title: Antibiotic susceptibility and characteristics of Neisseria meningitidis isolates from the African meningitis belt, 2000 to 2006: phenotypic and genotypic perspectives.
abstract: Up-to-date information regarding the antibiotic susceptibility of Neisseria meningitidis strains from African countries is highly limited. Our aim was to comprehensively describe the antibiotic susceptibilities of a selection of N. meningitidis isolates recovered between 2000 and 2006 from 18 African countries, mainly those within the meningitis belt. Susceptibilities to 11 antibiotics were determined using Etest for 137 N. meningitidis isolates (stringently selected from 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 percent of isolates displayed reduced susceptibility to rifampin, while 52% of the isolates were resistant to tetracycline, 74% were resistant to erythromycin, and 94% were resistant to sulfadiazine. The MICs of rifampin and tetracycline seemed to be associated with the serogroup of the isolates. In total, 18 sequence types (STs), 10 genosubtypes, and 8 different penA alleles were identified; the most common were ST-7, P1.20,9,35-1, and penA4, respectively. A high level of 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 beta-lactam antibiotics, rare isolates showed a reduced susceptibility to penicillins, but the expanded-spectrum cephalosporins are not affected at present.
authors.affiliation: Department of Laboratory Medicine, National Reference Laboratory for Pathogenic Neisseria, Orebro University Hospital, Orebro, Sweden. sara.thulin-hedberg@orebroll.se
authors.forename: Sara Thulin
authors.initials: ST
authors.lastname: Hedberg
authors.forename: Hans
authors.initials: H
authors.lastname: Fredlund
authors.forename: Pierre
authors.initials: P
authors.lastname: Nicolas
authors.forename: Dominique A
authors.initials: DA
authors.lastname: Caugant
authors.forename: Per
authors.initials: P
authors.lastname: Olcén
authors.forename: Magnus
authors.initials: M
authors.lastname: Unemo
mesh_terms: D000349:Africa; D005838:Genotype; D006801:Humans; D008585:Meningitis, Meningococcal / Q000382:microbiology*; D008826:Microbial Sensitivity Tests; D009345:Neisseria meningitidis / Q000145:classification / Q000187:drug effects* / Q000235:genetics; D010641:Phenotype; D017422:Sequence Analysis, DNA; D013997:Time Factors