化学发光免疫分析法检测肝纤维化血清标志物的性能评价

目的：验证某化学发光免疫分析系统检测透明质酸（HA ）、层粘连蛋白（LN ）、Ⅲ型前胶原 N端肽（PⅢP N-P）、Ⅳ型胶原（C-Ⅳ）的分析性能。方法参照相关标准文件中的方法,分别对精密度、加样针携带污染率、准确度、线性范围和参考区间进行验证。结果批内精密度验证结果显示,HA低值为3．38％,高值为1．00％;LN低值为4．42％,高值为0．78％;PⅢP N-P低值为4．39％,高值为0．35％;C-Ⅳ低值为4．42％,高值为0．40％。批间精密度验证结果显示,HA低值为4．49％,高值为3．86％;LN为低值为5．68％,高值为3．60％;PⅢP N-P低值为5．98％,高值为4．05％;C-Ⅳ低值为5．44％,高值为3．53％。加样针携带污染率验证结果显示,HA为0．99‰, LN为-0．41‰,PⅢP N-P为0．28‰,C-Ⅳ为0．53‰。各指标质控品实测值与靶值的相对偏差分别为HA 0．45％、LN -1．65％、PⅢP N-P -0．24％、C-Ⅳ-0．70％。线性范围验证结果显示,HA为12．84～1897．76 ng/mL ,LN为20．98～960．59 ng/mL ,PⅢP N-P为10．72～1923．48 ng/mL ,C-Ⅳ为11．85～1964．49 ng/mL。参考区间验证结果为HA＜100 ng/mL、LN＜50 ng/mL、PⅢP N-P＜30 ng/mL、C-Ⅳ＜30 ng/mL。结论该化学发光免疫分析系统检测HA、LN、PⅢP N-P、C-Ⅳ的主要分析性能指标达到预期要求,厂家提供的参考区间可以接受。     

基于循证构建住院患者肠内营养护理质量评价指标体系

目的 构建肠内营养护理质量评价指标体系,为提高临床护士执行力提供理论依据,以提高肠内营养护理质量。方法 基于循证方法学结合本院临床数据分析,应用德尔菲法对20名专家进行2轮函询,确定各指标内容及及重要性,结合层次分析法确定各指标权重。结果 经过2轮专家函询后,得到聚焦于过程质量指标下的一级指标1项即肠内营养规范符合率;4项二级指标即营养风险护理评估落实率、肠内营养护理评估落实率、肠内营养溶液配制落实率和肠内营养输注护理落实率;每项二级指标下级包括依次为3项、2项、3项、13项,共21项三级指标。结论 肠内营养护理质量评价指标体系具有科学性、有效性和可行性,可有效指导护士行为,评价肠内营养护理质量。     

Angiotensinogen gene is expressed and differentially regulated in multiple tissues of the rat.

To define the role of local synthesis of angiotensinogen in tissue angiotensin production, we have quantitated angiotensinogen messenger RNA (mRNA) levels in 17 different tissues of four groups of rats: control rats, nephrectomized rats, rats given dexamethasone, ethynylestradiol, and triiodothyronine, and nephrectomized rats given dexamethasone, ethynylestradiol, and triiodothyronine. Angiotensinogen mRNA was identified in 12 tissues: liver, kidney, brain, spinal cord, aorta, mesentery, atria, lung, adrenal, large intestine, stomach, and spleen. Angiotensinogen mRNA was not identified in pituitary, ventricle, testis, small intestine, or pancreas. When expressed per gram tissue wet weight, angiotensinogen mRNA levels of extrahepatic tissues were less than 4% of hepatic levels. However, when expressed per milligram total RNA, angiotensinogen mRNA levels of brain, spinal cord, aorta, and mesentery were 26-42% of hepatic levels. Regulation of angiotensinogen mRNA levels was tissue specific. This demonstration of a widespread tissue distribution of angiotensinogen mRNA may indicate a similarly widespread distribution of local angiotensin systems that are independent of the circulating renin-angiotensin system.     

5种中国罕见慢速生长非结核分枝杆菌标准株及临床分离株的药物敏感性分析

目的分别对熊本、慢生黄、施氏、苏尔加、三重分枝杆菌5种中国罕见分离的慢速生长非结核分枝杆菌标准株和临床分离株的药物敏感性进行分析。方法用微孔板Alamar blue显色法分别检测1株熊本分枝杆菌、3株慢生黄分枝杆菌、2株施氏分枝杆菌、2株苏尔加分枝杆菌、2株三重分枝杆菌等临床分离株及相应标准株对利福平、克拉霉素和阿米卡星等36种药物的最小抑菌浓度,判断分析其敏感性,并比较标准株及相应临床分离株对36种药物的敏感性差异。结果5种非结核分枝杆菌菌株中,多数对利福霉素类的利福喷丁和利福布丁、氨基糖苷类、多数氟喹诺酮类、卷曲霉素、大环内酯类（克拉霉素、罗红霉素和阿奇霉素）、利奈唑胺和氯法齐明等敏感。 三重分枝杆菌还对头孢菌素类药物表现出一定的敏感性。结论熊本、慢生黄、施氏、苏尔加、三重分枝杆菌等对克拉霉素等多种药物敏感,但有的临床分离株表现为耐药,治疗这些菌种感染时最好进行药物敏感性试验并联合用药。     

循证医学课程对医学生核心能力影响的系统评价

目的系统评价循证医学课程对医学生核心能力的影响。方法计算机检索CBM、CNKI、VIP、MEDLINE、ERIC、Academic Source Premier、Campbell Library,同时使用Google学术搜索有关循证医学教育的随机对照、非随机对照（与对照组比较或课程前后比较）研究,检索时间限定为1992年1月至2009年5月。两名研究者独立筛选文献,提取数据并交叉核对,而后采用Gemma Flores—Mateo等人改编的质量评价表评价文献质量,对纳入研究进行描述性分析：结果共纳入17篇文献,其中高质量文献2篇,中等质量15篇。内容包括医学科学基础知识、临床技能、信息管理三项核心能力。绝大多数研究结果显示循证医学课程能提高医学生的核心能力,少数研究显示无影响。结论循证医学能提高医学生的医学科学基础知识、临床技能和信息管理能力;对职业价值、态度、行为和伦理,群体健康和医疗卫生系统,信息管理和批判性思维四项核心能力无相关研究可纳入,无法予以评价。     

Comparison of the postantibiotic and postantibiotic sub-MIC effects of levofloxacin and ciprofloxacin on Staphylococcus aureus and Streptococcus pneumoniae.

The postantibiotic subminimum inhibitory concentration effect (PA SME) may simulate in vivo drug exposure more accurately than the postantibiotic effect (PAE) since subinhibitory concentrations of drug persist between antibiotic dosings. In this study, we compared the PAEs and PA SMEs of levofloxacin and ciprofloxacin for clinical isolates of fluoroquinolone-susceptible Staphylococcus aureus and Streptococcus pneumoniae. At two times the MIC, PAEs of levofloxacin were an average of 0.6 h longer than the PAEs obtained for ciprofloxacin for methicillin-susceptible and methicillin-resistant S. aureus strains. The PAEs of levofloxacin and ciprofloxacin ranged from 1.8 to 3.1 and 1.1 to 2.4 h, respectively. Continued exposure of the methicillin-resistant strain to 1/16, 1/8, and 1/4 the MIC resulted in PA SMEs of 6.5, 15.3, and >22.3 h, respectively, for levofloxacin and 3.8, 8.0, and 12.3 h, respectively, for ciprofloxacin. For isolates of S. pneumoniae, at two times the MIC of both fluoroquinolones, the average PAEs of levofloxacin and ciprofloxacin were equivalent: 1.3 h for the penicillin-susceptible isolate and 0.6 h for the penicillin-resistant isolate. Continued exposure of the penicillin-susceptible S. pneumoniae strain to 1/16, 1/8, and 1/4 the MIC resulted in average PA SMEs of 1.0, 1.4, and 2.8 h, respectively, for levofloxacin and 1.8, 2.0, and 2.5 h, respectively, for ciprofloxacin. Continued exposure of penicillin-resistant S. pneumoniae to 1/16, 1/8, and 1/4 the MIC of the same fluoroquinolones resulted in average PA SMEs of 0.6, 1.1, and 2.9 h, respectively, for levofloxacin and 0.6, 1.1, and 1.5 h, respectively, for ciprofloxacin. The PA SMEs observed demonstrate the superior activity of levofloxacin against methicillin-susceptible or methicillin-resistant S. aureus. Although PAEs were similar for the penicillin-susceptible and penicillin-resistant S. pneumoniae strains, the PA SME of levofloxacin at one-fourth the MIC was longer for penicillin-resistant S. pneumoniae.     

The antileishmanial agent licochalcone A interferes with the function of parasite mitochondria.

Our previous studies have shown that licochalcone A, an oxygenated chalcone, has antileishmanial (M. Chen, S.B. Christensen, J. Blom, E. Lemmich, L. Nadelmann, K. Fich, T.G. Theander, and A. Kharazmi, Antimicrob, Agents Chemother. 37:2550-2556, 1993; M. Chen, S.B. Christensen, T.G. Theander, and A. Khrazmi, Antimicrob. Agents Chemother. 38:1339-1344, 1994) and antimalarial (M. Chen, T.G. Theander, S.B. Christensen, L. Hviid, L. Zhai, and A. Kaharazmi, Antimicrob. Agents Chemother. 38:1470-1475, 1994) activities. We have observed that licochalcone A alters the ultrastructure of the mitochondria of Leishmania promastigotes (Chen et al., Antimicrob. Agents Chemother. 37:2550-2556, 1993). The present study was designed to examine this observation further and investigate the mechanism of action of antileishmanial activity of licochalcone A. Electron microscopic studies showed that licochalcone A altered the ultrastructure of Leishmania major promastigote and amastigote mitochondria in a concentration-dependent manner without damaging the organelles of macrophages or the phagocytic function of these cells. Studies on the function of the parasite mitochondria showed that licochalcone A inhibited the respiration of the parasite by the parasites. Moreover, licochalcone A inhibited the activity of the parasite mitochondrial dehydrogenase. The inhibition of the activity of the parasite mitochondrial enzyme correlated well with the changes in the ultrastructure of the mitochondria shown by electron microscopy. These findings demonstrate that licochalcone A alters the ultrastructure and function of the mitochondria of Leishmania parasites.     

Interview of Visiting Health Administrators from the Ministry of Health, Beijing, China

In April 1998, four health care administrators from Beijing, China visited the United States. During their visit, they were interviewed by Wen-Yin Chang, a doctoral student in nursing administration, at the University of Illinois at Chicago. The four administrators were: Dr. Aiming Sun, Deputy Director- General, Department of Medical Administration, Ministry of Health; Dr. Yuxiu Gong, Chief Nursing Division, Department of Medical Administration, Ministry of Health; Ms. Hanjun Men, Nursing Division, Ministry of Health, and Ms. Jing Yang, Vice-director, Nursing Management, Ministry of Health. Interview comments were translated to English by Ms. Chang.     

心理干预对牙颌面畸形患者家长心理健康状况的影响

目的探讨牙颌面畸形患者家长的心理健康状况，提出相应的护理干预对策。方法选择206例牙颌面畸形患者家长为研究对象，使用症状自评量表（SCL-90）分别在干预前后对其进行调查，比较干预前后研究对象SCL-90评分。结果牙颌面畸形患者家长SCL-90评分中躯体化、抑郁、焦虑、敌对、偏执、阳性项目数因子评分及总分均高于全国常模，差异均有统计学意义（t分别为15．01，12．92，10．79，4．55，4．43，16．43，9．79；P〈0．01）；干预后，牙颌面畸形患者家长躯体化、人际关系敏感、抑郁、焦虑、敌对、偏执、阳性项目数评分及总分分别为（1．42±0．65），（1．61±0．42），（1．40±0．38），（1．42±0．51），（1．45±0．49），（1．28±0．38），（26．35±9．27），（127．56±11．01）分，分别低于对照组的（1．86±0．34），（1．66±0．49），（1．97±0．32），（1．78±0．35），（1．65±0．41），（1．56±0．23），（47．32±11．96），（155．43±23．68）分，差异均有统计学意义（t分别为6．61，4．41，12．09，5．86，3．27，6．61，46．61，10．31；P〈0．01）。结论牙颌面畸形患者家长存在较多的心理健康问题，护理干预可改善患儿家长的心理状况。     

Dose or content? Effectiveness of pain rehabilitation programs for patients with chronic low back pain: A systematic review

We sought to systematically analyze the influence of dose of pain rehabilitation programs (PRPs) for patients with chronic low back pain (CLBP) on disability, work participation, and quality of life (QoL). Literature searches were performed in PubMed, Cochrane Library, Cinahl, and Embase up to October 2012, using MeSH terms, other relevant terms and free-text words. Randomized controlled trials in English, Dutch, and German, analyzing the effect of PRPs, were included. One of the analyzed interventions had to be a PRP. Outcomes should be reported regarding disability, work participation, or QoL. To analyze dose, the number of contact hours should be reported. Two reviewers independently selected titles, abstracts, and full-text articles on the basis of inclusion and exclusion criteria. Data were extracted and risk of bias was assessed. Effect sizes (ES) were calculated for each intervention, and influence of dose variables was analyzed by a mixed model analysis. Eighteen studies were identified, reporting a wide variety of dose variables and contents of PRPs. Analyses showed that evaluation moment, number of disciplines, type of intervention, duration of intervention in weeks, percentage of women, and age influenced the outcomes of PRPs. The independent effect of dose variables could not be distinguished from content because these variables were strongly associated. Because dose variables were never studied separately or reported independently, we were not able to disentangle the relationship between dose, content, and effects of PRPs on disability, work participation, and QoL.     

不同医院全血细胞计数比对实验结果分析

目的分析3家医院不同分析仪全血细胞计数比对实验结果。方法以西安交通大学第二附属医院(简称交大二院)采用的日本希森美康公司XE-2100型全自动血细胞分析仪(简称XE-2100分析仪)作为参比仪器,以西京医院采用的日本希森美康公司XN-3000分析仪(检测XN-3000分析仪)及唐都医院采用的XE-2100作为实验仪器,按照美国临床和实验室标准化协会(CLSI)发布的EP9-A2文件的要求,对白细胞(WBC)、红细胞(RBC)、血红蛋白(Hb)、血小板(PLT)、红细胞比容(HCT)检测结果进行比对分析,计算检测结果相关系数(r),以美国临床实验室修正法规(CLIA′88)规定的室间质量评价总允许误差范围为标准,判断检测结果偏差是否可接受。结果交大二院XE-2100分析仪和西京医院XN-3000分析仪WBC、RBC、Hb、HCT检测结果的r值分别为0.998、0.998、0.984、0.981,相关性良好,PLT检测结果的r值为0.953,相关性不佳;WBC、RBC、Hb、HCT检测结果比较差异无统计学意义(P0.05),但PLT检测结果比较差异有统计学意义(P0.05)。交大二院XE-2100分析仪和唐都医院XE-2100分析仪WBC、RBC、PLT、Hb、HCT检测结果的r值分别为0.999、0.999、0.998、0.999、0.998,相关性良好;各参数检测结果比较差异无统计学意义(P0.05)。结论不同医院全血细胞计数部分参数检测结果相关性良好,检测结果可以互认。     

Pharmacokinetics and tolerability of teicoplanin in healthy volunteers after single increasing doses.

In this double-blind, randomized study, five healthy subjects per group received doses of 15, 20, or 25 mg of teicoplanin per kg of body weight, and one subject per group received a 0.9% NaCl placebo as single intravenous infusion over 30 min. Serial blood samples and urine were collected for 13 days postadministration, and concentrations of teicoplanin were determined by microbiological assay. The pharmacokinetic data were analyzed by noncompartmental and compartmental analyses. Laboratory safety tests, audiometry, and serum creatinine clearance measurements were done prior to day 1 and on days 2 and 14. In the three groups, peak levels at the end of the infusion averaged 194, 197, and 253 mg/liter, respectively. Mean concentrations in plasma 24 h after the administration were 10.5, 13.6, and 19.8 mg/liter, respectively. Mean values of volume of distribution at steady state were 0.80, 0.87, and 0.87 liters/kg, respectively. Terminal half-lives averaged 88, 83, and 92 h. Mean total clearance values were 10.9, 11.0, and 11.3 mg/h/kg, respectively, with renal clearance accounting for 75, 81, and 78%, respectively, of the total. The 13-day cumulative mean urinary recovery ranged from 71 to 78% of the dose within the groups. The pharmacokinetics of teicoplanin appears to be linear in the range of administered doses. Teicoplanin was generally well tolerated. Side effects, appearing in five subjects, were represented by fevers, chills, and skin reactions; these adverse reactions were mild, but one episode of rash necessitated the interruption of infusion, and one episode of chills necessitated treatment with corticosteroids. There was no indication of drug-related modifications of laboratory test results.     

Open-label, dose escalation study of the safety and pharmacokinetic profile of tefibazumab in healthy volunteers

Tefibazumab (Aurexis) is a humanized monoclonal antibody being evaluated as adjunctive therapy for the treatment of Staphylococcus aureus infections. This open-label, dose escalation study evaluated the safety and pharmacokinetics of tefibazumab in 19 healthy volunteers aged 18 to 69 years. Each subject received a single administration of tefibazumab at a dose of 2, 5, 10, or 20 mg/kg of body weight infused over 15 min. Plasma samples for pharmacokinetic assessments were obtained before infusion as well as 1, 6, 12, and 24 h and 3, 4, 7, 21, 28, 42, and 56 days after dosing. Plasma concentrations of tefibazumab were detected 1 h after the end of the infusion, with a mean maximum concentration of drug in serum (C(max)) of 59, 127, 252, and 492 microg/ml following doses of 2, 5, 10, and 20 mg/kg, respectively. The median time to maximum concentration of drug in serum (T(max)) was 1.0 h for each dose. The mean elimination half-life (t(1/2)) was approximately 22 days. The volume of distribution (V) was 4.7, 6.7, 7.2, and 7.2 liters after doses of 2, 5, 10, and 20 mg/kg, respectively. Clearance (CL) was 6.0, 9.2, 10.2, and 9.9 ml/hr, respectively. At the highest dose, plasma levels of tefibazumab were >100 microg/ml for 21 days. On day 56, the mean plasma concentrations were 6.3, 10.0, 16.4, and 30.5 microg/ml for the 2, 5, 10, and 20 mg/kg doses, respectively. Tefibazumab exhibited linear kinetics across doses of 5, 10, and 20 mg/kg. No anti-tefibazumab antibodies were detected after dosing in any subject. There were no serious adverse events, and tefibazumab was well tolerated over the entire dose range.     

ACUTE AND CHRONIC ENTEROTOXIN ENTERITIS

1. Dogs develop severe gastrointestinal symptoms in response to intraintestinal administration of staphylococcal enterotoxin. These symptoms are salivation, vomiting, and diarrhea. 2. Staphylococcal enterotoxin induces acute enteritis marked by edema, hyperemia, round cell infiltration, mucosal exudation, and destruction of intestinal villi. 3. Prolonged administration of enterotoxin into the lumen of the intestine produced thickening of the entire bowel wall, edema, dilatation of the lymphatics, and exaggeration of submucous lymphoid nodules. The hypertrophy of the lymphoid nodules is visible, in the gross, as enlarged longitudinal mucosal ridges. This abnormality is arranged in skip areas, not dissimilar to those observed in human regional enteritis. 4. Chronic enterotoxin enteritis is associated with mesenteric lymph node hypertrophy. 5. The intestinal mucosa shows minute ulcerations, loss of villi, submucous fibrosis, and evidence of chronic inflammation.     

中国医学科学院北京协和医院陈敏章消化内镜中心和首家全国（消化科）内镜诊疗技术培训基地通过现场验收评价

中国医学科学院、中国协和医科大学党委书记、北京协和医院院长刘谦教授；医院党委书记常务副院长鲁重美教授；医院副院长、《中华肝胆外科杂志》副总编赵玉沛教授；著名消化内镜专家、前卫生部部长陈敏章教授的夫人李家熙研究员；国际消化内镜协会副主席、亚太消化内镜协会主席曹世植教授；中华医学会消化内镜分会主任委员、     

儿童系统性红斑狼疮患者血中自身抗体联合检测的临床意义

目的研究抗组氨酰-tRNA合成酶(Jo-1)抗体、抗干燥综合征(SS)-A抗体、抗SS-B抗体等非特异性抗体及抗核糖核蛋白(RNP)抗体、抗双链DNA(dsDNA)抗体、抗Sm抗体等特异性抗体在儿童系统性红斑狼疮(SLE)诊断中的意义,并与抗核抗体(ANA)的敏感性和特异性进行比较。探讨特异性自身抗体联合检测在儿童SLE诊断中的意义。方法选取60例SLE患儿作为疾病组,40例非SLE自身免疫性疾病患儿作为对照组。利用间接荧光法测定ANA抗体,免疫印迹法测定抗Jo-1抗体、抗SS-A抗体、抗SS-B抗体、抗RNP抗体、抗dsDNA抗体、抗Sm抗体。结果 ANA抗体、抗dsDNA抗体、抗RNP抗体、抗Sm抗体、抗SS-A抗体、抗SS-B抗体在儿童SLE患者中的阳性率分别为96.7%、48.3%、31.7%、30.0%、20.0%、18.3%,与对照组比较(22.5%、10.0%、7.5%、5.0%、5.0%、5.0%),差异均有统计学意义(P<0.01)。ANA的敏感性显著高于其他3种抗体,而其他3种抗体的特异性明显高于ANA;抗dsD-NA抗体、抗RNP抗体、抗Sm抗体的特异性分别为95.0%、92.5%、95.0%,差异有统计学意义(P<0.05);抗dsDNA抗体与抗RNP抗体、抗Sm抗体均无相关性。自身抗体的联合检测对儿童SLE敏感性的提高有明显的改善,但对特异性的提高则无明显改变。结论抗dsDNA抗体、抗RNP抗体、抗Sm抗体在儿童SLE诊断中特异性较高,而敏感性差异较大,其中抗dsDNA抗体的敏感性最高。此3种特异性抗体在SLE诊断中的互补作用显著。自身抗体的联合检测可明显提高SLE诊断的敏感性。     

Phenothiazine molecule provides the basic chemical structure for various classes of pharmacotherapeutic agents

The chemical structure of phenothiazine provides a most valuable molecular template for the development of agents able to interact with a wide variety of biological processes. Synthetic phenothiazines (with aliphatic, methylpiperazine, piperazine-ethanol, piperazine-ethyl, or piperidine side-chain) and/or phenothiazine-derived agents e.g., thioxanthenes, benzepines, imonostilbenes, tricyclic antidepressants, dimetothiazine, and cyproheptadine have been effective in the treatment of a number of medical conditions with widely different etiology. These include various currently clinically used drugs for their significant antihistamic, antipsychotic, anticholinergic (antiparkinson), antipruritic, and/or antiemetic properties. They are also employed, although to a minor extent, as antidepressants, antispasmodics, analgesics, and antiarrhythemics. Some of these agents are also useful as anti-inflammatory, coronary vasodilator, radioprotective, sedative, antitussive, and skeletal muscle-relaxing medication. Still, others show different degrees of effectiveness as antibacterials, anthelmintics, antimalarials, or local anesthetics; a few are valuable in the control of acute migraine attacks and intractable hiccough. Adding to the seemingly ever-expanding therapeutic use of phenothiazine derivatives, a number of "old" and newly synthesized compounds e.g., "half-mustard-type" and benzo[alpha]phenothiazines, appear to be helpful as multidrug resistance modifiers, a property of particular importance in cancer chemotherapy. Some phenothiazines inhibit human plasmatic leucine-enkephalin aminopeptidase(s), enzymes known to regulate the turnover rate of a wide range of bioactive substances. These findings could lead to the design of new therapeutic treatment modalities for conditions such as Alzeimer's and Creutzfeldt-Jakob disease. Hopefully, this work will help to the rational design of new and improved pharmacological approaches based on a better understanding of the correlation between chemical structure, pharmacodynamic properties, and pharmacological activity of various phenothiazines and phenothiazine-derived classes of drugs.     

Neisseria lactamica and Neisseria polysaccharea as possible sources of meningococcal beta-lactam resistance by genetic transformation.

We studied the susceptibilities of relatively penicillin G-resistant and -susceptible strains of Neisseria meningitidis, as well as Neisseria lactamica and Neisseria polysaccharea, to penicillin, ampicillin, and several cephalosporins. The MICs of penicillin, ampicillin, cephalothin, and cefuroxime for moderately resistant meningococci have increased two- to sixfold in relation to MICs for susceptible strains. For these strains of meningococci, N. lactamica, and N. polysaccharea, penicillin, ampicillin, cephalothin, and cefuroxime MICs for 50 and 90% of strains were similar. By genetic transformation of a penicillin-susceptible strain of N. meningitidis to low-level penicillin resistance with DNA from penicillin-resistant strains of N. meningitidis, N. lactamica, N. polysaccharea, and N. gonorrhoeae, isogenic strains with the same pattern of resistance to beta-lactams were obtained, suggesting that these commensal Neisseria spp. could be the source of meningococcal resistance genes.