Xie Qinghui, Yang Yang, Xu Wenwen, Yang Dandan, Li Jingrui, Tang Yijie, Shen Lingyun, Yu Fangyuan, Weng Wenhao, Long Fuquan, Luo Qingqiong
Department of Clinical Laboratory Medicine, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, 1278 Baode Road, Shanghai, 200443, China.
Department of Clinical Laboratory, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Ann Clin Microbiol Antimicrob. 2025 Jul 16;24(1):43. doi: 10.1186/s12941-025-00810-x.
Neisseria meningitidis (Nm), traditionally recognized as a nasopharyngeal commensal causing invasive meningococcal disease (IMD), has recently emerged as an etiological agent of urethritis worldwide, with sporadic urogenital cases in China raising epidemiological concerns.
Three urogenital Nm isolates were characterized to investigate their evolutionary features and transmission patterns. Through comprehensive laboratory characterization encompassing culture identification (Gram staining, oxidase testing, MALDI-TOF MS), antimicrobial susceptibility profiling, whole-genome sequencing, and functional colonization assays on urethral epithelial cells under nitrite-supplemented microaerobic conditions, three multidrug-resistant Nm isolates were identified.
All isolates demonstrated resistance to penicillin and sulfamethoxazole/trimethoprim, with isolate 24-SHSP-NM2 exhibiting additional ciprofloxacin resistance. The resistance was attributed to penA variants, mtrR promoter mutations, and gyrA substitutions. Phylogenetically, one isolate clustered with Japanese ST-11,026 strains and 2 clustered with Australian ST-1466 strains. Genomic characterization identified complete denitrification operons (aniA-norB) in all three isolates, which enable nitrite-enhanced epithelial colonization. ST-1466 isolates showed meningococcal B (MenB) vaccine component FHbp antigenic homology through FHbp variant 1.1.
These findings collectively demonstrate the convergent evolution of urogenital tropism, antimicrobial resistance (AMR) emergence, and metabolic adaptation to genitourinary microenvironments, underscoring the threat of genitourinary Nm infections. The study highlights the critical need to enhance molecular surveillance, implement rapid AMR screening, and prioritize MenB vaccination strategies in high-risk populations.
脑膜炎奈瑟菌（Nm）传统上被认为是一种引起侵袭性脑膜炎球菌病（IMD）的鼻咽共生菌，最近在全球范围内已成为尿道炎的病原体，中国散发性泌尿生殖系统病例引发了流行病学关注。
对三株泌尿生殖系统Nm分离株进行特征分析，以研究其进化特征和传播模式。通过综合实验室鉴定，包括培养鉴定（革兰氏染色、氧化酶试验、基质辅助激光解吸电离飞行时间质谱）、抗菌药物敏感性分析、全基因组测序以及在亚硝酸盐补充的微需氧条件下对尿道上皮细胞进行功能定植试验，鉴定出三株多重耐药Nm分离株。
所有分离株均对青霉素和磺胺甲恶唑/甲氧苄啶耐药，分离株24-SHSP-NM2还对环丙沙星耐药。耐药性归因于penA变体、mtrR启动子突变和gyrA替代。在系统发育上，一株分离株与日本ST-11026菌株聚类，两株与澳大利亚ST-1466菌株聚类。基因组特征分析在所有三株分离株中均鉴定出完整的反硝化操纵子（aniA-norB），其可实现亚硝酸盐增强的上皮定植。ST-1466分离株通过FHbp变体1.1显示出与脑膜炎球菌B（MenB）疫苗成分FHbp的抗原同源性。
这些发现共同证明了泌尿生殖系统嗜性、抗菌药物耐药性（AMR）出现以及对泌尿生殖微环境的代谢适应的趋同进化，突出了泌尿生殖系统Nm感染的威胁。该研究强调了加强分子监测、实施快速AMR筛查以及在高危人群中优先实施MenB疫苗接种策略的迫切需求。
