Emergence of ST-3587 harbouring and exhibiting dual resistance to penicillin and ciprofloxacin, Spain, 2024

Abstract

Dual penicillin -and ciprofloxacin- resistant causing invasive meningococcal disease (IMD) have recently emerged in association with sequence type (ST) 3587, harbouring ROB-1 β-lactamase ( ) and a mutated DNA gyrase (). These strains pose a threat to current antimicrobial treatment and prophylaxis.AIMWe aimed to characterise the first dual-resistant ST-3587 isolates harbouring and a mutated identified in Spain.METHODSThree isolates encoding were identified in 2024. They were characterised by whole genome sequencing to determine capsular genogroups, ST and genetic antimicrobial resistance markers. Dated phylogenetic analysis was performed alongside global ST-3587 strains.RESULTSThe three -encoding isolates belonged to ST-3587, genogroup Y, harboured a T91I mutation in and showed resistance to penicillin and ciprofloxacin. These isolates were obtained from urethral, oropharyngeal and blood samples, each from a different patient. According to the dated phylogenetic analysis of ST-3587 and the presence of , two clades were defined: clade I and clade II. Within clade II, subclade II.I was identified, comprising isolates which, in addition to , carried the T91I mutation in . This subclade included the three Spanish isolates, which exhibited close genetic relatedness.CONCLUSIONThis study documents the emergence of ST-3587 with dual resistance in Europe, including a documented urogenital infection by this lineage. Continued surveillance of antimicrobial resistance in , including non-invasive cases, is crucial for timely public health responses and effective IMD prevention strategies.

This work was supported by the “Instituto de Salud Carlos III” and cofinanced by the European Regional Development Fund (ERDF) grant no. FIS PI21/00132, and by the “Centro de Investigación Biomédica en Red” (CIBER de Enfermedades Infecciosas) grant no. CB21/12/00054.