Changing patterns of antibiotic sensitivity and resistance during an outbreak of meningococcal infection in Jos, Nigeria.

Isolates of Neisseria meningitidis from blood and cerebrospinal fluid (CSF) of 87 children admitted to the emergency paediatric unit (EPU) at the Jos University Teaching Hospital (JUTH) during an outbreak of meningococcal infection (between February and April 1996) were tested against the commonly used antibiotics in an attempt to determine the sensitivity and resistance pattern. There were 11 (15.1 per cent) positive for N. meningitidis out of 73 blood cultures and 61 (70 per cent) positive out of 87 CSF cultures. Seventy-seven and thirty-eight per cent respectively of the CSF isolates were resistant to benzylpenicillin and ampicillin. Sensitivity to chloramphenicol and erythromycin was 97 and 95 per cent, respectively. Out of the 11 positive blood cultures, 82 and 27 per cent were resistant to benzylpenicillin and ampicillin, respectively, while all the isolates (100 per cent) were sensitive to chloramphenicol and erythromycin. It is concluded that in view of the high level of resistance of the meningococci to benzylpenicillin in our environment, this drug should no longer be the drug of choice for the empirical and initial treatment of meningococcal infection. We recommend that chloramphenicol be the drug of choice for the empirical and initial treatment of meningococcal infection in our environment.