Service de Biologie Médicale, Hôpital d'Instruction des Armées Bégin, 69 avenue de Paris, 94163, Saint Mandé Cedex, France.
Infection. 2013 Jun;41(3):705-8. doi: 10.1007/s15010-013-0418-y. Epub 2013 Feb 14.
We report a secondary case of rifampicin-resistant meningococcal disease and our experience in managing contact cases. Rifampicin resistance resulting from rpoB gene mutations is still uncommon enough that changing the current recommendations for chemoprophylaxis is unwarranted. However, ensuring limited but appropriate chemoprophylaxis may prevent the development of antimicrobial resistance. Thus, the definition of contact cases should be strictly respected. In the case of culture-positive Neisseria meningitidis, in vitro susceptibility testing to rifampicin must be systematically performed in order to detect rifampicin-resistant strains and, thus, institute appropriate prophylaxis in order to prevent secondary transmission.
我们报告了一例利福平耐药性脑膜炎球菌病的继发病例，并介绍了我们在处理接触者病例方面的经验。利福平耐药性是由于 rpoB 基因突变引起的，这种情况仍然较为罕见，因此改变目前的化学预防建议是没有必要的。然而，确保有限但适当的化学预防措施可以防止抗菌药物耐药性的发展。因此，接触者病例的定义应严格遵守。对于脑膜炎奈瑟菌培养阳性的病例，必须系统地进行利福平体外药敏试验，以检测利福平耐药菌株，并因此采取适当的预防措施，以防止二次传播。
