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Antibiotic susceptibility and molecular analysis of invasive Neisseria meningitidis recovered in the Republic of Ireland, 1996 to 2016

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Abstract

This study examined the antimicrobial susceptibility of invasive meningococcal disease (IMD)–associated Neisseria meningitidis recovered in the Republic of Ireland between 1996 and 2016. In total, 1359 isolates representing over one-third of all laboratory-confirmed cases of IMD diagnosed each epidemiological year (EY; July 1–June 30) were analysed. All isolates were susceptible to ciprofloxacin, rifampicin and cefotaxime and 74% and 87% were susceptible to sulphonamide and penicillin, respectively. The proportion of isolates exhibiting reduced susceptibility to penicillin increased significantly during the study with no evidence of major clonal expansion or horizontal spread of a specific penA allele. Greater diversity observed among recently recovered meningococci and specifically among isolates exhibiting reduced penicillin susceptibility contributed to the overall increase in penA allele diversity throughout. The emergence and dissemination of strains with phenotypic and genotypic reduced susceptibility to penicillin increase the need for continued surveillance of antimicrobial susceptibility of meningococci in the Republic of Ireland especially in view of the recommendation of penicillin G as empiric treatment of choice for pre-hospital management.

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Any request for further anonymous data or isolates used in the study may be requested from the corresponding author.

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Acknowledgements

This work was presented in part at the 8th meeting of European Monitoring Group on Meningococci, 7–10 September 2005, Dublin (Abstract O5.3).

We would like to thank Piaras O’Lorcain for statistical support, Robert Mulhall and Richard Drew for helpful discussions and the staff of all the Clinical Microbiology Departments in hospitals in the Republic of Ireland for provision of the isolates used in this study.

We also acknowledge Steve Gray and staff (Meningococcal Reference Unit, Manchester, M13 9WL, U.K.) for performing isolate susceptibility testing prior to EY2006/2007, and Muhamed-Kheir Taha and Eva Hong (Neisseria Unit and the French National Reference Center for Meningococci, Institut Pasteur, Paris, France) curators of the penA allele database for allele assignment. This publication made use of the Neisseria Multi Locus Sequence Typing website (http://pubmlst.org/ neisseria/) developed by Keith Jolley and sited at the University of Oxford [45]. The development of Neisseria Multi Locus Sequence Typing website is supported by the Wellcome Trust and the European Union.

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Funding

This study was conducted as part of our routine work and was partially supported by a grant from the Irish Health Research Board (RP180/2001).

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Authors and Affiliations

  1. Irish Meningitis and Sepsis Reference Laboratory, Children’s Health Ireland at Temple Street, Dublin, Ireland

    Désirée E. Bennett, K. L. Meyler, M. T. Cafferkey & R. J. Cunney

  2. Department of Microbiology, Royal College of Surgeons in Ireland, Dublin, Ireland

    M. T. Cafferkey

  3. Department of Clinical Microbiology, Children’s Health Ireland, Dublin, Ireland

    R. J. Cunney

Authors
  1. Désirée E. Bennett
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  2. K. L. Meyler
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  3. M. T. Cafferkey
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  4. R. J. Cunney
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Contributions

D.E.B performed the molecular work, curated and analysed the data and was the main author of the manuscript. K.L.M performed the antimicrobial susceptibility testing and was a major contributor to the manuscript. M.T.C established the Irish Meningitis and Sepsis Reference Laboratory. M.T.C and R.J.C were involved in the design and supervision of the study. All authors participated in the drafting of the manuscript as well as read and approved the final manuscript.

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Correspondence to Désirée E. Bennett.

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N. meningitidis isolates were received as part of routine activity of the IMSRL for performing national surveillance of invasive meningococcal disease in the Republic of Ireland and were analysed anonymously.

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All authors have approved the manuscript and agree to its submission to European Journal of Clinical Microbiology and Infectious Diseases.

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Bennett, D.E., Meyler, K.L., Cafferkey, M.T. et al. Antibiotic susceptibility and molecular analysis of invasive Neisseria meningitidis recovered in the Republic of Ireland, 1996 to 2016. Eur J Clin Microbiol Infect Dis 40, 1127–1136 (2021). https://doi.org/10.1007/s10096-020-04114-0

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