Emergence of ciprofloxacin-resistant Neisseria meningitidis in North America.

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Emergence of ciprofloxacin-resistant Neisseria meningitidis in North America.

N Engl J Med. 2009 Feb 26;360(9):886-92

Authors: Wu HM, Harcourt BH, Hatcher CP, Wei SC, Novak RT, Wang X, Juni BA, Glennen A, Boxrud DJ, Rainbow J, Schmink S, Mair RD, Theodore MJ, Sander MA, Miller TK, Kruger K, Cohn AC, Clark TA, Messonnier NE, Mayer LW, Lynfield R

We report on three cases of meningococcal disease caused by ciprofloxacin-resistant Neisseria meningitidis, one in North Dakota and two in Minnesota. The cases were caused by the same serogroup B strain. To assess local carriage of resistant N. meningitidis, we conducted a pharyngeal-carriage survey and isolated the resistant strain from one asymptomatic carrier. Sequencing of the gene encoding subunit A of DNA gyrase (gyrA) revealed a mutation associated with fluoroquinolone resistance and suggests that the resistance was acquired by means of horizontal gene transfer with the commensal N. lactamica. In susceptibility testing of invasive N. meningitidis isolates from the Active Bacterial Core surveillance system between January 2007 and January 2008, an additional ciprofloxacin-resistant isolate was found, in this case from California. Ciprofloxacin-resistant N. meningitidis has emerged in North America.

PMID: 19246360 [PubMed - indexed for MEDLINE]

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