Penicillin-Resistant Strains of Neisseria Meningitidis in Spain

Sáez-Nieto, Juan Antonio; Campos, José; Trallero, Emilio Pérez; Baroja, I Muñoz; Anasagasti, Y; Idígoras, Pedro; Pérez-Yarza, Eduardo González

doi:10.1016/s0140-6736(88)92256-8

Cited by 24 publications

(18 citation statements)

References 7 publications

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“…In addition to plasmid-mediated resistance to penicillin, several reports have recently documented the appearance of low-level resistance to penicillin (MIC > 0.1 ,ug/ml) in meningococci (6,47,60,71). These isolates were found to have a penicillin-binding protein 3 with a decreased affinity for penicillin (47).…”

Section: Molecular Biology Andevolution Of P-lactamase Plasmids Inmentioning

confidence: 99%

Beta-lactamase plasmids and chromosomally mediated antibiotic resistance in pathogenic Neisseria species

Dillon

Yeung

1989

Clin Microbiol Rev

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Section: Molecular Biology Andevolution Of P-lactamase Plasmids Inmentioning

confidence: 99%

Beta-lactamase plasmids and chromosomally mediated antibiotic resistance in pathogenic Neisseria species

Dillon

Yeung

1989

Clin Microbiol Rev

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“…Isolates of Neisseria meningitidis (meningococci) with increased levels of resistance to penicillin have been reported in the last few years, particularly from Spain and the United Kingdom (10,11,15). Resistance is due, at least in part, to the development of altered forms of penicillin-binding protein 2 (PBP 2) that have a decreased affinity for the antibiotic (9,11).…”

mentioning

confidence: 99%

Interspecies recombination between the penA genes of Neisseria meningitidis and commensal Neisseria species during the emergence of penicillin resistance in N. meningitidis: natural events and laboratory simulation

et al. 1994

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The penicillin-binding protein 2 genes (penA) of penicillin-resistant Neisseria meningitidis have a mosaic structure that has arisen by the introduction of regions from the penA genes of Neisseria flavescens or Neisseria cinerea. Chromosomal DNA from both N. cinerea and N. flavescens could transform a penicillin-susceptible isolate of N. meningitidis to increased resistance to penicillin. With N. flavescens DNA, transformation to resistance was accompanied by the introduction of the N. flavescens penA gene, providing a laboratory demonstration of the interspecies recombinational events that we believe underlie the development of penicillin resistance in many meningococci in nature. Surprisingly, with N. cinerea DNA, the penicillin-resistant transformants did not obtain the N. cinerea penA gene. However, the region of the penA gene derived from N. cinerea in N. meningitidis K196 contained an extra codon (Asp-345A) which was not found in any of the four N. cinerea isolates that we examined and which is known to result in a decrease in the affinity of PBP 2 in gonococci.

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“…Meningococci were considered moderately susceptible to penicillin and/or ampicillin when MICs of both antibiotics were 20.12 ,ug/ml and fully susceptible when MICs were .0.06 ,ug/ml (2,8,(11)(12)(13)(14)(15) …”

Section: Methodsmentioning

confidence: 99%

“…The existence of Pen' Ampr strains (penicillin MIC, <0.06 ,ug/ml; ampicillin MIC, >0.12 ,ug/ml) is well documented (11,(13)(14)(15) moderately susceptible populations are of clinical and epidemiological interest. In the present study, we addressed the question of whether the three phenotypes mentioned above can be reliably discriminated by the disk susceptibility testing method.…”

mentioning

confidence: 99%

“…With regard to penicillin and ampicillin susceptibilities, three phenotypes have been described in N. meningitidis: susceptible to penicillin and ampicillin (Pens AmpS), moderately susceptible to both penicillin and ampicillin (Penr Ampr), and susceptible to penicillin and moderately susceptible to ampicillin (Pen' Ampr) (11,14). The existence of Pen' Ampr strains (penicillin MIC, <0.06 ,ug/ml; ampicillin MIC, >0.12 ,ug/ml) is well documented (11,(13)(14)(15) and was described in Spain at least 7 years before the first Penr strain appeared (11).…”

mentioning

confidence: 99%

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Discriminative criteria for Neisseria meningitidis isolates that are moderately susceptible to penicillin and ampicillin

Campos

Trujillo

Seuba

et al. 1992

Antimicrob Agents Chemother

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The prevalence of Neisseria meningitidis isolates that are moderately susceptible to penicillin and ampicillin has increased very quickly in Spain; the current prevalences in our hospital are 48.4 and 55.6%, respectively. We studied the reliability of the disk diffusion method for discriminating between fully susceptible (MIC, .0.06 ,ug/ml) and moderately susceptible (MICs, 0.12 to 1.0 pg/ml) isolates. Thirty-eight isolates (12 Pens AmpS, 18 Penr Ampr, and 8 Pen' Ampr) were assayed by the disk diffusion and plate dilution methods by use of disks of 1, 2, 5, and 10 U of penicillin, 2 and 10 pg of ampicillin, and 1 pg of oxacillin on Mueller-Hinton agar with or without 5% sheep blood. Breakpoints were generated, and their discriminative values were determined with a collection of 195 meningococcal strains isolated consecutively from cerebrospinal fluid or blood. None of the strains produced 1-lactamase. Penicillin-and ampicillin-susceptible strains (MIC, <0.06 ,ug/ml) had oxacillin inhibition zones of >11 mm on blood agar. Moderate susceptibility to ampicillin and penicillin was suggested by an inhibition zone of < 10 mm around the 1-,ug oxacillin disk and an inhibition zone of .26 mm around the 2-U penicillin disk. We conclude that discrimination between fuly susceptible and moderately susceptible populations ofN. meningitidis can be accomplished by the disk diffusion method by use of Mueller-Hinton agar plus 5% sheep blood with the 1-,ug oxacillin disk (which is especially suited for screening methods) and the 2-U penicillin disk. The lack of an oxacillin inhibition zone indicates moderate susceptibility to either penicillin or ampicillin or both.Neisseria meningitidis isolates that are moderately susceptible to penicillin (MIC, 20.12 jg/ml) have been described in the last few years in Spain, England, and South Africa (1, 3, 11-13, 15, 16). Most of these isolates do not produce ,-lactamase, and modifications of the penicillinbinding proteins are believed to be a major mechanism of resistance (4, 5, 13). Current penicillin MICs for moderately susceptible isolates (0.12 to 1.0 ug/rml) are only 2-to 20-fold higher than that for the fully susceptible ones (.0.06 ,ug/ml) (8,(13)(14)(15).With regard to penicillin and ampicillin susceptibilities, three phenotypes have been described in N. meningitidis: susceptible to penicillin and ampicillin (Pens AmpS), moderately susceptible to both penicillin and ampicillin (Penr Ampr), and susceptible to penicillin and moderately susceptible to ampicillin (Pen' Ampr) (11, 14). The existence of Pen' Ampr strains (penicillin MIC, <0.06 ,ug/ml; ampicillin MIC, >0.12 ,ug/ml) is well documented (11,(13)(14)(15) moderately susceptible populations are of clinical and epidemiological interest. In the present study, we addressed the question of whether the three phenotypes mentioned above can be reliably discriminated by the disk susceptibility testing method. MATERIALS AND METHODSStrains. Identification of strains as N. meningitidis was carried out by standard bacteriological methods. ...

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Penicillin-Resistant Strains of Neisseria Meningitidis in Spain

Cited by 24 publications

References 7 publications

Beta-lactamase plasmids and chromosomally mediated antibiotic resistance in pathogenic Neisseria species

Beta-lactamase plasmids and chromosomally mediated antibiotic resistance in pathogenic Neisseria species

Interspecies recombination between the penA genes of Neisseria meningitidis and commensal Neisseria species during the emergence of penicillin resistance in N. meningitidis: natural events and laboratory simulation

Discriminative criteria for Neisseria meningitidis isolates that are moderately susceptible to penicillin and ampicillin

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