Vázquez Julio A
Reference Laboratory for Meningococci, National Centre for Microbiology-Instituto de Salud Carlos III,
FEMS Microbiol Rev. 2007 Jan;31(1):97-100. doi: 10.1111/j.1574-6976.2006.00050.x. Epub 2006 Nov 24.
One of the most controversial topics concerning Neisseria meningitidis is the definition of antimicrobial resistance. A process of harmonization, promoted by the European Monitoring Group on Meningococci (EMGM), is already in progress. There are several aspects of the MIC definition for meningococcal strains for which a consensus is needed, as follows. (1) What methods can be used? At present, both the Etest and agar dilution methods are recommended by the EMGM. Microdilution, also a recommended method, is not used across Europe. (2) What media produce the most reliable data? The use of Mueller-Hinton medium supplemented with 5% blood is recommended for the MIC determination of N. meningitidis by both Etest and agar dilution method. (3) What is the minimum set of antimicrobial agents to be tested? A minimum set should include rifampicin, ciprofloxacin (or another quinolone), penicillin, ampicillin and ceftriaxone. (4) What are the most suitable breakpoints for definition? There is no widely accepted robust evidence base for the definition of breakpoints. Although progress has been made in achieving a standardized methodology, we are still far from obtaining common breakpoints for antimicrobial resistance definition. These differences will imply inability for building a common epidemiologic figure about drug resistance.
关于脑膜炎奈瑟菌最具争议的话题之一是抗菌药物耐药性的定义。由欧洲脑膜炎球菌监测小组（EMGM）推动的统一进程已经在进行中。对于脑膜炎球菌菌株的最低抑菌浓度（MIC）定义，有几个方面需要达成共识，如下所述。（1）可以使用哪些方法？目前，EMGM推荐使用Etest法和琼脂稀释法。微量稀释法也是一种推荐方法，但在欧洲并未广泛使用。（2）哪种培养基能产生最可靠的数据？对于通过Etest法和琼脂稀释法测定脑膜炎奈瑟菌的MIC，推荐使用添加5%血液的Mueller-Hinton培养基。（3）要测试的抗菌药物的最小组合是什么？最小组合应包括利福平、环丙沙星（或另一种喹诺酮类药物）、青霉素、氨苄西林和头孢曲松。（4）定义的最合适断点是什么？对于断点的定义，尚无广泛接受的可靠证据基础。尽管在实现标准化方法方面已经取得了进展，但我们距离获得抗菌药物耐药性定义的通用断点仍有很大差距。这些差异将意味着无法构建关于耐药性的共同流行病学数据。
