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Previous Volume 360:886-892 February 26, 2009 Number 9 Next

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SUMMARY

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.

Source Information

From the Epidemic Intelligence Service Program, Office of Workforce and Career Development (H.M.W., S.C.W.), and the Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Coordinating Center for Infectious Diseases (H.M.W., B.H.H., C.P.H., S.C.W., R.T.N., X.W., S.S., R.D.M., M.J.T., A.C.C., T.A.C., N.E.M., L.W.M.), Centers for Disease Control and Prevention, Atlanta; the Emerging Infections Program, Minnesota Department of Health, St. Paul (B.A.J., A.G., D.J.B., J.R., R.L.); and the North Dakota Department of Health, Bismarck (M.A.S., T.K.M., K.K.).

Address reprint requests to Dr. Wu at the Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, 1600 Clifton Rd., MS C-09, Atlanta, GA 30333, or at hwu{at}cdc.gov.

Full Text of this Article

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