Hedberg ST, Fredlund H, Nicolas P, Caugant DA, Olcén P, Unemo M
Antibiotic susceptibility and characteristics of Neisseria meningitidis isolates from the African meningitis belt 2000-2006 - phenotypic and genotypic perspectives. [JOURNAL ARTICLE]
Antimicrob Agents Chemother 2009 Feb 2.
Up-to-date information regarding the antibiotic susceptibility of Neisseria meningitidis from African countries is highly limited. Our aim was to comprehensively describe the antibiotic susceptibility of a selection of N. meningitidis isolates recovered between 2000 and 2006, from 18 African countries, mainly within the meningitis belt. The susceptibility to 11 antibiotics was determined using Etest for 137 N. meningitidis isolates (stringently selected out of 693 available isolates). The isolates were also characterized by serogrouping, multilocus sequence typing, genosubtyping and penA allele identification. All N. meningitidis isolates were susceptible to ceftriaxone, chloramphenicol and ciprofloxacin. No isolate produced beta-lactamase. Only three isolates (2%) displayed reduced susceptibility to penicillin G. The two isolates with the highest penicillin G MICs were the only isolates showing reduced susceptibility to ampicillin and cefuroxime. One of these isolates was also resistant to penicillin V. One per cent displayed reduced susceptibility to rifampicin, while 52% of the isolates were resistant to tetracycline, 74% to erythromycin, and 94% to sulfadiazine. MICs of rifampicin and tetracycline seemed to be associated with the serogroup of the isolates. In total, 18 sequence types (STs), 10 genosubtypes, and eight different penA alleles were identified; the most common were ST-7, P1.20,9,35-1, and penA4, respectively. High correlation was found between ST, genosubtype and penA allele. In conclusion, N. meningitidis isolates from the African meningitis belt remain highly susceptible to the antibiotics used. Regarding ss-lactam antibiotics, rare isolates showed a reduced susceptibility to penicillins, but the expanded-spectrum cephalosporins are not affected at present.
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