Emergence of ciprofloxacin-resistant Neisseria meningitidis in North America.
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.
Wu
Henry M
HM
Office of Workforce and Career Development, and the Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA. hwu@cdc.gov
Harcourt
Brian H
BH
Hatcher
Cynthia P
CP
Wei
Stanley C
SC
Novak
Ryan T
RT
Wang
Xin
X
Juni
Billie A
BA
Glennen
Anita
A
Boxrud
David J
DJ
Rainbow
Jean
J
Schmink
Susanna
S
Mair
Raydel D
RD
Theodore
M Jordan
MJ
Sander
Molly A
MA
Miller
Tracy K
TK
Kruger
Kirby
K
Cohn
Amanda C
AC
Clark
Thomas A
TA
Messonnier
Nancy E
NE
Mayer
Leonard W
LW
Lynfield
Ruth
R
D000293:Adolescent; D000328:Adult; D000368:Aged; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D001483:Base Sequence; D002353:Carrier State / Q000382:microbiology; D002939:Ciprofloxacin / Q000627:therapeutic use*; D024881:Drug Resistance, Bacterial / Q000235:genetics*; D006801:Humans; D007223:Infant; D008589:Meningococcal Infections / Q000188:drug therapy* / Q000382:microbiology; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009345:Neisseria meningitidis / Q000145:classification / Q000187:drug effects / Q000235:genetics* / Q000302:isolation & purification; D010614:Pharynx / Q000382:microbiology; D017354:Point Mutation; D014481:United States; D055815:Young Adult
D000890:Anti-Infective Agents; D002939:Ciprofloxacin