{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T03:06:09Z","timestamp":1791342369377,"version":"4.3.1"},"reference-count":51,"publisher":"American Society for Microbiology","issue":"10","license":[{"start":{"date-parts":[[2008,10,1]],"date-time":"2008-10-01T00:00:00Z","timestamp":1222819200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["J Clin Microbiol"],"published-print":{"date-parts":[[2008,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:p>\n            <jats:italic>Neisseria meningitidis<\/jats:italic>\n            strains (meningococci) with decreased susceptibility to penicillin (MICs, &gt;0.06 \u03bcg\/ml) have been reported in several parts of the world, but the prevalence of such isolates in Africa is poorly described. Data from an active national laboratory-based surveillance program from January 2001 through December 2005 were analyzed. A total of 1,897 cases of invasive meningococcal disease were reported, with an average annual incidence of 0.83\/100,000 population. Of these cases, 1,381 (73%) had viable isolates available for further testing; 87 (6%) of these isolates tested intermediately resistant to penicillin (Pen\n            <jats:sup>i<\/jats:sup>\n            ). Pen\n            <jats:sup>i<\/jats:sup>\n            meningococcal isolates were distributed throughout all provinces and age groups, and there was no association with outcome or human immunodeficiency virus infection. The prevalence of Pen\n            <jats:sup>i<\/jats:sup>\n            was lower in serogroup A (7\/295; 2%) than in serogroup B (24\/314; 8%), serogroup C (9\/117; 8%), serogroup Y (22\/248; 9%), or serogroup W135 (25\/396; 6%) (\n            <jats:italic>P<\/jats:italic>\n            = 0.02). Pulsed-field gel electrophoresis grouped 63\/82 Pen\n            <jats:sup>i<\/jats:sup>\n            isolates into nine clusters, mostly according to serogroup. The clustering of patterns from Pen\n            <jats:sup>i<\/jats:sup>\n            isolates was not different from that of penicillin-susceptible isolates. Twelve sequence types were identified among 18 isolates arbitrarily selected for multilocus sequence typing. DNA sequence analysis of the\n            <jats:italic>penA<\/jats:italic>\n            gene identified 26 different alleles among the Pen\n            <jats:sup>i<\/jats:sup>\n            isolates. Intermediate penicillin resistance is thus widespread among meningococcal serogroups, has been selected in a variety of lineages, and, to date, does not appear to be associated with increased mortality. This is the first report describing the prevalence and molecular epidemiology of Pen\n            <jats:sup>i<\/jats:sup>\n            meningococcal isolates from sub-Saharan Africa.\n          <\/jats:p>","DOI":"10.1128\/jcm.00221-08","type":"journal-article","created":{"date-parts":[[2008,7,24]],"date-time":"2008-07-24T01:00:45Z","timestamp":1216861245000},"page":"3208-3214","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":29,"title":["<i>Neisseria meningitidis<\/i>\n            Intermediately Resistant to Penicillin and Causing Invasive Disease in South Africa in 2001 to 2005"],"prefix":"10.1128","volume":"46","author":[{"given":"Mignon","family":"du Plessis","sequence":"first","affiliation":[{"name":"National Institute for Communicable Diseases (NICD) of the National Health Laboratory Service (NHLS)"},{"name":"School of Pathology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"von Gottberg","sequence":"additional","affiliation":[{"name":"National Institute for Communicable Diseases (NICD) of the National Health Laboratory Service (NHLS)"},{"name":"School of Pathology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheryl","family":"Cohen","sequence":"additional","affiliation":[{"name":"National Institute for Communicable Diseases (NICD) of the National Health Laboratory Service (NHLS)"},{"name":"School of Public Health, University of the Witwatersrand, Johannesburg, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda","family":"de Gouveia","sequence":"additional","affiliation":[{"name":"National Institute for Communicable Diseases (NICD) of the National Health Laboratory Service (NHLS)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keith P.","family":"Klugman","sequence":"additional","affiliation":[{"name":"National Institute for Communicable Diseases (NICD) of the National Health Laboratory Service (NHLS)"},{"name":"Hubert Department of Global Health, Rollins School of Public Health, and Division of Infectious Diseases, School of Medicine, Emory University, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.45.12.3625-3628.2001"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1074\/jbc.M304607200"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1086\/377739"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/47.3.285"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.48.1.358-359.2004"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.19.2.316"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1128\/jcm.33.7.1784-1786.1995"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.39.2.823.2001"},{"key":"e_1_3_2_10_2","first-page":"54","year":"1988","unstructured":"Botha, P. 1988. 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