ArticleEmerging infectious diseases2018
Evolution of Sequence Type 4821 Clonal Complex Meningococcal Strains in China from Prequinolone to Quinolone Era, 1972-2013.
Article in Emerging infectious diseases, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 20 citations in OpenAlex.
- Hyperinvasive and quinolone-resistant meningococci cc4821 achieved immune evasion through capsule switching.BMC microbiology · 2026Article
- Genomic Typing of Meningococcal Carriage Isolates in an Urban Sexual Health Clinic.Pathogens (Basel, Switzerland) · 2026Article
- Origin ofEmerging microbes & infections · 2025Article
- Meningococcal C Disease Outbreak Caused by Multidrug-Resistant Neisseria meningitidis, Fiji.Emerging infectious diseases · 2025Article
- Review
- Metagenomic data from cerebrospinal fluid permits tracing the origin and spread of Neisseria meningitidis CC4821 in China.Communications biology · 2022Article
- Serogroup Y Clonal Complex 23 Meningococcus in China Acquiring Penicillin Resistance from Commensal Neisseria lactamica Species.Antimicrobial agents and chemotherapy · 2022Article
- Current Methods for Recombination Detection in Bacteria.International journal of molecular sciences · 2022Review
- Meningococcal vaccines in China.Human vaccines & immunotherapeutics · 2021Article
- Evolution of Sequence Type 4821 Clonal Complex Hyperinvasive and Quinolone-Resistant Meningococci.Emerging infectious diseases · 2021Article
- Evolutionary analysis of gyrA gene from Neisseria meningitidis bacterial strains of clonal complex 4821 collected in China between 1978 and 2016.BMC microbiology · 2020Article
- Meningococcal Quinolone Resistance Originated from Several CommensalAntimicrobial agents and chemotherapy · 2020Article
- Article
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Authors and funding
9 authors at 4 institutions in 3 countries.
Funding
Abstract
The expansion of hypervirulent sequence type 4821 clonal complex (CC4821) lineage Neisseria meningitidis bacteria has led to a shift in meningococcal disease epidemiology in China, from serogroup A (MenA) to MenC. Knowledge of the evolution and genetic origin of the emergent MenC strains is limited. In this study, we subjected 76 CC4821 isolates collected across China during 1972-1977 and 2005-2013 to phylogenetic analysis, traditional genotyping, or both. We show that successive recombination events within genes encoding surface antigens and acquisition of quinolone resistance mutations possibly played a role in the emergence of CC4821 as an epidemic clone in China. MenC and MenB CC4821 strains have spread across China and have been detected in several countries in different continents. Capsular switches involving serogroups B and C occurred among epidemic strains, raising concerns regarding possible increases in MenB disease, given that vaccines in use in China do not protect against MenB.
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