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Meningococcal C Disease Outbreak Caused by Multidrug-Resistant Neisseria meningitidis, Fiji
Aneley Getahun Strobel
1 , Aalisha Sahukhan
1, Anaseini Ratu, Jimaima Kailawadoko, Isireli Koroituku, Shalini Singh, Samuel McEwen, Sakiusa Baleivanualala, Mathilda Wilmot, Silivia Matanitobua, Kerrie Stevens, Anaseini Vesikula, Talica Cabemaiwai, Raquel Cooper, Mere Taufa, Jokaveti Tadrau, Kristy Horan, Daniel Faktaufon, Benjamin P. Howden
2, and Eric Rafai
2
Author affiliation: The University of Melbourne at Peter Doherty Institute for infection and Immunity, Melbourne, Victoria, Australia (A.S. Getahun, M. Wilmot, K. Stevens, R. Cooper, K. Horan, B.P. Howden); Fiji National University, Suva, Fiji (A.S. Getahun, A. Ratu); Fiji Ministry of Health and Medical Services, Suva (A. Sahukhan, J. Kailawadoko, I. Koroituku, S. Singh, S. McEwen, S. Baleivanualala, S. Matanitobua, A. Vesikula, T. Cabemaiwai, M. Taufa, J. Tadrau, D. Faktaufon, E. Rafai); Centre for Pathogen Genomics, The University of Melbourne, Melbourne (B.P. Howden)
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Figure 3
Figure 3. Genomic relatedness between Neisseria meningitidis strains identified from invasive meningococcal disease outbreak in Fiji, January 2016–August 2023, and publicly available gene sequences. A) Phylogenetic tree of Fiji MLST 4821 isolates and related sequences. Bar charts indicate location and presence or absence of antimicrobial resistance genes. A total of 18 MenC strains associated with the outbreak and 5 MenC strains from the post outbreak surveillance period were typed as MLST 4821 and included in analysis. All 23 strains were found to contain the gyrA point mutation T91I, and only 1 strain contained the rpoB point mutation H553Y. Of the 18 strains associated with the outbreak, 5 contained the penA point mutations; A510V, F504L, and N512Y. B) Mashtree generated neighbor-joining tree of publicly available PubMLST (https://pubmlst.org) data typed as MLST 4821 clonal complex and the MLST 4821 Fiji strains. When placed in this global context, the strains from Fiji form a separate cluster and appear to have a common ancestor with strains that have been isolated in China. AMR, antimicrobial reistant; MenC, N. meningitidis serotype C; MLST, multilocus sequence type; NA, not available.
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