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.

本研究检查了1996 年至 2016 年在爱尔兰共和国发现的侵袭性脑膜炎球菌病 (IMD) 相关脑膜炎奈瑟菌的抗菌药物敏感性。总共有 1359 株分离株，占每个流行病学年度诊断出的所有 IMD 实验室确诊病例的三分之一以上（安永；7 月 1 日至 6 月 30 日）进行了分析。所有分离株对环丙沙星、利福平和头孢噻肟敏感，分别有 74% 和 87% 对磺胺和青霉素敏感。在研究期间，对青霉素敏感性降低的分离株比例显着增加，没有证据表明特定penA的主要克隆扩增或水平传播等位基因。在最近恢复的脑膜炎球菌中观察到的更大的多样性，特别是在表现出降低的青霉素敏感性的分离株中观察到的更大的多样性有助于整个penA等位基因多样性的整体增加。表型和基因型菌株的出现和传播降低了对青霉素的敏感性，这增加了在爱尔兰共和国对脑膜炎球菌的抗微生物敏感性进行持续监测的必要性，特别是考虑到推荐青霉素 G 作为院前管理的经验性治疗选择。