[Standardization of the Neisseria meningitidis antibiogram. Detection of strains relatively resistant to penicillin].

Studying the susceptibility of 189 Neisseria meningitidis strains to penicillin, amoxicillin, cefotaxime, ceftriaxone, chloramphenicol and rifampicin by determination of minimum inhibitory concentrations (MICs) by agar dilution (reference method), E-test and disc diffusion method on Mueller-Hinton agar at 37 degrees C with 5% CO2 enabled us to standardize the antibiograms. While MIC determination by agar dilution is still the reference method, it is possible to obtain exact or approximate MIC values using the E-test. For laboratories that cannot determine penicillin MICs, it is impossible to detect strains that are relatively resistant to penicillin (RRP strains: 0.1 < or = MIC < or = 1 mg/l) using a 10-U penicillin disc. A 1 microgram-oxacillin disc allows MIC to be determined in most cases when the oxacillin inhibition zone is < or = 10 mm. Such strains must be sent to a reference laboratory for exact MIC determination. Based on our results and literature data on pharmacokinetics, we propose critical concentrations for these various antibiotics as well as critical diameters for chloramphenicol and rifampicin discs.