The resistance of Neisseria meningitidis to the antimicrobial agents: an issue still in evolution

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Abstract
Among the bacteria, Neisseria meningitidis does not appear to be one of the more efficient in terms of developing resistance to antimicrobial agents. Nevertheless, because the meningococcus is a naturally transformable species, the acquisition and subsequent spread of mechanisms for resistance to antimicrobial agents can easily happen. Sulfonamides have been widely used and resistance to them is now common, but most strains are fully susceptible to rifampicin or ciprofloxacin, the other drugs used in chemoprophylaxis. Although moderate susceptibility to penicillin is mounting, the clinical significance of this level of resistance remains uncertain. However, the use of alternative β-lactam antibiotics such as cefotaxime or ceftriaxone is becoming frequent. Moreover, a high level of resistance to chloramphenicol might be spreading into the meningococcal population. Continued surveillance for resistance for detecting changes in the susceptibility to those drugs used in chemoprophylaxis or treatment of meningococcal disease will be useful and further multi-centre analysis should be used to standardise break-points, methods and culture media to be used for determination of minimum inhibitory concentrations.