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Invasive disease caused by Neisseria meningitidis relatively resistant to penicillin in North Carolina

C R Woods1, A L Smith, B L Wasilauskas

  • 1Dept. of Pediatrics, Bowman Gray School of Medicine, Winston-Salem, NC 27157.

The Journal of Infectious Diseases
|August 1, 1994
PubMed

Insights

Penicillin-resistant Neisseria meningitidis strains causing invasive disease were identified in the US. This resistance is linked to altered penicillin-binding protein 2, necessitating a review of treatment guidelines.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Clinical Medicine

Background:

  • Neisseria meningitidis is a significant cause of bacterial meningitis and sepsis.
  • Penicillin is a primary treatment for meningococcal disease.
  • Reduced susceptibility to penicillin in N. meningitidis has been reported internationally.

Observation:

  • A case of sepsis and meningitis in North Carolina was caused by a Neisseria meningitidis isolate with relative penicillin resistance.
  • This resistance mechanism involves decreased affinity of penicillin-binding protein 2.
  • Previously unrecognized invasive disease due to penicillin-resistant strains was identified retrospectively in the US.

Findings:

  • Three additional cases from 1991 and one from 1993 were identified, indicating the presence of these resistant strains in the US.
  • Surveillance suggests sporadic historical occurrence of penicillin-resistant N. meningitidis.
  • The resistance mechanism is linked to alterations in penicillin-binding protein 2.

Implications:

  • The emergence of penicillin-resistant Neisseria meningitidis in the US requires monitoring.
  • Clinical practice for treating meningococcal disease may need reconsideration if resistance prevalence increases.
  • Understanding resistance mechanisms is crucial for effective antimicrobial stewardship.

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