RT Journal Article SR Electronic(1) A1 Lees, John A A1 Kremer, Philip H. C A1 Manso, Ana S A1 Croucher, Nicholas J A1 Ferwerda, Bart A1 Serón, Mercedes Valls A1 Oggioni, Marco R A1 Parkhill, Julian A1 Brouwer, Matthijs C A1 van der Ende, Arie A1 van de Beek, Diederik A1 Bentley, Stephen DYR 2017 T1 Large scale genomic analysis shows no evidence for pathogen adaptation between the blood and cerebrospinal fluid niches during bacterial meningitis JF Microbial Genomics, VO 3 IS 1 OP SP mgen000103 DO https://doi.org/10.1099/mgen.0.000103 PB Microbiology Society, SN 2057-5858, AB Recent studies have provided evidence for rapid pathogen genome diversification, some of which could potentially affect the course of disease. We have previously described such variation seen between isolates infecting the blood and cerebrospinal fluid (CSF) of a single patient during a case of bacterial meningitis. Here, we performed whole-genome sequencing of paired isolates from the blood and CSF of 869 meningitis patients to determine whether such variation frequently occurs between these two niches in cases of bacterial meningitis. Using a combination of reference-free variant calling approaches, we show that no genetic adaptation occurs in either invaded niche during bacterial meningitis for two major pathogen species, Streptococcus pneumoniae and Neisseria meningitidis. This study therefore shows that the bacteria capable of causing meningitis are already able to do this upon entering the blood, and no further sequence change is necessary to cross the blood–brain barrier. Our findings place the focus back on bacterial evolution between nasopharyngeal carriage and invasion, or diversity of the host, as likely mechanisms for determining invasiveness., UL https://www.microbiologyresearch.org/content/journal/mgen/10.1099/mgen.0.000103