Using Neisseria meningitidis genomic diversity to inform outbreak strain identification

PLoS Pathog. 2021 May 18;17(5):e1009586. doi: 10.1371/journal.ppat.1009586. eCollection 2021 May.

Abstract

Meningococcal disease is a life-threatening illness caused by the human-restricted bacterium Neisseria meningitidis. Outbreaks in the USA involve at least two cases in an organization or community caused by the same serogroup within three months. Genome comparisons, including phylogenetic analysis and quantification of genome distances can provide confirmatory evidence of pathogen transmission during an outbreak. Interpreting genome distances depends on understanding their distribution both among isolates from outbreaks and among those not from outbreaks. Here, we identify outbreak strains based on phylogenetic relationships among 141 N. meningitidis isolates collected from 28 outbreaks in the USA during 2010-2017 and 1516 non-outbreak isolates collected through contemporaneous meningococcal surveillance. We show that genome distance thresholds based on the maximum SNPs and allele distances among isolates in the phylogenetically defined outbreak strains are sufficient to separate most pairs of non-outbreak isolates into separate strains. Non-outbreak isolate pairs that could not be distinguished from each other based on genetic distances were concentrated in the clonal complexes CC11, CC103, and CC32. Within each of these clonal complexes, phylodynamic analysis identified a group of isolates with extremely low diversity, collected over several years and multiple states. Clusters of isolates with low genetic diversity could indicate increased pathogen transmission, potentially resulting in local outbreaks or nationwide clonal expansions.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cluster Analysis
  • Disease Outbreaks*
  • Epidemiological Monitoring
  • Genetic Variation*
  • Genomics
  • Humans
  • Meningococcal Infections / epidemiology
  • Meningococcal Infections / microbiology*
  • Neisseria meningitidis / genetics*
  • Neisseria meningitidis / isolation & purification
  • Phylogeny
  • United States / epidemiology

Grants and funding

All reagents and materials were purchased with funds from CDC. A.C.R., A.C., H-Y.C., A.E.B, L.A.M., and X.W were supported by CDC. M.M.M. and L.H.H. received no specific funding for this work. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.