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

Year: 2026

Type: article

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.

Source: Microbial Genomics

DOI: 10.1099/mgen.0.001703

Institutions: Universitat Autònoma de Barcelona, Instituto de Salud Carlos III, Vall d'Hebron Institut de Recerca, Centro de Investigación Biomédica en Red, Centro de Investigación Biomédica en Red Enfermedades Infecciosas, Vall d'Hebron Hospital Universitari, Hospital Universitari Arnau de Vilanova, Instituto de Investigación Biomédica de Lleida, Marqués de Valdecilla University Hospital, Instituto de Investigación Marqués de Valdecilla, Bellvitge University Hospital, Institut d'Investigació Biomédica de Bellvitge, Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Hospital General Universitario Gregorio Marañón, Hospital Universitario Reina Sofía, Institut de Recerca Biomèdica Catalunya Sud, Hospital Universitari Joan XXIII de Tarragona, Althaia, Universitat Internacional de Catalunya, Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Institut de Recerca Sant Joan de Déu, Complejo Hospitalario Universitario de Santiago, Hospital Universitario 12 De Octubre, Hospital Regional Universitario de Málaga, Hospital Universitari de Tortosa Verge de la Cinta, Hospital Universitari Germans Trias i Pujol, Hospital de Sant Pau, Institut de Recerca Sant Pau, Health Research Institute of the Balearic Islands, Hospital Universitario Son Espases

Language: English

Topic: Bacterial Infections and Vaccines

Subfield: Microbiology

Field: Immunology and Microbiology

Domain: Life Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,839

Funders: Centro de Investigación Biotecnológica en Red de Enfermedades Infecciosas, Instituto de Salud Carlos III

Awards: G2695153742, Caracterización de Neisseria meningitidis tras la introducción de la vacuna frente al serogrupo B e identificación de factores predisponentes para la enfermedad meningocócica invasiva

OpenAlex ID: W7160925884