Cocirculation of Hajj and non-Hajj strains among serogroup W meningococci in Italy, 2000 to 2016

Cecilia Fazio, Arianna Neri, Paola Vacca, Andrea Ciammaruconi, Milena Arghittu, Anna Maria Barbui, Caterina Vocale, Paola Bernaschi, Patrizia Isola, Irene Alessandra Galanti, Antonella Mencacci, Rosella De Nittis, Maria Chironna, Anna Giammanco, Elisabetta Pagani, Alessandro Bisbano, Paola Stefanelli

Research output: Contribution to journalArticlepeer-review


In Italy, B and C are the predominant serogroups among meningococci causing invasive diseases. Nevertheless, in the period from 2013 to 2016, an increase in serogroup W Neisseria meningitidis (MenW) was observed. This study intends to define the main characteristics of 63 MenW isolates responsible of invasive meningococcal disease (IMD) in Italy from 2000 to 2016. We performed whole genome sequencing on bacterial isolates or single gene sequencing on culture-negative samples to evaluate molecular heterogeneity. Our main finding was the cocirculation of the Hajj and the South American sublineages belonging to MenW/clonal complex(cc)11, which gradually surpassed the MenW/cc22 in Italy. All MenW/cc11 isolates were fully susceptible to cefotaxime, ceftriaxone, ciprofloxacin, penicillin G and rifampicin. We identified the full-length NadA protein variant 2/3, present in all the MenW/cc11. We also identified the fHbp variant 1, which we found exclusively in the MenW/cc11/Hajj sublineage. Concern about the epidemic potential of MenW/cc11 has increased worldwide since the year 2000. Continued surveillance, supported by genomic characterisation, allows high-resolution tracking of pathogen dissemination and the detection of epidemic-associated strains.
Original languageEnglish
Pages (from-to)33-41
Number of pages9
Issue number4
Publication statusPublished - Jan 24 2019


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