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[Meningococcal infection caused by Neisseria meningitidis serogroup C]
M I Ursua1, M Rodríguez-Mayo, J Fernández-Quintairos
1Servicio de Microbiología, Complejo Hospitalario Arquitecto Marcide-Profesor Novoa Santos, Ferrol, La Coruña.
Background:
In recent years an increase has been observed in the prevalence of meningococcal infection by Neisseria meningitidis serogroup C and in the appearance of strains with moderate resistance to penicillin.
Patients And Methods:
A microbiologic study of the cases of meningococcal infection of serogroup C treated from 1995 to 1996 in the health care area of Ferrol (La Coruña, Spain) was carried out.
Results And Conclusions:
Twenty-nine cases were detected in 1995 and 28 in 1996. Meningococcal infection was observed in patients ranging from 8 months to 21 years of age (mean 5.7 years). Distribution by sex was homogeneous. Two patients died. According to the clinical presentation, 11 were sepsis (38%), 4 meningitis (14%) and 14 both processes (48%). In 4 LCR samples, the analytical study was normal with posterior positive culture results. The detection of bacterial antigen by latex agglutination in CSF only detected 32% of the cases. MIC study determined that 11 strains (38%) presented moderate resistance to penicillin, 9 with a MIC of 0.12 microgram/ml, one with a MIC of 0.25 microgram/ml and another with a MIC of 0.5 microgram/ml. In all the cases the strains were sensitive to cefotaxime (MIC < or = 0.06 microgram/ml) and rifampicin (MIC < or = 0.5 microgram/ml). All the strains belonged to serogroup C serotype 2b, serosubtype P1.2,5. During the study period 4 additional cases of meningococcal disease by serogroup B were observed.
Insights
Meningococcal infections caused by Neisseria meningitidis serogroup C increased, with many strains showing penicillin resistance. However, all strains remained sensitive to cefotaxime and rifampicin.
Area of Science:
- Microbiology
- Infectious Diseases
- Epidemiology
Background:
- Observed increase in Neisseria meningitidis serogroup C infections.
- Emergence of Neisseria meningitidis strains with moderate penicillin resistance.
Purpose of the Study:
- To conduct a microbiologic study of serogroup C Neisseria meningitidis infections.
- To analyze cases treated between 1995 and 1996 in Ferrol, Spain.
Main Methods:
- Microbiologic analysis of clinical cases.
- Minimum Inhibitory Concentration (MIC) studies for antibiotic resistance.
- Serotyping and serosubtyping of Neisseria meningitidis strains.
Main Results:
- 57 cases of serogroup C Neisseria meningitidis infection identified (29 in 1995, 28 in 1996).
- 38% of strains exhibited moderate penicillin resistance (MIC 0.12-0.5 µg/ml).
- All strains were sensitive to cefotaxime and rifampicin.
Conclusions:
- Neisseria meningitidis serogroup C infections pose a significant public health concern.
- Penicillin resistance in Neisseria meningitidis serogroup C necessitates alternative treatment strategies.
- Cefotaxime and rifampicin are effective treatment options against these resistant strains.