Sudáfrica
Fil: Nzenze, Susan A.. University of the Witwatersrand; Sudáfrica
Fil: Kandasamy, Rama. University of Oxford; Reino Unido
Fil: Ravikumar, K.L.. Kempegowda Institute of Medical Sciences Hospital & Research Centre; India
Fil: Elmdaghri, Naima. University of Casablanca; Marruecos
Fil: Kwambana Adams, Brenda. Colegio Universitario de Londres; Reino Unido. London School of Hygiene and Tropical Medicine; Gambia
Fil: Grassi Almeida, Samanta Cristine. Instituto Adolfo Lutz; Brasil
Fil: Skoczynska, Anna. National Medicines Institute; Polonia
Fil: Egorova, Ekaterina. Moscow Research Institute for Epidemiology and Microbiology; Rusia
Fil: Titov, Leonid. Republican Research and Practical Center for Epidemiology and Microbiology; Bielorrusia
Fil: Saha, Samir K.. Dhaka Shishu Hospital; Bangladesh
Fil: Paragi, Metka. National Laboratory of Health, Environment and Food; Eslovenia
Fil: Everett, Dean B. Malawi Liverpool Wellcome Trust Clinical Research Programme; Malaui. University of Edinburgh; Reino Unido
Fil: Antonio, Martin. London School of Hygiene and Tropical Medicine; Gambia
Fil: Klugman, Keith P.. University of the Witwatersrand; Sudáfrica. National Institute for Communicable Diseases; Sudáfrica. University of Emory; Estados Unidos
Fil: Li, Yuan. Centers for Disease Control and Prevention; Estados Unidos
Fil: Metcalf, Benjamin J. Centers for Disease Control and Prevention; Estados Unidos
Fil: Beall, Bernard. Centers for Disease Control and Prevention; Estados Unidos
Fil: McGee, Lesley. Centers for Disease Control and Prevention; Estados Unidos
Fil: Breiman, Robert F.. University of Emory; Estados Unidos
Fil: Bentley, Stephen D. Wellcome Sanger Institute; Reino Unido
Fil: von Gottberg, Anne. National Institute for Communicable Diseases; Sudáfrica. University of the Witwatersrand; Sudáfrica
Fil: Brooks, Abdullah W.. Global Pneumococcal Sequencing Consortium; Estados Unidos
Fil: Corso, Alejandra. Global Pneumococcal Sequencing Consortium; Estados Unidos
Fil: Faccone, Diego Francisco. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina