The role of interspecies recombination in the evolution of antibiotic-resistant pneumococci

Author:

D'Aeth Joshua C1ORCID,van der Linden Mark PG2,McGee Lesley3,de Lencastre Herminia45,Turner Paul67ORCID,Song Jae-Hoon8,Lo Stephanie W9,Gladstone Rebecca A9,Sá-Leão Raquel10,Ko Kwan Soo8ORCID,Hanage William P11,Breiman Robert F12,Beall Bernard3,Bentley Stephen D9,Croucher Nicholas J1ORCID,Corso Alejandra13,Faccone Diego14,Gagetti Paula13,Brooks Abdullah W15,Hasanuzzaman Md16,Malaker Roly16,Saha Samir K16,Davydov Alexander17,Titov Leonid17,de Cunto Brandileone Maria Cristina18,Almeida Samanta Cristine Grassi18,Ip Margaret19,Ho Pak Leung20,Law Pierra20,Zhao Chunjiang21,Wang Hui21,Keenan Jeremy22,Sampane-Donkor Eric23,Veeraraghavan Balaji24,Nagaraj Geetha25,Ravikumar KL25,Givon-Lavi Noga26,Porat Nurit26,Benisty Rachel26,Dagan Ron26,Bigogo Godfrey27,Verani Jennifer28,Kiran Anmol29,Everett Dean B30,Cornick Jennifer29,Alaerts Maaike29,Sekaran Shamala Devi31,Clarke Stuart C32,Belabbès Houria33,Diawara Idrissa34,Zerouali Khalid35,Elmdaghri Naima36,Moiane Benild37,Sigauque Betuel37,Mucavele Helio37,Pollard Andrew J38,Kandasamy Rama38,Carter Philip E39,Obaro Stephen40,Shakoor Sadia41,Lehmann Deborah42,Ford Rebecca43,Ochoa Theresa J44,Skoczynska Anna45,Sadowy Ewa45,Hryniewicz Waleria45,Doiphode Sanjay46,Egorova Ekaterina47,Voropaeva Elena48,Urban Yulia48,Paragi Metka49,Kastrin Tamara49,Von Gottberg Anne50,Ndlangisa Kedibone M50,De Gouveia Linda50,Du Plessis Mignon50,Ali Mushal50,Wolter Nicole50,Madhi Shabir A51,Nzenze Susan A51,Srifuengfung Somporn5253,Kwambana-Adams Brenda54,Foster-Nyarko Ebenezer54,Bojang Ebrima54,Antonio Martin54,Tientcheu Peggy-Estelle54,Moïsi Jennifer55,Nurse-Lucas Michele56,Akpaka Patrick E57,Eser Özgen Köseoglu58,Maguire Alison59,Aanensen David60,Bentley Leon61,Bhai Jyothish N Nair Thulasee61,Mostowy Rafal60,Lees John A62,Klugman Keith P63,Hawkins Paulina64,Cleary David32,

Affiliation:

1. MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom

2. Institute for Medical Microbiology, National Reference Center for Streptococci, University Hospital RWTH Aachen, Aachen, Germany

3. Respiratory Diseases Branch, Centers for Disease Control and Prevention, Atlanta, United States

4. Laboratory of Molecular Genetics, Instituto de Tecnologia Química e Biológica, Universidade Nova de Lisboa, Oeiras, Portugal

5. Laboratory of Microbiology and Infectious Diseases, The Rockefeller University, New York, United States

6. Cambodia Oxford Medical Research Unit, Angkor Hospital for Children, Siem Reap, Cambodia

7. Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom

8. Department of Molecular Cell Biology, Sungkyunkwan University School of Medicine, Suwon, Republic of Korea

9. Parasites & Microbes, Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, United Kingdom

10. Laboratory of Molecular Microbiology of Human Pathogens, Instituto de Tecnologia Química e Biológica, Universidade Nova de Lisboa, Oeiras, Portugal

11. Center for Communicable Disease Dynamics, Harvard T.H. Chan School of Public Health, Boston, United States

12. Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, United States

13. Administración Nacional de Laboratorios e Institutos de Salud, Buenos Aires, Argentina

14. Instituto Nacional de Enfermedades Infecciosas (INEI)-Administración Nacional de Laboratorios e Institutos de Salud (ANLIS) "Dr. C. Malbrán", Buenos Aires, Argentina

15. International Centre for Diarrheal Diseases Research, Dhaka, Bangladesh

16. Child Health Research Foundation, Dhaka, Bangladesh

17. The Republican Research and Practical Center for Epidemiology and Microbiology, Minsk, Belarus

18. Center of Bacteriology, Adolfo Lutz Institute, São, Paulo, Brazil

19. Chinese University of Hong Kong, Hong Kong, China

20. The University of Hong Kong, Hong Kong, China

21. Peking University People 's Hospital, China

22. University of California, San Francisco, San Francisco, United States

23. School of Biomedical and Allied Health Sciences University of Ghana, Accra, Ghana

24. Christian Medical College, India

25. Kempegowda Institute of Medical Sciences Hospital & Research Center, Bangalore, India

26. Ben-Gurion University of the Negev, Beer-Sheva, Israel

27. Kenya Medical Research Institute, Kisumu, Kenya

28. Centers for Disease Control and Prevention, Atlanta, United States

29. Malawi-Liverpool-Wellcome-Trust, Blantyre, Malawi

30. University of Edinburgh, Edinburgh, United Kingdom

31. MAHSA University, Selangor, Malaysia

32. University of Southampton, Southampton, United Kingdom

33. Ibn Rochd university-hospital center, Casablanca, Morocco

34. Mohammed VI University of Health Sciences (UM6SS), Casablanca, Morocco

35. Faculté de médecine et de pharmacie de Casablanca, Casablanca, Morocco

36. Faculty of Medicine and Pharmacy & Ibn Rochd University Hospital Center, Casablanca, Morocco

37. Centro de Investigação em Saúde da Manhiça, Maputo, Mozambique

38. University of Oxford and the NIHR Oxford Biomedical Research Centre, Oxford, United Kingdom

39. Kenepuru Science Centre, Porirua, New Zealand

40. University of Nebraska Medical Center, Omaha, United States

41. The Aga Khan University, Karachi, Pakistan

42. The University of Western Australia, Perth, Australia

43. Papua New Guinea Institute of Medical Research, Goroka, Papua New Guinea

44. Instituto de Medicina Tropical, Universidad Peruana Cayetano Heredia, Lima, Peru

45. National Medicines Institute, Warsaw, Poland

46. Hamad Medical Corporation, Doha, Qatar

47. Moscow Research Institute for Epidemiology and Microbiology, Moscow, Russian Federation

48. Gabrichevsky Epidemiology and Microbiology Research Institute, Moscow, Russian Federation

49. National Laboratory of Health, Environment and Food, Ljubljana, Slovenia

50. Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases, Johannesburg, South Africa

51. University of the Witwatersrand, Johannesburg, South Africa

52. Faculty of Medicine, Siam University, Thailand

53. Faculty of Medicine Siriraj Hospital, Mahidol University, Thailand

54. Medical Research Council Unit, Banjul, Gambia

55. Agence de Médecine Préventive, Paris, France

56. Department of Paraclinical Sciences, The University of the West Indies, St., Augustine, Trinidad and Tobago

57. The University of the West Indies, St., Augustine, Trinidad and Tobago

58. Hacettepe University Faculty of Medicine, Ankara, Turkey

59. University of Cambridge, Cambridge, United Kingdom

60. Imperial College London, United Kingdom

61. Wellcome Sanger Institute, Cambridge, United Kingdom

62. Imperial College London, London, United Kingdom

63. Bill & Melinda Gates Foundation, Seattle, United States

64. Rollins School of Public Health, Emory University, Atlanta, United States

Abstract

Multidrug-resistant Streptococcus pneumoniae emerge through the modification of core genome loci by interspecies homologous recombinations, and acquisition of gene cassettes. Both occurred in the otherwise contrasting histories of the antibiotic-resistant S. pneumoniae lineages PMEN3 and PMEN9. A single PMEN3 clade spread globally, evading vaccine-induced immunity through frequent serotype switching, whereas locally circulating PMEN9 clades independently gained resistance. Both lineages repeatedly integrated Tn916-type and Tn1207.1-type elements, conferring tetracycline and macrolide resistance, respectively, through homologous recombination importing sequences originating in other species. A species-wide dataset found over 100 instances of such interspecific acquisitions of resistance cassettes and flanking homologous arms. Phylodynamic analysis of the most commonly sampled Tn1207.1-type insertion in PMEN9, originating from a commensal and disrupting a competence gene, suggested its expansion across Germany was driven by a high ratio of macrolide-to-β-lactam consumption. Hence, selection from antibiotic consumption was sufficient for these atypically large recombinations to overcome species boundaries across the pneumococcal chromosome.

Funder

Wellcome Trust

Medical Research Council

Department for International Development

Bill and Melinda Gates Foundation

National Institutes of Health

Royal Society

Centers for Disease Control and Prevention

Publisher

eLife Sciences Publications, Ltd

Subject

General Immunology and Microbiology,General Biochemistry, Genetics and Molecular Biology,General Medicine,General Neuroscience

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