Penicillin-insensitive meningococci in Rouen between 1996 and 1998: epidemiological, clinical and microbiological aspects

Objective: The, authors had for aim to study the epidemiological, clinical, and, microbiological features of meningococcal infections, especially those due to strains with reduced susceptibility to penicillin, identified at the Rouen University Hospital, France. Patients and methods: We studied the clinical presentation, the antibiotherapy used, and the microbiological characteristics of each Neisseria meningitidis strain for all patients in whom a meningococcal strain had been isolated and identified in our laboratory. Results: Twenty two strains were isolated: 14 from cases of meningitis, 2 from meningococcemia, 2 from osteoarthritis and 4 from broncho-pulmonary samples. Twenty one of the 22 isolated strains were studied: 19 (90.5%) belonged to serogroup B; 7 strains presented with a reduced susceptibility to penicillin (MIC ranging from 0.125 mg l(-1) to 0.98 mg l(-1)). All strains were susceptible to cefotaxime or ceftriaxone. Antibiotic regimens used for meningitis and meningococcemia varied, but all included cefotaxime or ceftriaxone. Conclusion: In this 3 yearlong retrospective study (1996-1998), 33% of our meningococcal strains presented with reduced susceptibility to penicillin. According to some authors, there is a risk of low response or failure to penicillin or aminopenicillin based antibiotherapy for these strains. On the other hand, our small series showed a good efficacy of a first line antibiotherapy based on a third generation cephalosporin such as cefotaxime or ceftriaxone. (C) 2003 Editions scientifiques et medicales Elsevier SAS. All rights reserved.