Abstract
BACKGROUND: Neisseria meningitidis (Nm) is increasingly being recognized as a novel causative agent of urogenital infections. Recognition of urethritis caused by Nm remains inadequate in China. This study investigates the molecular characterization of Nm isolates cultured from patients with urethritis at a sentinel surveillance hospital in Guangzhou, China from 2022 to 2024. METHODS: Three Nm isolates were cultured from urethral swab samples of consecutive, non-duplicate urethritis cases between 2022 and 2024. Bacterial identification was determined using the VITEK-2 system. Antimicrobial susceptibility testing was performed via the disc diffusion and broth microdilution methods. Whole genome sequencing was conducted using the DNBSEQ platform. Genomic characterization was performed using Multilocus sequence typing (MLST), along with analyses of resistance genes, phylogeny and theoretical vaccine coverage. RESULTS: Three Nm isolates were nonsusceptible to penicillin and harbored penA mutations; one of these was also resistant to ciprofloxacin and carried a gyrA mutation. MLST revealed that one isolate belonged to sequence type ST-11,026 (clonal complex 32), and the other two isolates were identified as ST-1466 (clonal complex 174). Phylogenetic analysis demonstrated that our urethritis strains were genetically related to invasive strains from the United States and urogenital Japanese strains, and shared a more recent most recent common ancestor. We also confirmed that the strains were covered by the Trumenba vaccine. CONCLUSIONS: This study provides the first genomic characterization of urogenital colonized Nm strains in Guangzhou, China. The phylogenetic analysis further confirms that two foreign Nm urogenital lineages have circulated in China, which are associated with decreased penicillin susceptibility. It is essential to strengthen species identification capabilities and routinely conduct antimicrobial susceptibility testing to monitor the spread of urogenital Nm strains.