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Antibiotic resistance in Neisseria meningitidis

B A Oppenheim1

  • 1Public Health Laboratory, Withington Hospital, West Didsbury, Manchester, United Kingdom.

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|January 1, 1997
PubMed

Insights

Penicillin resistance in meningococcal infections is rising due to altered penicillin-binding proteins. While penicillin remains effective, low-dose treatments may fail, necessitating careful antibiotic selection for meningococcal disease management.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Pharmacology

Background:

  • Penicillin is the standard treatment for meningococcal infections.
  • Emerging concerns exist regarding meningococcal susceptibility to penicillin and other antibiotics.
  • Reported penicillin resistance varies globally, with minimum inhibitory concentrations between 0.1 mg/L and 1.28 mg/L.

Purpose of the Study:

  • To investigate the current status of antibiotic susceptibility in Neisseria meningitidis.
  • To understand the mechanisms and implications of emerging antibiotic resistance in meningococcal disease.
  • To inform clinical practice regarding the effective management of meningococcal infections and their contacts.

Main Methods:

  • Review of international reports on meningococcal antibiotic resistance.
  • Analysis of penicillin-binding protein alterations as a resistance mechanism.
  • Assessment of clinical implications for treatment regimens and contact management.

Main Results:

  • Penicillin resistance in meningococci is linked to altered penicillin-binding proteins.
  • While penicillin is generally effective, low-dose regimens may be insufficient for resistant strains.
  • Beta-lactamase production is rare but significant; sulfonamide and rifampin resistance are key concerns for contact prophylaxis.

Conclusions:

  • Clinicians must monitor meningococcal antibiotic susceptibility due to emerging resistance.
  • Adjusted penicillin-binding proteins contribute to reduced penicillin susceptibility.
  • Alternative antibiotics and careful dosing are crucial for treating meningococcal infections and managing contacts effectively.

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